Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC,Canada.
PERFORM Centre, Concordia University, CRIR-Centre de Réadaptation Constance-Lethbridge du CIUSSS COMLT, Montreal, QC,Canada.
J Sport Rehabil. 2023 Jul 11;32(7):834-839. doi: 10.1123/jsr.2022-0390. Print 2023 Sep 1.
Stress fractures are one of the most common injuries in athletes. Unfortunately, they are hard to diagnose, require multiple radiology exams and follow-up which leads to more exposure to radiation and an increase in cost. Stress fractures that are mismanaged can lead to serious complications and poorer outcomes for the athlete. During the rehabilitation process, it would be beneficial to be able to monitor the healing of fractures to know when it is safe to gradually allow a patient to a return to sport because the return to activity is not usually objective and based on pain level.
Can infrared thermography (IRT) be a useful tool to measure the pathophysiological state of the fracture healing? The aim of this critically appraised topic is to analyze the current evidence of IRT for measuring the temperature change in fractures to provide recommendations for medical practitioners.
For this critically appraised topic, we examined 3 articles that compared medical imaging and IRT over multiple time points during the follow-up. The 3 articles concluded that a 1 °C asymmetry in temperature followed by a return to normal (less than 0.3 °C) temperature during the healing process of fractures can be monitored using IRT.
Once the patient has been diagnosed with a fracture, IRT can safely be used to monitor the evolution of a fracture. When the thermogram progresses from a hot thermogram to a cold thermogram, the healing is considered good enough to return to sport.
Grade 2 evidence exists to support IRT being used by clinicians to monitor fracture healing. Due to the limited research and novelty of the technology, the current recommendations are for following the treatment of the fracture once the initial diagnosis is made.
应力性骨折是运动员中最常见的损伤之一。不幸的是，它们很难诊断，需要多次进行放射学检查和随访，这会导致更多的辐射暴露和成本增加。如果处理不当，应力性骨折可能会导致严重的并发症和运动员预后较差。在康复过程中，能够监测骨折的愈合情况以了解何时可以安全地逐渐允许患者重返运动是有益的，因为重返活动通常不是客观的，并且基于疼痛水平。
红外热成像（IRT）能否成为测量骨折愈合病理生理状态的有用工具？本批判性评价专题的目的是分析 IRT 测量骨折温度变化的现有证据，为医务人员提供建议。
在本批判性评价专题中，我们检查了 3 篇比较多次随访期间医学成像和 IRT 的文章。这 3 篇文章的结论是，骨折愈合过程中可以使用 IRT 监测 1°C 的温度不对称，随后恢复正常（小于 0.3°C）温度。
一旦患者被诊断出骨折，就可以安全地使用 IRT 来监测骨折的演变。当热图从热图变为冷图时，愈合被认为足以返回运动。
有 2 级证据支持临床医生使用 IRT 监测骨折愈合。由于研究有限且技术新颖，目前的建议是在做出初始诊断后遵循骨折的治疗。
