Fatigue Fracture of the Calcaneus

Serrano, Simão; Figueiredo, Pedro; Pinheiro, João Páscoa

doi:10.1097/phm.0000000000000457

Cited by 10 publications

(8 citation statements)

References 17 publications

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“…A second magnetic resonance imaging was ordered as the patient’s symptoms and physical examination findings progressed despite treatment. Metabolic and nutritional issues are recommended to be considered in bilateral stress fractures11 ) . Although this case was not bilateral, as the condition progressed, these issues were considered.…”

Section: Discussionmentioning

confidence: 99%

Nonhealing, progressive stress fractures of the foot in a 13-year-old basketball player: is vitamin K deficiency a risk factor?

Bayramoğlu

Ünlütürk

2017

J Phys Ther Sci

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[Purpose] To report an adolescent male basketball player with nonhealing stress fractures of the foot and discuss the probable factors. [Subject and Methods] A 13-year-old basketball player presented with right foot pain. He had been playing basketball for three years and practicing 5 days/week. He denied any increase in daily training intensity. Magnetic resonance imaging confirmed stress fractures of the cuboid and cuneiform, with mild edema of the soft tissues between the tarsal bones and tenosynovitis of the flexor hallucis and flexor digitorum longi. The foot was immobilized for 4 weeks, with progressive weight bearing introduced at the fifth week. At the 6th week, while still restricted to partial weight bearing, he reported diffuse severe pain. The entire foot was painful with palpation, and new imaging showed stress fractures of the talus, cuboid, cuneiform, and proximal first metatarsal bones, and tenosynovitis of the flexor hallucis longus and flexor digitorum longus tendons with progression of the soft tissue edema around the tarsal bones. Acute phase reactants were elevated; vitamin K level was low. [Results] He started participating in games again at the 6th month post-injury. [Conclusion] Management of patients with stress fractures includes immobilization, physical therapy, and biomechanical arrangements. If the expected healing does not occur, a deficiency of vitamin K might be considered as a factor. Questioning on dietary habits of the patient and encouraging adequate intake of the deficient nutrient might assist in the healing process.

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Section: Discussionmentioning

confidence: 99%

Nonhealing, progressive stress fractures of the foot in a 13-year-old basketball player: is vitamin K deficiency a risk factor?

Bayramoğlu

Ünlütürk

2017

J Phys Ther Sci

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“…Current management protocols advocate conservative management for these injuries, in the form of cessation of activity and immobilisation in a moon boot or below knee cast, non-weightbearing for 4 wk, then partial weight-bearing for a further 4 wk[15,23,41,59]. For conservative management, return rates post injury is 100%, with return times ranging between 11 to 12 wk[23,59].…”

Section: Low Risk Sport-related Lower Limb Stress Fracturesmentioning

confidence: 99%

“…For conservative management, return rates post injury is 100%, with return times ranging between 11 to 12 wk[23,59]. Surgical management is reserved for fracture which fail to unite despite prolonged compliant conservative management; the current recommended treatment is drilling of the fracture site, with or without bone graft[60].…”

Section: Low Risk Sport-related Lower Limb Stress Fracturesmentioning

confidence: 99%

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Lower limb stress fractures in sport: Optimising their management and outcome

Robertson¹,

Wood²

2017

WJO

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Stress fractures in sport are becoming increasing more common, comprising up to 10% of all of sporting injuries. Around 90% of such injuries are located in the lower limb. This articles aims to define the optimal management of lower limb stress fractures in the athlete, with a view to maximise return rates and minimise return times to sport. Treatment planning of this condition is specific to the location of the injury. However, there remains a clear division of stress fractures by “high” and “low” risk. “Low risk” stress fractures are those with a low probability of fracture propagation, delayed union, or non-union, and so can be managed reliably with rest and exercise limitation. These include stress fractures of the Postero-Medial Tibial Diaphysis, Metatarsal Shafts, Distal Fibula, Medial Femoral Neck, Femoral Shaft and Calcaneus. “High risk” stress fractures, in contrast, have increased rates of fracture propagation, displacement, delayed and non-union, and so require immediate cessation of activity, with orthopaedic referral, to assess the need for surgical intervention. These include stress fractures of the Anterior Tibial Diaphysis, Fifth Metatarsal Base, Medial Malleolus, Lateral Femoral Neck, Tarsal Navicular and Great Toe Sesamoids. In order to establish the optimal methods for managing these injuries, we present and review the current evidence which guides the treatment of stress fractures in athletes. From this, we note an increased role for surgical management of certain high risk stress fractures to improve return times and rates to sport. Following this, key recommendations are provided for the management of the common stress fracture types seen in the athlete. Five case reports are also presented to illustrate the application of sport-focussed lower limb stress fracture treatment in the clinical setting.

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“…Early diagnosis is crucial for the success of therapeutic management. Unfortunately, because stress fractures require a high index of clinical suspicion, they are frequently underdiagnosed and undertreated[ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Stress fractures in uncommon location: Six case reports and review of the literature

Ficek¹,

Cyganik²,

Rajca³

et al. 2020

WJCC

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BACKGROUND Individuals’ interest in sports activities has been increasing, contributing to more stress fracture occurrences in uncommon locations on the skeleton. In this study, several cases of stress fractures in atypical locations are presented, and the possibility of combining diagnostic methods to make accurate and quick diagnoses is explored. Additionally, different causes of stress fractures, as well as various modalities of treatment, are highlighted. Other potential factors of stress fractures were identified by a literature review. CASE SUMMARY Six cases of stress fractures in the calcaneus, intermediate cuneiform bone, sacrum, tibia (bilateral), navicular bone and femoral neck are presented, with different types of diagnostic imaging and treatments. All of the cases were associated with an aspect of mobility because all of the patients were physically active in various sport disciplines. CONCLUSION The type of therapeutic procedure selected should depend on the specific clinical case, i.e ., the patient’s condition and level of physical activity.

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Fatigue Fracture of the Calcaneus

Cited by 10 publications

References 17 publications

Nonhealing, progressive stress fractures of the foot in a 13-year-old basketball player: is vitamin K deficiency a risk factor?

Nonhealing, progressive stress fractures of the foot in a 13-year-old basketball player: is vitamin K deficiency a risk factor?

Lower limb stress fractures in sport: Optimising their management and outcome

Stress fractures in uncommon location: Six case reports and review of the literature

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