Bone stress injuries can cause long-lasting damage, especially in young athletes and military conscripts, if not diagnosed and treated properly. Diagnosis has been traditionally based on clinical, radiographic and scintigraphic examinations, but MRI has become increasingly important. High resolution MRI is particularly valuable for the grading of bone stress injuries. The clinician should be aware of the wide range of bone stress injuries and available diagnostic methods. Early diagnosis is the prerequisite for avoiding long-lasting complications. Most bone stress injuries heal with closed treatment, but surgery is necessary in some cases. They heal well if the diagnosis is not delayed and the treatment adequate. n Bone stress injuries are mostly seen among longdistance runners, soldiers, dancers, athletes and other sportsmen. The patients are usually young or middle-aged (Table 1). About 400-500 sportsmen are affected by a bone stress injury annually in Finland (population 5 million; Hulkko and Orava 1991). The global incidence of bone stress injuries in sports has been estimated to be 2-4%: 2% in men and 7% in women (Johnson et al. 1994). Female athletes run an up to four times higher risk of a bone stress injury (Brunet et al. 1990, Zernicke et al. 1993). Among athletes, one fth of all musculoskeletal stress injuries are located in bones (Bennell et al. 1996). Bone stress injuries of the lower extremities are commonest in the shin of long-distance runners (Table 1).
Fifty heterosexual male patients with histologically verified genital warts of short duration ( < 3 months) were randomly allocated to treatment with either 0 25% or 05% idoxuridine
Background The optimal treatment of diaphyseal fractures of the lower extremities in patients who also have serious chest injuries is not known.Patients and methods We retrospectively evaluated the effect of an early intramedullary nailing (IMN) of femur or tibia fractures on respiratory function in 61 consecutive polytraumatized patients with unilateral or bilateral pulmonary contusion (thoracic AIS ≥ 3) admitted to our trauma intensive care unit between January 2000 and June 2001. 27 patients had a diaphyseal fracture of at least one long bone of the lower extremity, which was treated with IMN within 24 hours of admission.Results We found no difference between patients with or without a lower extremity fracture regarding the length of ventilator treatment, oxygenation ratio (PaO 2 /FiO 2 ) or in the incidence of acute respiratory distress syndrome (ARDS), pneumonia, multi-organ failure or mortality.Interpretation In this retrospective study, IMN of a long bone fracture in a patient with multiple injuries and with a coexisting pulmonary contusion did not impair pulmonary function or outcome.
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