From the Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH (Dr. Miller and Dr. Kaeding), and the Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY (Dr. Rodeo).
J Am Acad Orthop Surg. 2020 Jan 1;28(1):1-9. doi: 10.5435/JAAOS-D-19-00112.
In an era of continual single-sport specialization and year-round training, overuse injuries, including stress injuries of bone, are increasingly common. These injuries can be season- or even career-ending. For many elite and professional athletes, the traditional treatment strategy of immobilization and extended rest from sports participation is often not practical or acceptable. An understanding of modern strategies for evaluating and treating stress fractures is paramount for maintaining athletic participation and optimal athletic performance. This begins with the ability to categorize and stratify bony stress injuries by both severity and risk of fracture progression. Surgical procedures such as open reduction and internal fixation or intramedullary fixation with possible bone grafting remain the standard of care for chronic or severe stress fractures. However, emerging techniques to augment the biologic environment are a minimally invasive adjunct for stimulating and supporting bone healing in elite-level athletes to optimize bone health, expedite recovery, and decrease the risk of nonunion or catastrophic fracture.
在持续的单一专项运动专业化和全年训练的时代，过度使用损伤（包括骨骼的压力性损伤）越来越常见。这些损伤可能会导致赛季甚至职业生涯的结束。对于许多精英和职业运动员来说，传统的治疗策略——运动参与的固定和长期休息，往往不切实际或不可接受。了解评估和治疗压力性骨折的现代策略对于保持运动员的参与度和最佳运动表现至关重要。这首先需要能够根据严重程度和骨折进展风险对骨骼压力性损伤进行分类和分层。手术治疗，如切开复位和内固定或髓内固定加可能的植骨，仍然是慢性或严重压力性骨折的标准治疗方法。然而，增强生物环境的新兴技术是一种微创辅助方法，用于刺激和支持精英运动员的骨骼愈合，以优化骨骼健康，加快康复速度，并降低非愈合或灾难性骨折的风险。
