Wallenböck E
Unfallkrankenhaus Graz, Osterreich.
Wien Klin Wochenschr. 1998 Nov 13;110(21):759-65.
Stress fractures are caused by overstrain. Depending on their etiology, stress fractures may be categorized as insufficiency or fatigue fractures. A fatigue fracture occurs when repeated axial or rotational force is applied to the bone. In contrast, an insufficiency fracture is observed in bones with altered biomechanical characteristics. In a mixed patient population drawn from the Military Hospital Graz and the Unfallkrankenhaus (Traumatological Hospital) Graz, we were able to corroborate these etiologies. At the former institution, all 21 recruits (mean age, 20.5 years) had fractures of the fatigue type. In the population at the Traumatological Hospital--16 patients with a higher average age of 43.5 years--insufficiency fractures predominated. Diagnosis and differential diagnosis proved difficult in both groups, since plain radiography does not demonstrate the fracture for 2-3 weeks after the occurrence. All stress fractures were treated conservatively. Approximately two thirds of all stress fractures occur in the lower extremities. The main age group at risk is unknown. A sudden change in the activity or training regimen or a change in biomechanics can cause a stress fracture. The absence of individual risk factors makes it difficult to prevent stress fractures.
应力性骨折是由过度劳损引起的。根据其病因，应力性骨折可分为骨质疏松性骨折或疲劳性骨折。当骨骼反复受到轴向或旋转力作用时，就会发生疲劳性骨折。相比之下，骨质疏松性骨折则见于生物力学特性发生改变的骨骼。在来自格拉茨军事医院和格拉茨创伤医院的混合患者群体中，我们能够证实这些病因。在前者机构中，所有21名新兵（平均年龄20.5岁）均为疲劳性骨折。在创伤医院的患者群体中——16名平均年龄较高，为43.5岁——骨质疏松性骨折占主导。两组的诊断和鉴别诊断都很困难，因为X线平片在骨折发生后2至3周内无法显示骨折情况。所有应力性骨折均采用保守治疗。大约三分之二的应力性骨折发生在下肢。主要的高危年龄组尚不清楚。活动或训练方案的突然改变或生物力学的改变都可能导致应力性骨折。由于缺乏个体危险因素，应力性骨折难以预防。
