Gahr Patrick, Mittlmeier Thomas
Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland.
Unfallchirurgie (Heidelb). 2023 Nov;126(11):863-871. doi: 10.1007/s00113-023-01346-5. Epub 2023 Jul 4.
In the basic entirety of stress fractures, insufficiency fractures are defined as fractures caused by prolonged normal or physiological loading of a bone with insufficient elastic resistance. This clearly distinguishes it from fatigue fractures, in which excessive loads are continuously applied to a bone with normal elastic resistance. According to Pentecost (1964) both entities of stress fracture result from "the inherent inability of the bone to withstand stress applied without violence in a rhythmical, repeated, subthreshold manner". This distinguishes them from acute traumatic fractures. In the clinical routine these differences are not always so clearly presented. The example of the H‑shaped sacral fracture is used to illustrate the relevance of a clear terminology. In this context, current controversies in the treatment of sacral insufficiency fractures are discussed.
在应力性骨折的基本整体中，不全骨折被定义为由弹性阻力不足的骨骼长时间承受正常或生理负荷所导致的骨折。这使其与疲劳骨折明显区分开来，在疲劳骨折中，正常弹性阻力的骨骼持续承受过大负荷。根据彭特科斯特（1964年）的观点，应力性骨折的这两种类型均源于“骨骼内在无法承受以有节奏、反复、低于阈值的方式施加的非暴力应力”。这将它们与急性创伤性骨折区分开来。在临床实践中，这些差异并不总是如此清晰地呈现出来。以H形骶骨骨折为例来说明明确术语的相关性。在此背景下，讨论了骶骨不全骨折治疗中的当前争议。
