Department of Orthopaedic Surgery and Traumatology, Turku University Hospital and University of Turku, Turku, Finland.
Scand J Surg. 2012;101(4):261-4. doi: 10.1177/145749691210100407.
Stress fractures are common overuse injuries in athletes. Medial malleolar stress fractures are rare but they have an important clinical relevance because of their tendency to cause considerable disability and loss of time in sports without proper treatment. The diagnosis of medial malleolar stress fracture is often a challenge and it is therefore often delayed which may cause even further problems in the treatment. The purpose of this study was to increase the awareness of medial malleolar stress fractures as a possible cause for medial ankle pain and to stress the importance of MRI in the diagnostics as well as to evaluate the results of surgical treatment.
Between 1995 and 2008, a total of ten athletes with a medial malleolar stress fracture were operated at our centre. All operated cases during those years were included in the study. The cases were retrospectively analyzed. Return to pre-injury level of sport was evaluated and considered as an indicator of successful treatment.
Initially all standard radiographs were negative whereas in MRI the fractures were all visible. After operative treatment all medial malleolar stress fractures healed clinically in three to four months and all except one of the athletes were able to return to their pre-injury level of sports.
Early MRI is recommended if a medial malleolar stress fracture is suspected. Surgical treatment seems to result in rapid healing of the fracture and return to sports. In our opinion early surgery should be considered especially in athletes.
应力性骨折是运动员常见的过度使用损伤。内踝应力性骨折虽然少见，但由于其未经适当治疗可能导致相当大的残疾和运动时间损失，因此具有重要的临床意义。内踝应力性骨折的诊断常常具有挑战性，因此常常被延误，这可能会导致治疗中出现进一步的问题。本研究旨在提高对内踝应力性骨折作为内踝疼痛可能原因的认识，并强调 MRI 在诊断中的重要性，并评估手术治疗的结果。
1995 年至 2008 年间，我们中心共对 10 名内踝应力性骨折运动员进行了手术。这些年的所有手术病例均被纳入研究。对病例进行回顾性分析。重返受伤前的运动水平被评估为治疗成功的指标。
最初所有标准的 X 线片均为阴性，而 MRI 上所有骨折均可见。经手术治疗后，所有内踝应力性骨折均在 3 至 4 个月内临床愈合，除 1 名运动员外，所有运动员均能恢复到受伤前的运动水平。
如果怀疑有内踝应力性骨折，建议早期行 MRI 检查。手术治疗似乎可使骨折迅速愈合并恢复运动。我们认为，尤其是在运动员中，应考虑早期手术。
