Apophyseal avulsion fractures of the ischial tuberosity (AFIT) in pediatric athletes are relatively uncommon injuries with treatment and return to sport (RTS) outcomes being largely unknown. The purpose of this review is to perform a systematic review analyzing RTS and predictors of successful RTS for pediatric athletes sustaining AFIT. Studies reporting on athletes strictly under the age of 18 years sustaining an AFIT with reported RTS status were included. RTS was analyzed based on injury acuity, mechanism, and management, whereas the incidence of any complications was recorded. A total of 33 studies comprising 90 cases of AFIT were identified. The mean age of athletes sustaining injuries was 14.7 + 1.4 years (range, 9–17 years), most commonly participating in soccer (n = 25), sprinting (n = 21), and gymnastics (n = 7). Acute trauma during sporting activities was responsible for 74.4% (n = 77/90) of injuries. A total of 82% (n = 74/90) of athletes reported successful RTS at an average of 7.0 + 5.0 months. Athletes undergoing surgery had a significantly higher RTS rate (n = 36/38, 94.7%) compared with athletes treated nonoperatively (n = 38/52, 73.08%; P = 0.008). When reported, a high rate of misdiagnosis was reported (39.4%, n = 28/71). Complications were reported in 15.8% (n = 7/38) and 32.7% (n = 17/52) of athletes managed surgically and conservatively, respectively. As such, the high rate of misdiagnosis and subsequent high rate of complications and poor rate of RTS highlight the importance of accurate diagnosis and treatment. Future prospective studies evaluating patient outcomes based on fracture displacement, sporting activity, and management strategies are warranted to better treat pediatric athletes. Study design: Level IV, systematic review.

儿童运动员的坐骨结节骨突撕脱骨折（AFIT）是相对罕见的损伤，其治疗和恢复运动（RTS）结果在很大程度上尚不清楚。本综述的目的是对维持 AFIT 的儿科运动员的 RTS 和成功 RTS 的预测因素进行系统评价。研究报告严格限制在 18 岁以下的运动员维持 AFIT 并报告 RTS 状态。根据损伤严重程度、机制和治疗对 RTS 进行分析，同时记录任何并发症的发生率。总共有 33 项研究，包括 90 例 AFIT 病例。受伤运动员的平均年龄为 14.7 + 1.4 岁（范围为 9-17 岁），最常参加足球 ( n = 25)、短跑 ( n = 21) 和体操 ( n = 7)。74.4% ( n = 77/90) 的伤害是由体育活动期间的急性创伤造成的。共有 82% ( n = 74/90) 的运动员报告平均 7.0 + 5.0 个月成功完成 RTS。与接受非手术治疗的运动员（ n = 38/52，73.08%；P = 0.008 ）相比，接受手术的运动员的 RTS 率显着较高（ n = 36/38，94.7%）。报告时，误诊率很高（39.4%，n = 28/71）。接受手术治疗和保守治疗的运动员分别有 15.8% ( n = 7/38) 和 32.7% ( n = 17/52)出现并发症。因此，高误诊率以及随之而来的高并发症率和RTS率差凸显了准确诊断和治疗的重要性。未来的前瞻性研究需要根据骨折移位、体育活动和管理策略来评估患者的预后，以更好地治疗儿科运动员。研究设计：IV 级，系统评价。