Stress fracture in a ceratopsian phalanx

1988 ◽  
Vol 62 (2) ◽  
pp. 302-303 ◽  
Author(s):  
Bruce M. Rothschild
Keyword(s):  
Fatigue Fracture ◽  
Stress Fracture ◽  
Fracture Stress ◽  
Stress Fractures ◽  
Periosteal Reaction ◽  
Stress Fatigue

A prominent anterior bulge on a ceratopsian dinosaur phalanx was examined for evidence of infection or stress (fatigue) fracture. The presence of a knife-slice type radiolucency, associated with periosteal reaction, was pathognomonic (diagnostic) for a stress fracture. Stress fractures have previously been recognized only in humans, racing greyhounds, and horses.

Evaluation of Tarsal Navicular Stress Fracture Fixation Using Intraoperative O-arm Computed Tomography

2014 ◽  
Vol 7 (6) ◽  
pp. 515-521 ◽  
Author(s):  
Andrew R. Hsu ◽  
Simon Lee
Keyword(s):  
Computed Tomography ◽  
Stress Fracture ◽  
Guide Wire ◽  
Weight Bearing ◽  
Fracture Site ◽  
Stress Fractures ◽  
Functional Impairments ◽  
Intraoperative Ct ◽  
Intraoperative Computed Tomography ◽  
Anatomic Reduction

Stress fractures of the tarsal navicular are high-risk injuries that can result in displacement, avascular necrosis, malunion, and nonunion. Delayed diagnosis and improper treatment can lead to long-term functional impairments and poor clinical outcomes. Increased shear stress and decreased vascularity in the central third of the navicular can complicate bony healing with often unpredictable return times to activity using conservative management in a non-weight-bearing cast. There recently has been increasing debate regarding the effectiveness of treatment options with a trend toward surgical management to anatomically reduce and stabilize navicular stress fractures in athletes. However, anatomic reduction and fixation of the navicular can be difficult despite direct visualization and intraoperative fluoroscopy. We report a case of a chronic navicular stress fracture in a high-level teenage athlete treated with open reduction internal fixation (ORIF) and calcaneus autograft using intraoperative computed tomography (CT) (O-arm®, Medtronic, Minneapolis, MN) for real-time evaluation of fracture reduction and fixation. Intraoperative CT was fast, reliable, and allowed for confirmation of guide wire orientation, alignment, and length across the fracture site. Anatomic fixation of navicular stress fractures can be challenging, and it is important for surgeons to be aware of the potential advantages of using intraoperative CT when treating these injuries. Levels of Evidence: Therapeutic, Level IV: Case Report

A descriptive study of stress fractures in competitive event horses in the UK

2004 ◽  
Vol 1 (4) ◽  
pp. 233-238
Author(s):  
Emma Hayton ◽  
Jennifer C Sneddon
Keyword(s):  
Stress Fracture ◽  
Descriptive Study ◽  
Stress Fractures ◽  
Anatomical Location ◽  
True Prevalence ◽  
Fracture Prevalence ◽  
The Uk ◽  
The Impact ◽  
Larger Sample ◽  
Age Category

AbstractThe impact of stress fractures on competitive event horses in the UK is completely unknown. Ninety-one replies to 450 questionnaires sent to competitive event riders across the UK indicated that 11 horses, representing 12% of the responders, had a confirmed stress fracture. As data on the total number of horses owned or ridden by the riders were not available, the true prevalence of stress fractures in this sample of horses could not be directly assessed. Within the bounds of this study, competitive level of the rider had a significant effect on stress fracture prevalence (X2(0.05, df. 2) = 24.74, P<0.05), as did years of eventing experience (X2(0.05, df. 1) = 27.80, P<0.01). Training regime was also influential (X2(0.05,df. 1) = 26.30, PX20.01). There was a predominance of fractures in geldings (X2(0.05, df. 1) = 24.45, P<0.03); however, geldings constituted 82% of reported cases. Thoroughbred cross horses had a significantly lower incidence of stress fractures than Thoroughbreds (X2(0.05, df. 1) = 20.82, P<0.01) but constituted only 18% of the sample. Horses in the oldest age category (9–12 years) had 6% of all stress fractures (X2(0.05, df. 2) = 24.54, P<0.1). All fractures occurred on the foreleg at the knee or below, with no significant effect of anatomical location. Seventy-three per cent of horses were not competing when diagnosed (X2(0.05, df. 1) = 22.27, P<0.1). These data indicate that useful preliminary data were yielded by the questionnaire and that further research with a larger sample size is justified.

