Stress fracture of the right distal femur following bilateral fractures of the proximal fibulas

Yasuda, Tadashi; Miyazaki, Kazumi; Tada, Kohei; Matsuda, Yasutaka; Murakami, Hitoshi

doi:10.1177/036354659202000624

Cited by 8 publications

(2 citation statements)

References 7 publications

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“…Stress fractures are overuse injuries usually occurring in military personnel and athletes [ 1 , 2 , 3 ]. Among the various theories known for the mechanism of stress fractures, the most accepted is the repetitive stress after microtrauma to the bone with insufficient rest for the healing process [ 4 ]. The incidence of a stress fracture in the medial femoral condyle is unknown due to its rarity.…”

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confidence: 99%

Medial femoral Condyle Stress Fracture: A Case Report

Ojha¹,

Nayak²,

Gamanagatti³

et al. 2022

JOCR

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Introduction: Stress fractures are common in athletics and military recruits exposed to repetitive mechanical stresses. They are usually located in the weight-bearing lower limb and foot bone, usually in the metatarsals and tibial shaft. The medial femoral condyle is an unusual site for a stress fracture so reporting such a case is imperative. Case Report: We report a case of a medial femoral condyle stress fracture in a young adult without any athletic or military background, which was managed conservatively by cast application. Conclusion: Stress fractures of the medial femoral condyle are an infrequent phenomenon in individuals without any military or athletic background. Surgeons should have to be very vigilant when dealing with cases of indistinct knee pain. Keywords: Stress fracture, medial femoral condyle, insufficiency fracture, sports injury

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Section: Introductionmentioning

confidence: 99%

Medial femoral Condyle Stress Fracture: A Case Report

Ojha¹,

Nayak²,

Gamanagatti³

et al. 2022

JOCR

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“…3 10-14 There is one case report of bilateral distal femur fractures in a 15 year old male rugby player. 20 We present here a unique occurrence of stress fractures of the femoral shaft in seven collegiate female lacrosse players, six of which occurred within the span of three consecutive seasons.…”

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confidence: 96%

Stress fractures of the femoral shaft in women’s college lacrosse: a report of seven cases and a review of the literature

2005

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Background: Stress fractures do not often occur in the shaft of the femur. They are more common in the femoral neck, the tibial shaft, the metatarsals, and other bones of the foot. In female athletes, stress fractures classically afflict the distance runner, the ballerina, the gymnast, and the figure skater. Objectives: To describe the clinical presentation, diagnosis, treatment, and outcome of seven college female lacrosse players with femoral shaft stress fractures, and review the literature. Results: The unusual results of this study support the principle that clinical suspicion should be high when treating any female athlete regardless of the sport. In this case series, an abrupt change in the quality of the running surface during the competitive training season was the only underlying common thread among the athletes. Conclusion: The findings suggest that risk factors for the female athlete are variable and are no longer limited to the undernourished or overtrained.

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An Unusual Cause of a Stress Femoral Fracture in a Long-Distance Runner: A Case of Bilateral Fracture

Freslon

Soyer

Iborra

et al. 2004

The Journal of Trauma: Injury, Infection, and Critical Care

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everal factors are responsible for stress fractures. Repetitive physical forces without adequate rest are always involved, and bone quality is often evoked. A hormonal imbalance can alter the quality of bones as described in physically active women. 1 We report an unusual case of a bilateral femoral fracture in a long-distance runner that we suspect was caused by intensive sporting practices, male hypogonadism, and low bone density. CASE REPORTA 40-year-old manual worker, ex-smoker (20 packs per year), with a height of 180 cm and a weight 68 kg (80 kg in 1994), who had been a long-distance runner at the regional level for 5 years (60 -70 km/wk), was examined in February 1999 after having suffered from a moderate but permanent pain in his right thigh for 3 weeks. The pain had increased progressively. The examination was normal except that palpation caused a pain in the middle third of the thigh. The radiograph results were negative, but a scintigram (hydroxymethylene diphosphonate-technetium-99m) revealed a stress fracture in the middle third posteromedial cortex of the right femur ( Fig. 1). He was told to stop all sport for 1.5 months, after which he began to run again as normal. Six months later, in early August 1999, a distal dull pain occurred in the left thigh. It did not perturb his day-to-day life but made running difficult. An ultrasound examination was carried out by another physician and revealed a "pulled muscle." However, 4 days later, the patient took part in a marathon. After 100 m, without trauma, he felt a violent crack in his left thigh that caused him to collapse. A radiograph showed a spiral oblique displaced fracture of the distal third femoral shaft without bone density alteration (Fig. 2). A plate was inserted to fix the fracture (Fig. 3). The patient returned to work 6 months later. The plate was removed 1 year later and the patient was able to start running again. He was symptomless and reached his previous level.The recurring and bilateral character of the these stress fractures, the displacement of one of them, and the shaft location induced us to carry out an etiologic examination. Perioperative biopsies did not reveal any structures indicative of a malignancy but revealed a decrease in the amount of bone tissue with a thinning of the spongy bone layer. Osteodensitometry revealed an osteopenia (density, 0.759 g/cm 2 ϭ t score Ϫ2 and z score Ϫ1.19 at the femoral neck). The hemogram and plasma electrolytogram were normal, with normal blood chemistry excluding chronic alcohol intoxication. The phosphocalcic results, with calcium intake, were normal (1.2 g/day) and fluorine salt was not prescribed (calcium level, 2.15 mmol/L [normal, 2.1-2.6 mmol/L]; phosphorus level, 1.23 mmol/L [normal, 0.8 -1.4 mmol/L]; protein level, 62 g/L [normal, 60 -80 g/L]). Corticotropin, thyrotropin, and lactotropin levels were normal, but a net testosterone level was only 2.2 nmol/L (normal, 12-40 nmol/L) 2 days after the surgical procedure. Two and a half months later, this level was at the lower limit (12 nmol...

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Stress fracture of the right distal femur following bilateral fractures of the proximal fibulas

Cited by 8 publications

References 7 publications

Medial femoral Condyle Stress Fracture: A Case Report

Medial femoral Condyle Stress Fracture: A Case Report

Stress fractures of the femoral shaft in women’s college lacrosse: a report of seven cases and a review of the literature

An Unusual Cause of a Stress Femoral Fracture in a Long-Distance Runner: A Case of Bilateral Fracture

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