Maquirriain J, Ghisi J P
High Performance National Training Centre (CeNARD), Mayling CC, Ruta Panamericana Km 50 Pilar, Buenos Aires 1631, Argentina.
Br J Sports Med. 2006 May;40(5):454-9; discussion 459. doi: 10.1136/bjsm.2005.023465.
Modern professional tennis involves powerful movements repeatedly subjecting the musculoskeletal system to heavy mechanical load. Thus tennis players are exposed to high risk of overuse injuries including stress fractures.
To determine the incidence and distribution of stress fractures in elite tennis players.
Retrospective cohort study.
The cohort study population consisted of 139 elite players (mean (SD) age, 20.0 (5.0) years; 48 female, 91 male). Stress fractures were identified and confirmed radiologically from medical records during a two year period. Injuries were analysed according to age, sex, site, severity, delay in diagnosis, and time needed to return to sports.
15 players sustained 18 stress fractures, corresponding to an overall case incidence of 12.9% (95% confidence interval (CI), 8.1 to 20.0). The tarsal navicular was most affected (n = 5; 27%), followed by the pars interarticularis (n = 3; 16%), the metatarsals (n = 3; 16%), the tibia (n = 2; 11%) and the lunate (n = 2; 11%). Magnetic resonance imaging showed a greater incidence of "high grade" lesions (94.4%). Stress fracture incidence was significantly higher in juniors (20.3% (95% CI, 11.4 to 33.2)) than in professional players (7.5% (2.8 to 15.6)) (p = 0.045).
There was a high absolute risk (12.9%) of stress fractures in elite tennis players over a two year period. Junior players were at highest risk. The lesions are a major cause of disruption both of training and of competition. Risk factors should therefore be identified and prevention emphasised.
现代职业网球运动包含强力动作，会使肌肉骨骼系统反复承受巨大机械负荷。因此，网球运动员面临过度使用损伤的高风险，包括应力性骨折。
确定精英网球运动员应力性骨折的发生率和分布情况。
回顾性队列研究。
队列研究人群由139名精英运动员组成（平均（标准差）年龄，20.0（5.0）岁；女性48名，男性91名）。在两年期间，通过医疗记录从影像学上识别并确认应力性骨折。根据年龄、性别、部位、严重程度、诊断延迟以及恢复运动所需时间对损伤进行分析。
15名运动员发生了18例应力性骨折，总体病例发生率为12.9%（95%置信区间（CI），8.1至20.0）。舟状骨受影响最大（n = 5；27%），其次是关节突（n = 3；16%）、跖骨（n = 3；16%）、胫骨（n = 2；11%）和月骨（n = 2；11%）。磁共振成像显示“高级别”损伤的发生率更高（94.4%）。青少年球员的应力性骨折发生率（20.3%（95%CI，11.4至33.2））显著高于职业球员（7.5%（2.8至15.6））（p = 0.045）。
在两年期间，精英网球运动员发生应力性骨折的绝对风险很高（12.9%）。青少年球员风险最高。这些损伤是训练和比赛中断的主要原因。因此，应识别风险因素并强调预防。
