Clement D B, Ammann W, Taunton J E, Lloyd-Smith R, Jesperson D, McKay H, Goldring J, Matheson G O
Sports Medicine Division, Univ. of British Columbia, Vancouver, Canada.
Int J Sports Med. 1993 Aug;14(6):347-52. doi: 10.1055/s-2007-1021191.
Seventy-one athletes with 74 stress injuries to the femur were studied using a case-controlled design. Forty-three were females (26.6 yrs) and 28 were males (31.2 yrs). Each patient had exercise-induced pain in the hip, groin or thigh and a Tec-99m-MDP bone scan showing focal uptake of radionuclide in the femur. Running was the most common activity at the time of injury (89.2%) followed by triathlon (4.6%) and aerobic dance (4.6%). Thirty per cent of the runners had increased their training duration immediately prior to their first symptom. Anterior thigh pain was the most frequent site of exercise-induced pain (45.9%) followed by hip pain (27%) and groin pain (8.1%). During the clinical examination, when asked to hop on the affected limb, 70.3% of the patients had pain reproduced in the hip, groin or anterior thigh. There were 39 cases (53%) involving focal uptake of radionuclide in the femoral shaft, 15 (20%) in the lesser trochanter, 11 (15%) in the intertrochanteric region between the femoral neck and the greater trochanter, 8 (11%) in the femoral neck and 1 (1%) in the greater trochanter. Two patients suffered displaced fractures, one at the femoral neck and the other in the shaft of the femur. Neither patient had previously sought medical attention for their leg pain. Of 46 plain radiographs taken, only 11 (24%) were abnormal. The mean time to diagnosis and recovery were 6.6 and 10.4 weeks respectively. Substitution of cycling and water exercise for running were the most common therapeutic interventions.
采用病例对照设计对71名股骨应力性损伤的运动员进行了研究。其中43名女性（平均年龄26.6岁），28名男性（平均年龄31.2岁）。每位患者均有运动诱发的髋部、腹股沟或大腿疼痛，且99m锝-亚甲基二膦酸盐（99mTc-MDP）骨扫描显示股骨有放射性核素局部摄取。受伤时最常见的活动是跑步（89.2%），其次是铁人三项（4.6%）和气功舞蹈（4.6%）。30%的跑步运动员在首次出现症状前立即增加了训练时长。大腿前侧疼痛是运动诱发疼痛最常见的部位（45.9%），其次是髋部疼痛（27%）和腹股沟疼痛（8.1%）。临床检查时，当要求患者单腿跳跃时，70.3%的患者在髋部、腹股沟或大腿前侧出现疼痛。39例（53%）放射性核素局部摄取位于股骨干，15例（20%）位于小转子，11例（15%）位于股骨颈与大转子之间的转子间区域，8例（11%）位于股骨颈，1例（1%）位于大转子。2名患者发生移位骨折，1例在股骨颈，另1例在股骨干。两名患者此前均未因腿痛就医。46张X线平片中，仅11张（24%）异常。诊断和恢复的平均时间分别为6.6周和10.4周。最常见的治疗干预措施是用骑自行车和水上运动替代跑步。