Recurrence of Scaphoid Stress Fracture: A Case Report

2021 ◽  
Author(s):  
Nick A. Johnson ◽  
Tom Kurien ◽  
Tracy C. Horton
Keyword(s):  
Case Report ◽  
Stress Fracture ◽  
Stress Fractures ◽  
Case Description ◽  
Male Athletes ◽  
Repetitive Loading ◽  
High Level ◽  
Optimum Management ◽  
Prevention Of Recurrence ◽  
Early Fixation

Abstract Background Scaphoid stress fractures are rare and typically present in young, elite male athletes. Due to the infrequency in which these injuries are encountered, the optimum management is not established. Case Description We present the case of a 20-year-old male gymnast with bilateral stress fractures of the scaphoid waist. Following conservative treatment, clinical and radiological signs of union were seen bilaterally. Eight months after return to normal activities, a unilateral recurrence of the stress fracture occurred. This was successfully treated with internal fixation and bone grafting. Literature Review Scaphoid stress fractures are most frequently seen in gymnasts but also occur in participants of other sports involving repetitive loading of an extended wrist. This action conveys force predominantly through the waist of the scaphoid. Most case studies have reported high union rates, whether treated operatively or conservatively, and the patients returned to high-level sport with no further problems. Stress fracture recurrence has been reported in other bones such as the metatarsal and tibia but never before in the scaphoid. Our case is unusual in that the patient suffered ongoing problems due to a recurrence of the scaphoid stress fracture after returning to normal activities. Clinical Relevance Clinicians should be aware that scaphoid stress fracture recurrence can occur, counsel patients accordingly, and remain vigilant after apparent union. We would recommend early fixation to allow a quicker return to function and prevention of recurrence.

scholarly journals Unilateral Pedicle Stress Fracture in a Long-Term Hemodialysis Patient with Isthmic Spondylolisthesis

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Keishi Maruo ◽  
Toshiya Tachibana ◽  
Shinichi Inoue ◽  
Fumihiro Arizumi ◽  
Shinichi Yoshiya
Keyword(s):  
Stress Fracture ◽  
Hemodialysis Patient ◽  
Contralateral Side ◽  
Pedicle Screw Fixation ◽  
Stress Fractures ◽  
Leg Pain ◽  
Isthmic Spondylolisthesis ◽  
Pedicle Fracture ◽  
History Of

Most unilateral pedicle stress fractures occur on the contralateral side of patients with unilateral spondylolysis. However, there are few reports of unilateral pedicle stress fractures in patients with bilateral spondylolysis and spondylolisthesis. We report a unique case of unilateral pedicle stress fracture in a long-term hemodialysis patient with isthmic spondylolisthesis. A 65-year-old man who had undergone hemodialysis presented with lower back pain that had persisted for several years. The patient experienced severe right lower extremity pain with no history of trauma. Computed tomography revealed unilateral pedicle fracture with bilateral L5 spondylolysis and spondylolisthesis with progression of scoliosis. The patient underwent Gill laminectomy of L5 with pedicle screw fixation at L4-S1 and interbody fusion at L5-S1. The patient’s leg pain ceased immediately, and he began walking without leg pain. In our present patient, development of scoliosis caused by destructive spondyloarthropathy may have contributed to a unilateral pedicle fracture.

scholarly journals Association of Serum Vitamin D Levels and Stress Fractures in Collegiate Athletes

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096696
Author(s):  
David Millward ◽  
Allison D. Root ◽  
Jeremy Dubois ◽  
Randall P. Cohen ◽  
Luis Valdivia ◽  
...  
Keyword(s):  
Vitamin D ◽  
Stress Fracture ◽  
Serum Vitamin ◽  
Stress Fractures ◽  
Serum Vitamin D ◽  
Outdoor Sports ◽  
Vitamin D Levels ◽  
Study Results ◽  
The Mean ◽  
Indoor Sports

