Department of Orthopaedics and Sports Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
FIFA Medical Centre of Excellence Tokyo, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Knee Surg Sports Traumatol Arthrosc. 2018 Jul;26(7):1943-1949. doi: 10.1007/s00167-017-4552-4. Epub 2017 Apr 25.
To identify unknown risk factors associated with fifth metatarsal stress fracture (Jones fracture).
A case-controlled study was conducted among male Japanese professional football (soccer) players with (N = 20) and without (N = 40) a history of Jones fracture. Injury history and physical examination data were reviewed, and the two groups were compared. Univariate and multivariate logistic regression controlling for age, leg dominance and body mass index were used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) to describe the association between physical examination data and the presence or absence of Jones fractures.
From 2000 to 2014, among 162 professional football club players, 22 (13.6%; 21 Asians and one Caucasian) had a history of Jones fracture. Thirteen out of 22 (60%) had a Jones fracture in their non-dominant leg. The mean range of hip internal rotation (HIR) was restricted in players with a history of Jones fracture [25.9° ± 7.5°, mean ± standard deviation (SD)] compared to those without (40.4° ± 11.1°, P < 0.0001). Logistic regression analyses demonstrated that HIR limitation increased the risk of a Jones fracture (OR = 3.03, 95% CI 1.45-6.33, P = 0.003). Subgroup analysis using data prior to Jones fracture revealed a causal relationship, such that players with a restriction of HIR were at high risk of developing a Jones fracture [Crude OR (95% CI) = 6.66 (1.90-23.29), P = 0.003, Adjusted OR = 9.91 (2.28-43.10), P = 0.002]. In addition, right HIR range limitation increased the risks of developing a Jones fracture in the ipsilateral and the contralateral feet [OR = 3.11 (1.35-7.16) and 2.24 (1.22-4.12), respectively]. Similarly, left HIR range limitation increased the risks in the ipsilateral or the contralateral feet [OR (95% CI) = 4.88 (1.56-15.28) and 2.77 (1.08-7.08), respectively].
The restriction of HIR was associated with an increased risk of developing a Jones fracture. Since the HIR range is a modifiable factor, monitoring and improving the HIR range can lead to prevent reducing the occurrence of this fracture.
III.
确定与第五跖骨应力性骨折（Jones 骨折）相关的未知危险因素。
对 20 名患有（病例组）和 40 名无（对照组）Jones 骨折的日本职业足球运动员进行病例对照研究。回顾了损伤史和体格检查数据，并对两组进行了比较。使用单变量和多变量逻辑回归控制年龄、腿优势和体重指数，以获得比值比（OR）和 95%置信区间（CI）来描述体格检查数据与 Jones 骨折的存在或不存在之间的关联。
2000 年至 2014 年间，在 162 名职业足球俱乐部球员中，有 22 名（13.6%；21 名亚洲人和 1 名白种人）有 Jones 骨折史。22 名中有 13 名（60%）在非优势腿中发生了 Jones 骨折。与无 Jones 骨折的运动员相比，有 Jones 骨折史的运动员髋关节内旋（HIR）范围受限[25.9°±7.5°，平均值±标准差（SD）]（P<0.0001）。逻辑回归分析表明，HIR 受限增加了 Jones 骨折的风险（OR=3.03，95%CI 1.45-6.33，P=0.003）。使用 Jones 骨折前的数据进行的亚组分析显示了一种因果关系，即 HIR 受限的运动员发生 Jones 骨折的风险较高[粗比值比（95%CI）=6.66（1.90-23.29），P=0.003，调整比值比=9.91（2.28-43.10），P=0.002]。此外，右侧 HIR 范围受限增加了同侧和对侧足部发生 Jones 骨折的风险[OR=3.11（1.35-7.16）和 2.24（1.22-4.12）]。同样，左侧 HIR 范围受限增加了同侧或对侧足部发生 Jones 骨折的风险[OR（95%CI）=4.88（1.56-15.28）和 2.77（1.08-7.08）]。
HIR 受限与发生 Jones 骨折的风险增加有关。由于 HIR 范围是一个可改变的因素，因此监测和改善 HIR 范围可以预防和减少这种骨折的发生。
III。
