Stress fractures

Speed, C. A.

doi:10.1007/bf01450958

Cited by 12 publications

(5 citation statements)

References 45 publications

(35 reference statements)

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“…The pathogenesis of bone 'fatigue' stress fractures has been reviewed comprehensively (Speed 1998;Riggs 2002). It is recognised that repetitive loading of a limb results in stress-induced remodelling and that a fine balance is set up between accumulated microdamage and its repair (Hasegawa et al 1988;Burr et al 1990).…”

Section: Discussionmentioning

confidence: 99%

The application of a scintigraphic grading system to equine tibial stress fractures: 42 cases

Ramzan

Newton

Shepherd

et al. 2003

Equine Veterinary Journal

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Summary Reasons for performing study: Tibial stress fractures are an important cause of lameness in the Thoroughbred racehorse. While it is recognised that these injuries can vary in clinical presentation and radiographic or scintigraphic appearance, little has been done to quantify lesion severity. By contrast the scintigraphic grading of tibial stress fractures in human athletes is widely reported and assists in the selection of appropriate management regimes. Objectives: To determine the relationship between scintigraphic grade, clinical severity and radiographic appearance of tibial stress fractures. Methods: The current study involved the retrospective analysis of records from 42 Thoroughbreds with abnormal tibial scintigraphic activity. Results: There was a significant association between lesion site and scintigraphic grade and good correlation of scintigraphic scoring between investigators. No significant association was found between scintigraphic grade and either radiographic grade or degree of lameness. Conclusions: The study confirmed that radiographic appearance is an unreliable measure of clinical severity or stage of progression of lesions. The scintigraphic grading system used in the study was not of use in defining stress fracture severity in the equine tibia. Potential relevance: Despite this finding, there is clearly a need for prospective investigations to explore the potential for targeted management regimes for tibial injuries based on lesion site or clinical criteria.

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Section: Discussionmentioning

confidence: 99%

The application of a scintigraphic grading system to equine tibial stress fractures: 42 cases

Ramzan

Newton

Shepherd

et al. 2003

Equine Veterinary Journal

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“…Nuclear scintigraphy and MRI can give positive results earlier. 16 In most cases stress fractures can be treated nonoperatively. Prophylactic arthrodeses of the hindfoot or ankle are recommended in patients with inflammatory arthritides and severe angular deformity of the ankle region in order to avoid stress fractures of the ankle and forefoot region.…”

Section: Discussionmentioning

confidence: 99%

“…2,14 Muscle weakness and spasm with resulting alteration in force distribution across the joints may also contribute to the development of stress fractures. 16 The metatarsal (MT) bones, distal tibia, and fibula are typical sites for stress fractures in patients with inflammatory arthritides. 21 The present study was performed to determine the presence of predisposing factors for forefoot, hindfoot, and distal tibial and fibular stress fractures in patients with inflammatory arthritides.…”

Section: Introductionmentioning

confidence: 99%

Stress Fractures of the Ankle and Forefoot in Patients with Inflammatory Arthritides

Mäenpää¹,

Lehto

Belt³

2002

Foot Ankle Int.

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Twenty-four stress fractures occurring in the metatarsal bones and ankle region were examined in 17 patients with inflammatory arthritides. There were 16 metatarsal, four distal fibular, two distal tibial, and two calcaneus fractures. Radiographic analyses were performed to determine the presence of possible predisposing factors for stress fractures. Metatarsal and ankle region stress fractures were analyzed separately. Stress fractures occurred most frequently in the second and third metatarsals. In metatarsal fractures, there was a trend for varus alignment of the ankle to cause fractures of the lateral metatarsal bones and valgus alignment of the medial metatarsal bones. Valgus deformity of the ankle was present in patients with distal fibular fractures in the ankle region group. Calcaneus fractures showed neutral ankle alignment. Malalignment of the ankle and hindfoot is often present in distal tibial, fibular, and metatarsal stress fractures. Additionally, patients tend to have long disease histories with diverse medication, reconstructive surgery and osteoporosis. If such patients experience sudden pain, tenderness, or swelling in the ankle region, stress fractures should be suspected and necessary examinations performed.

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“…Stress fractures can be classified into 2 groups. Fatigue fractures and insufficiency fractures (1–5). The first may occur when repetitive muscular forces or stresses are applied to a normal bone (6–8), and are most common in adolescents, athletes, and military recruits (3–5, 7–10).…”

Section: Introductionmentioning

confidence: 99%

“…The first may occur when repetitive muscular forces or stresses are applied to a normal bone (6–8), and are most common in adolescents, athletes, and military recruits (3–5, 7–10). Insufficiency fractures, in contrast, are found when physiologic forces are applied to a weakened bone in patients with diseases such as osteoporosis, osteomalacia, and fibrous dysplasia (3, 5). Although insufficiency fractures and fatigue fractures are somehow overlapping conditions, in this report we have focused on patients with a diagnosis of fatigue fracture.…”

Section: Introductionmentioning

confidence: 99%

Fatigue fractures suggesting clinical monarthritis

Garcı́a-Porrúa

Armesto

Mañana

2003

Arthritis & Rheumatism

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Objective. To examine etiologic factors, clinical features, and outcome in a series of consecutive patients with fatigue fractures diagnosed at a rheumatology division for a defined population over a 14-month period. Methods. A prospective study of the patients diagnosed with fatigue fracture at the rheumatology division of the Hospital Xeral-Calde (Lugo, Spain) between July 2000 and August 2001 was conducted. Hormonal status, body mass index, lifestyle, job, underlying diseases, and drug intake, which might be attributable risk factors for the stress fracture, were assessed. In all the patients a followup of at least 6 months was required. Results. Six consecutive patients (4 women) fulfilled the inclusion criteria. All of them were younger than 65 years (median 45 years; range 36 -64 years) and had a body mass index lower than 25. In this series no distinctive occupation was found. The delay to diagnosis since the onset of symptoms ranged from 0.5 to 6 months (median 1.5). All patients but 1 were sent to the rheumatology division because of a clinical diagnosis of monarthritis. Pain and swelling were the presenting symptoms. Conventional radiographs were normal and fine needle aspiration of the joints yielded negative results for microcrystals and organisms. Magnetic resonance imaging disclosed the presence and site of fracture in all the cases. Sequelae of mechanical pain and subsequent osteoarthritis were observed in the 3 cases with longer delay to diagnosis. Conclusion. Fatigue fractures are not exceptional in unselected adults. Rheumatologists should consider this diagnosis in patients presenting with monarthritis. Physician awareness is required to prevent the development of sequelae.

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Stress fractures

Cited by 12 publications

References 45 publications

The application of a scintigraphic grading system to equine tibial stress fractures: 42 cases

The application of a scintigraphic grading system to equine tibial stress fractures: 42 cases

Stress Fractures of the Ankle and Forefoot in Patients with Inflammatory Arthritides

Fatigue fractures suggesting clinical monarthritis

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