MSK-29 · Groin Injuries, Athletic Pubalgia, and Leg Length Discrepancy

Groin Injuries, Athletic Pubalgia, and Leg Length Discrepancy. Part of the Musculoskeletal series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: a full grade three complete rupture might require surgical repair. That can take up to six months — Correct: Grade 1 adductor strain: 1-2 weeks; grade 2: 3-6 weeks; grade 3 complete tear (non-operative): 2-3 months. Six months applies only to surgical repair of a retracted proximal avulsion. (2) In the audio: which usually involves a pelvic floor repair or release of the adductor longus fascia to decompress the area — Correct: Athletic pubalgia surgery repairs the posterior inguinal wall (transversalis fascia, conjoint tendon, rectus abdominis insertion), often with adductor longus tenotomy, not the pelvic floor. Recovery averages 6-12 weeks. (3) In the audio: the instability is defined as over two millimeters of vertical displacement, two millimeters. — Correct: Confirmed correct as stated: more than 2 mm of vertical displacement on a single-leg flamingo view indicates symphyseal instability (not 2 cm). (4) In the audio: adductor strains account for a full 10% of all sports injuries — Correct: The 10 percent figure counts injuries within specific sports, roughly 10 to 11 percent of all injuries in professional ice hockey and soccer, not 10 percent of sports injuries generally. Adductor-related groin pain is the most common defined entity among athletes presenting with groin pain, about 61 percent. (5) In the audio: greater than five centimeters in a growing child, conservative management is inadequate, and you are looking at surgical equalization — Correct: The two operations sit in different bands. Epiphysiodesis of the longer limb is the standard operation for a projected 2 to 5 cm; limb lengthening is what is considered above a projected 5 cm. Below that, an insole covers up to about 2 cm and an external sole lift up to about 5 cm, and the roughly 1 cm in-shoe ceiling is a footwear rule of thumb rather than a published limit. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/MSK-29.