Department of Radiology, ED 4, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205-2664, USA.
Department of Radiology, The Ohio State Wexner Medical Center, Columbus, OH, USA.
Pediatr Radiol. 2020 Nov;50(12):1735-1741. doi: 10.1007/s00247-020-04760-8. Epub 2020 Aug 18.
Tibial stress fractures are not uncommon in pediatric athletes. The severity of injury may be graded using magnetic resonance imaging (MRI).
To determine whether Fredericson MRI grading of tibial stress fractures can differentiate times to recovery across different grades in pediatric athletes.
A medical record search identified all athletes younger than 19 years old who had tibial stress fractures confirmed by MRI and were treated by sports medicine specialists in our clinic system over a 5-year period. Two pediatric radiologists graded MRI exams using the Fredericson system. Time to recovery (in days) was defined in four ways: pain onset to full participation, pain onset to zero pain, first treatment to full sport participation and first treatment to zero pain. Recovery times were compared to tibial stress fracture Fredericson MRI grade and to the use of a recovery device.
Thirty-eight pediatric athletes (age range: 7-18 years, mean: 15.4±2.2 years) had 42 tibial stress fractures while participating in 12 different sports. About half (55%) were track and/or cross-country athletes. The mean time from diagnosis to report of no pain for all patients was 55.6±5.0 days. We found no significant difference in time to recovery across stress fracture grade or with the use of a recovery device.
No differences were noted between Fredericson stress fracture grades and different time periods to recovery or between differences in recovery time and the return to full participation in sports, regardless of the use of assistive devices.
胫骨应力性骨折在青少年运动员中并不少见。磁共振成像（MRI）可对损伤严重程度进行分级。
确定 Fredericson 胫骨应力性骨折 MRI 分级是否可以区分不同严重程度的患儿运动员的恢复时间。
通过病历检索，确定了在 5 年内，通过 MRI 证实患有胫骨应力性骨折且在我们诊所系统中接受运动医学专家治疗的所有 19 岁以下的运动员。两位儿科放射科医生使用 Fredericson 系统对 MRI 检查进行分级。恢复时间（以天计）有以下 4 种定义方式：疼痛发作至完全参与、疼痛发作至无疼痛、首次治疗至完全运动参与和首次治疗至无疼痛。恢复时间与胫骨应力性骨折 Fredericson MRI 分级以及恢复设备的使用情况进行了比较。
38 名青少年运动员（年龄 7-18 岁，平均 15.4±2.2 岁）在参与 12 种不同运动项目时发生了 42 例胫骨应力性骨折。约一半（55%）为田径和/或越野运动员。所有患者从诊断到报告无疼痛的平均时间为 55.6±5.0 天。我们发现，在恢复时间方面，骨折严重程度或使用恢复设备之间没有显著差异。
无论是否使用辅助设备，Fredericson 应力性骨折分级与不同的恢复时间或恢复时间与完全重返运动之间均无差异。
