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疲劳性跖骨骨折

[Fractures of the metatarsal bones caused by fatigue].

作者信息

Ivanovski A, Medjedović D, Perisić V

机构信息

Military Medical Centre, Novi Sad.

出版信息

Srp Arh Celok Lek. 1998 Mar-Apr;126(3-4):107-10.

PMID:9863365
Abstract

UNLABELLED

The term stress (marching) fracture relates to a fracture provoked without acute trauma, on healthy bone and as a consequence of repeated, long-term, rhythmic load [4, 5]. Stress fractures are mostly observed in young people (12-25 years of age) [15]. The course of this phenomenon we found by medical examination; this means that it is found either by detection or spontaneous ambulance reports. The aim of this study is to point at a possible appearance of these fractures at young soldiers and sportsmen.

MATERIAL AND METHOD

During the routine ambulance practice, and by the prospective study on 29 subjects, the study was performed by using oral inquiry [9]. The studied individuals were soldiers who were complaining of pain, swellings and redness of the feet. Except clinical orthopedic examination, additional laboratory analysis was made.

RESULTS

The results are shown in tables. Table 1 shows that stress fractures of metatarsus bones usually appear during the period of first thirty days of the military service, i.e. during the days of the hardest exertion. The most frequent training absence, which is caused by stress fractures, is during this period of time (Table 2). Of all military duties, marching had the biggest influence on appearance of this disease (Table 3).

DISCUSSION

On the basis of available literature it is evident that there are factors which might have the influence on the occurrence of the disease (hypovitaminosis, foot-wear, foot deformation, body weight, muscle fatigue, etc.). Stress fractures are mentioned in connection with some diseases or special clinical deformations such as rheumatoid arthritis, chronic bronchitis, arthrosis deformities, after arthroplastics, Mb. Bechterew, etc. Consequently, stress fractures do not appear only in a healthy bone, as it is defined [4, 5]. In the clinical practice it was established that the diagnosis of this pathology had, in a few cases, the same clinical picture. On the basis of our experience, by observing, we have concluded that stress fractures occur on healthy or changed bones as the result of physical fatigue of the material, and repeated movements. It is still unclear why these changes are unilateral.

CONCLUSION

a) Stress fractures are frequently appearing at young soldiers. b) Most frequently they appear in beginning of hard and exhaustible training.

摘要

未标注

应力(行军)性骨折是指在无急性创伤的情况下,因健康骨骼反复承受长期有节奏的负荷而引发的骨折[4,5]。应力性骨折多见于年轻人(12 - 25岁)[15]。我们通过医学检查发现了这种现象的病程;这意味着它要么通过检测发现,要么通过自发的急救报告发现。本研究的目的是指出这些骨折在年轻士兵和运动员中可能出现的情况。

材料与方法

在常规急救实践中,通过对29名受试者的前瞻性研究,采用口头询问的方式进行研究[9]。研究对象为抱怨脚部疼痛、肿胀和发红的士兵。除了临床骨科检查外,还进行了额外的实验室分析。

结果

结果列于表格中。表1显示,跖骨应力性骨折通常出现在服役的前三十天内,即在最艰苦训练的日子里。由应力性骨折导致的最频繁的训练缺勤发生在这段时间(表2)。在所有军事任务中,行军对这种疾病的出现影响最大(表3)。

讨论

根据现有文献,显然有一些因素可能会影响疾病的发生(维生素缺乏、鞋类、足部变形、体重、肌肉疲劳等)。应力性骨折与一些疾病或特殊临床畸形有关,如类风湿性关节炎、慢性支气管炎、关节畸形、关节置换术后、贝赫切特病等。因此,应力性骨折并非如所定义的那样仅出现在健康骨骼中[4,5]。在临床实践中发现,在少数情况下,这种病理的诊断具有相同的临床表现。根据我们的经验,通过观察,我们得出结论,应力性骨折是由于材料的身体疲劳和反复运动而在健康或改变的骨骼上发生的。目前尚不清楚为什么这些变化是单侧的。

结论

a)应力性骨折在年轻士兵中频繁出现。b)它们最常出现在艰苦且使人疲惫的训练开始时。

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