Kaiser Philip B, Guss Daniel, DiGiovanni Christopher W
Harvard Combined Orthopaedic Surgery Residency Program, Boston, MA, USA.
Massachusetts General Hospital, Boston, MA, USA.
Foot Ankle Orthop. 2023 Aug 14;8(3):24730114231195045. doi: 10.1177/24730114231195045. eCollection 2023 Jul.
Stress fractures of the foot and ankle are common injuries in athletes. Management differs considerably based on fracture location and predisposing factors. Repetitive loading of the foot and ankle in athletes should result in physiologic bone remodeling in accordance with Wolff's law. However, when there is not sufficient time for complete healing to occur before additional loads are incurred, this process can instead lead to stress fracture. Assessment of the athlete's training regimen and overall bone health is paramount to both the discovery and treatment of these injuries, although diagnosis is often delayed in the setting of normal-appearing initial radiographs. While most stress fractures of the foot or ankle can usually be treated nonoperatively with a period of activity modification, fractures in certain locations are considered "high risk" due to poor intrinsic healing and may warrant more proactive operative management.
足踝部应力性骨折是运动员常见的损伤。根据骨折部位和诱发因素,治疗方法有很大差异。运动员足踝部的反复负荷应根据沃尔夫定律导致生理性骨重塑。然而,当在承受额外负荷之前没有足够的时间实现完全愈合时,这个过程反而会导致应力性骨折。评估运动员的训练方案和整体骨骼健康对于这些损伤的发现和治疗至关重要,尽管在初次X线片表现正常的情况下诊断往往会延迟。虽然大多数足踝部应力性骨折通常可以通过一段时间的活动调整进行非手术治疗,但某些部位的骨折由于自身愈合能力差而被认为是“高风险”的,可能需要更积极的手术治疗。