Background: Low vitamin D levels along with high-intensity athletic training may put an athlete at increased risk for a stress fracture. Purpose: To assess whether supplementation with vitamin D is associated with a reduced risk of stress fractures in college athletes. We also assessed differences in vitamin D levels among athletes participating in outdoor versus indoor sports. Study Design: Cohort study; Level of evidence, 2. Methods: The study participants included 802 National Collegiate Athletic Association Division I intercollegiate athletes (497 men and 305 women) on a sports team for at least 1 semester from 2012 to 2018. All athletes who had a baseline vitamin D level in their medical record were included. Athletes with vitamin D levels <40 ng/mL were given vitamin D supplements. We assessed differences in the rate of stress fracture among those who maintained or improved vitamin D levels to ≥40 ng/mL and those who did not, as well as differences in average baseline vitamin D levels by sport type (indoor vs outdoor). Results: The rate of stress fracture was 12% higher (95% CI, 6-19; P < .001) for those who remained low in vitamin D compared with those who were low at baseline but improved their vitamin D status to ≥40 ng/mL. The rate of stress fracture was also 12% higher (95% CI, 5-18; P < .001) for those who had low vitamin D levels compared with those who maintained normal levels. The mean baseline vitamin D values were significantly higher for men participating in outdoor sports versus indoor sports. For men, the mean vitamin D level was 5.7 ng/mL higher (95% CI, 0.9-10.5; P = .01) in outdoor athletes. For women, the mean vitamin D level was 3.7 ng/mL higher (95% CI, –0.58 to 8.03; P < .04) for outdoor versus indoor sports. Conclusion: Study results indicated that correcting low serum vitamin D levels reduces the risk of stress fracture. This study also presented evidence that athletes who participate in indoor sports may be at greater risk for vitamin D deficiency than those who compete in outdoor sports.

Surgical management of chronic pelvic instability following periacetabular osteotomy nonunion

2020 ◽  
Vol 30 (6) ◽  
pp. 787-792
Author(s):  
Alexander D Shearman ◽  
Aresh Hashemi-Nejad ◽  
Marcus JK Bankes ◽  
Angus D Lewis
Keyword(s):  
Stress Fracture ◽  
Soft Tissues ◽  
Periacetabular Osteotomy ◽  
Case Series ◽  
Stress Fractures ◽  
Pubic Ramus ◽  
Ilioinguinal Approach ◽  
Superior Pubic Ramus ◽  
Stoppa Approach ◽  
Pelvic Instability

Introduction: Periacetabular osteotomy (PAO) is an established treatment for symptomatic acetabular dysplasia in skeletally mature individuals without arthritis. Pelvic nonunion and associated stress fractures are under-reported. Nonunited stress fractures can cause continued buttock pain and pelvic instability. The aim of this study is to report on our experience managing patients with ongoing pain following nonunion of PAO. Patients and methods: 8 patients presented to a tertiary referral pelvic service with symptomatic PAO nonunion between 2015-2018. All patients underwent open reduction internal fixation of the superior pubic ramus nonunion, with ipsilateral iliac autograft, at an average of 48.1 (15–82) months following initial osteotomy. Demographic and perioperative data were recorded. Follow-up was on average to 9.9 months, once union was confirmed radiographically. Results: All patients were female and average age was 31.8 (18–41) years. In 7/8 (87.5%) patients a modified Stoppa approach was successfully utilised. 1 patient required an ilioinguinal approach due to the amount of rotational correction. All patients went on to union at the superior pubic ramus and reported improvement in mechanical symptoms. 5/8 (62.5%) patients were noted to develop union of the posterior column or inferior pubic ramus stress fracture indirectly. 2/8 (25%) patients developed progression of intra-articular pain, despite restoration of pelvic stability. 1 patient required intraoperative transfusion due to femoral vein injury. There were no other complications seen in this series. Conclusions: To our knowledge, this is the largest case series of surgically managed PAO nonunion. Pelvic instability resulting from nonunion and stress fracture can be satisfactorily addressed by mobilising, grafting and plating the nonunion at the superior pubic ramus. The modified Stoppa approach is suitable in most cases, allowing excellent exposure whilst minimising the insult to soft tissues. The altered anatomy of the pelvis following PAO should be anticipated to reduce the risk to nearby neurovascular structures.

scholarly journals Metacarpal Stress Fracture Is Not an Uncommon Condition in Adolescent Racket Athletes

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Karen Nishikawa ◽  
Yuka Kimura ◽  
Daisuke Chiba ◽  
Norihiro Sasaki ◽  
Shizuka Sasaki ◽  
...  
Keyword(s):  
Stress Fractures ◽  
Periosteal Reaction ◽  
Initial Visit ◽  
Acute Trauma ◽  
Plain Radiographs ◽  
Trauma History ◽  
The Third ◽  
Hand Pain ◽  
Right Hand ◽  
Sports Activities

