Growth, Development, and Injury of the Bony Hip and Pelvis

The formation of the bony hip and pelvis is a metamorphosis of changes in the growing child. As we take a closer look at this growth and development, one must also consider the regions that act as muscle, ligament, and tendinous attachments that support and stabilize the hip. The ilium, ischium, and pubic bones ossify and form the bony pelvis. These are termed the primary ossification centers of the pelvis. Secondary centers of ossification serve as muscle and ligament attachments on both the pelvis and the femur, predisposing them to avulsion-type injuries. Many of these sites are absent at birth and develop as the individual matures skeletally and adopts an upright bipedal gait. Interestingly, females tend to be fused 1–2 years before males in this region. This chapter will explore the bony growth and development of the hip and pelvis and its impact on sports injuries.