Stress fractures were first described in Prussian soldiers by Breithaupt in 1855. They occur as the result of repeatedly making the same movement in a specific region, which can lead to fatigue and imbalance between osteoblast and osteoclast activity, thus favoring bone breakage. In addition, when a particular region of the body is used in the wrong way, a stress fracture can occur even without the occurrence of an excessive number of functional cycles. The objective of this study was to review the most relevant literature of recent years in order to add key information regarding this pathological condition, as an updating article on this topic.

PurposeThe purpose is to compare the incidence and characteristics of injuries sustained in two consecutive seasons of the São Paulo State Football Championship.MethodsProspective study performed using an electronic form previously developed by the Medical Committee of the São Paulo State Football Federation, sent to the physicians responsible for the tournament's series A1 and A2 teams, after each round.Results17.63 injuries sustained per 1000 hours of matches in the A1 series and 14.91 injuries sustained per 1000 hours of matches in the A2 series. Incidence of injuries per 1000 hours of matches decreased from 24.16 to 17.63 in the A1 series (p<0.037) and from 19.10 to 14.01 in the A2 series (p<0.064). External defenders suffered most injuries, while muscular injuries were most common and lower limbs, the most affected areas. Most injuries occurred between 30 and 45 minutes of the match and only 11.9% of the injuries required surgery.ConclusionsPrevalence and frequency of injuries decreased between seasons. Most injuries were sustained in the lower limbs; strains were the most common injuries, followed by strains and contusions; MRIs were the most frequently requested exams and most injuries were classified as moderate (8-28 days). Level of evidence III, Cross-Sectional Study.

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Objective: To evaluate the low energy extracorporeal shock waves therapy (ESWT) associated with physical therapy in the treatment of chronic muscle injuries classified as grades 2 and 3 in the lower limbs of amateur athletes. Methods: Eight athletes presenting with lower limb muscle injury for more than three weeks were treated with physiotherapy and ESWT. We evaluated the following parameters during treatment: palpable gap, muscle strength, pain, and Tegner score, as well as ultrasound image features and the ability to return to sports practice. Results: The average time of the first evaluation of the injury was 8.75 weeks. All patients presented muscle strength grade V after eight weeks. The pain score evolved from 5.75 to 0.5 points of the visual analogue scale (VAS), at the end of the treatment. The Tegner score after treatment was six points on average. Patients returned to sports practice after 8.14 weeks. Conclusion: ESWT associated with physical therapy proved to be effective to treat long-term muscle injury, with good performance and the ability to return to sport practice for all patients. Level of Evidence IV, Case Series, Prospective Study.

No. of Pages 8 r e v b r a s o r t o p . 2 0 1 5;x x x(x x):xxx-xxx w w w . r b o . o r g . b r Artigo de atualização Fraturas por estresse: definição, diagnóstico e tratamento ଝ informações sobre o artigo Histórico do artigo: Recebido em 5 de janeiro de 2015 Aceito em 5 de fevereiro de 2015 On-line em xxx Palavras chave: Fraturas por estresse/epidemiologia Fraturas por estresse/fisiopatologia Fraturas por estresse/diagnóstico Fraturas por estresse/classificação Fraturas por estresse/tratamento r e s u m o A fratura por estresse foi descrita inicialmente em soldados prussianos por Breithaupt em 1855 e ocorre como o resultado de um número repetitivo de movimentos em determinada região que pode levar a fadiga e desbalanço da atuação dos osteoblastos e osteoclastos e favorecer a ruptura óssea. Além disso, quando usamos uma determinada região do corpo de maneira errônea, a fratura por estresse pode ocorrer mesmo sem que ocorra um número excessivo de ciclos funcionais. O objetivo deste estudo é revisar a literatura mais relevante dos últimos anos para agregar as principais informaç ões a respeito dessa patologia em um artigo de atualização do tema. © 2015 Sociedade Brasileira de Ortopedia e Traumatologia. Publicado por Elsevier Editora Ltda. Todos os direitos reservados. Stress fractures: definition, diagnosis and treatment Keywords:Stress fracture/epidemiology Stress fracture/physiopathology Stress fracture/diagnosis Stress fracture/classification Stress fracture/treatment a b s t r a c t Stress fractures were first described in Prussian soldiers by Breithaupt in 1855. They occur as the result of repeatedly making the same movement in a specific region, which can lead to fatigue and imbalance between osteoblast and osteoclast activity, thus favoring bone breakage. In addition, when a particular region of the body is used in the wrong way, a stress fracture can occur even without the occurrence of an excessive number of functional cycles. The objective of this study was to review the most relevant literature of recent years in order to add key information regarding this pathological condition, as an updating article on this topic.