Background. Stress fractures of the metacarpal bones are considered uncommon. We report on 11 adolescent athletes with these stress fractures, successfully treated with cessation of sports activities. Representative case presentation. In case 1, a 15-year-old male tennis player presented with right hand pain of 4-week duration without an acute trauma history. Tenderness existed on palpation along the dorsal and proximal second metacarpal bone. Plain radiographs demonstrated a periosteal reaction on the proximal shaft of the second metacarpal. Racket swinging was suspended. He returned to competitive tennis 2 months after the initial visit and continues to participate without symptoms. In case 2, a 16-year-old male boxer presented with right hand pain of 2-week duration that arose while punching. Acute trauma history was absent. Tenderness existed on palpation over the third metacarpal of the right hand. Plain radiographs demonstrated no periosteal reaction or fracture line. MRI showed a high signal on the third metatarsal bone on fat suppression and a low signal on T2-weighted images. Nonoperative treatment was initiated without external fixation, and punching was suspended. He returned to boxing 1 month after the initial visit without symptoms. Conclusions. The current case series of metacarpal stress fractures demonstrate that this condition is not as rare as previously reported. Metacarpal stress fractures are generally ignored since the clinical and radiological findings are mostly unclear. If an athlete experiences hand pain without acute onset during sports activities, especially in racket sports, the presence of a metacarpal stress fracture should be assessed by MRI.

Assessment of Bulk Mechanical Properties of HDPE Hybrid Composite Filled with 1D/2D Nanofiller System

2018 ◽  
Vol 917 ◽  
pp. 12-16 ◽  
Author(s):  
Nitesh Dhar Badgayan ◽  
Santosh Kumar Sahu ◽  
Sutanu Samanta ◽  
Pattela Srinivasa Rama Sreekanth
Keyword(s):  
Mechanical Properties ◽  
Impact Toughness ◽  
Yield Stress ◽  
Stress Fracture ◽  
Fracture Stress ◽  
Hexagonal Boron Nitride ◽  
Test Results ◽  
Mechanical Mixing ◽  
Multi Walled Carbon Nanotubes ◽  
Walled Carbon Nanotubes

Current work reports on evaluation of bulk mechanical properties of High Density Polyethylene (HDPE) reinforced with functionalized 1D (Multi Walled Carbon Nanotubes- (MWCNTs) and 2D (hexagonal-Boron Nitride Nanoplatelets-(h-BNNPs) fillers. Mechanical mixing and injection moulding technique was used to prepare the composites. Evaluation of bulk mechanical properties like hardness, yield stress, fracture stress, impact toughness and Young`s modulus was carried out. The optimum properties were exhibited by HDPE/0.25 MWCNT/0.1 BNNP. Hardness, yield stress, fracture stress, impact toughness and Young`s modulus was observed to increase by 93.84, 80.83, 59.23, 115 and 42.05% on comparison with pure HDPE. TEM images confirm the tubular and hexagonal morphology of MWCNT and h-BNNP. It is concluded from test results that addition of MWCNT and h-BNNP into HDPE has improvised mechanical properties.

Non Invasive Measurement of Blood Flow in the Human Lower Extremity

2007 ◽  
Author(s):  
Hehe Zhou ◽  
John E. Novotny ◽  
Liyun Wang
Keyword(s):  
Blood Flow ◽  
Lower Extremity ◽  
Stress Fracture ◽  
Financial Burden ◽  
Lower Extremities ◽  
Focal Ischemia ◽  
Stress Fractures ◽  
Diagnostic Tools ◽  
Blood Flows ◽  
Non Invasive

Stress fracture in lower extremities occurs commonly among military recruits and athletes during intensive physical training. This injury has a marked impact on the health of military personnel and imposes a significant financial burden [1]. Despites advances in stress fracture studies, its pathogeneses remains poorly understood and early diagnostic tools are lacking. Focal ischemia is a potential initiator of site-specific bone remodeling and may cause stress fractures in human lower extremity [2, 3]. We hypothesize that intensive repetitive loading impairs intramedullary blood flow due to pressurization of the bone marrow cavity, leading to focal ischemia and eventual development of stress fractures. To begin to test our hypothesis, we developed and validated a quantitative, non-invasive method to measure blood flow in vivo. The approach was based on Cine Phase Contrast MRI (CPC-MRI), a dynamic motion measurement and visualization modality that was originally designed for cardiovascular studies. By measuring the phase shift that is induced by pulsatile blood flows in the magnetic resonance signal, cross-sectional images and velocity maps are acquired of the moving fluid. This technique has been adapted to study blood flows in skeletal muscles [4], intracranial flows [5], and muscle mechanics and joint kinematics [6]]. We first performed a flow phantom study to validate the reliability and accuracy of CPC-MRI in measuring flow velocity. We then quantified the effects of brief exercise on blood flows in the lower extremities of human subjects. These non-invasive measurements will help us better understand the interplay between vasculature and skeletal system in various physiological and pathological conditions.

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