scholarly journals Repetition of an Unusual Stress Fracture in an Anorexic Man: A Case Report

2002 ◽  
Vol 10 (2) ◽  
pp. 210-212 ◽  
Author(s):  
S Myers ◽  
D Bell ◽  
J Gorman ◽  
J Best ◽  
J Rooney
Keyword(s):  
Risk Factors ◽  
Anorexia Nervosa ◽  
Case Report ◽  
Stress Fracture ◽  
Stress Fractures ◽  
Inhaled Corticosteroid ◽  
Proximal Fibula ◽  
Repeated Stress ◽  
Abnormal Gait ◽  
Unusual Stress

Stress fractures of the fibula commonly occur distally in runners, whereas stress fractures of the proximal fibula are uncommon and typically occur in jumpers. Furthermore, it is rare for a stress fracture to be repeated in the same bone. We report a case of a repeated stress fracture of the proximal fibula in a male runner with abnormal gait that primarily involved excessive pronation. Unusual risk factors in this case were anorexia nervosa and use of an inhaled corticosteroid. The patient was treated conservatively, and healing of the fracture was completed at 12 weeks.

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.

Stress Fractures at the Base of the Second Metatarsal in Ballet Dancers

1996 ◽  
Vol 17 (2) ◽  
pp. 89-94 ◽  
Author(s):  
Martin J. O'Malley ◽  
William G. Hamilton ◽  
John Munyak ◽  
Michael J. DeFranco
Keyword(s):  
Risk Factors ◽  
Stress Fracture ◽  
Symptomatic Treatment ◽  
Senior Author ◽  
Stress Fractures ◽  
Ballet Dancers ◽  
Persistent Symptoms ◽  
Common Location ◽  
Second Metatarsal ◽  
Delayed Menarche

Stress fractures are a frequent injury in ballet companies and the most common location is at the base of the second metatarsal. While previous reports have focused on risk factors for this injury (overtraining, delayed menarche, poor nutrition), there is no published series describing the natural history and outcome following this fracture. We reviewed the office records of the senior author and identified 51 professional dancers (64 fractures) who sustained a stress fracture at the base of the second metatarsal. History of a previous stress fracture in the lower extremity was seen in 19 patients and delayed menarche in the women was common. The clinical presentation was insidious onset of midfoot pain an average of 2.5 weeks prior to seeking medical care. The initial radiographs of the foot were positive in 19 patients, questionable in 3 patients, and negative in 42 patients. The usual location of the fracture was at the proximal metaphyseal-diaphyseal junction (three fractures extended into the tarsometatarsal joint). Treatment consisted of a short leg walking cast for 6 patients, and a wooden shoe and symptomatic treatment for the remainder. At follow-up, 14% of patients still had occasional pain or stiffness in the midfoot with dancing. The patients returned to performance at an average of 6.2 weeks following diagnosis. No patients required bone grafting for persistent symptoms. There were eight refractures (at the same site) occurring an average of 4.3 years, all of which healed with conservative care. Stress fractures at the base of the second metatarsal are common in ballet dancers and can usually be treated with symptomatically. The results of this study are discussed in terms of risk factors, the use of a posterior-anterior view of the foot to eliminate overlap at Lisfranc's joint, and our present treatment regimen.

Unusual stress fracture of the femoral neck in a young adult not caused by excessive stress: a case report

2004 ◽  
Vol 9 (6) ◽  
pp. 650-653 ◽  
Author(s):  
Kenji Takahara ◽  
Hiroyuki Nakagawa ◽  
Mikio Kamimura ◽  
Hiroyuki Hashidate ◽  
Amu Kawaguchi ◽  
...  
Keyword(s):  
Case Report ◽  
Young Adult ◽  
Femoral Neck ◽  
Stress Fracture ◽  
Unusual Stress ◽  
Excessive Stress

Tibial Stress Fracture Following Ankle Arthrodesis

2020 ◽  
Vol 41 (5) ◽  
pp. 556-561
Author(s):  
Mohamed Abdelaziz Elghazy ◽  
Noortje C. Hagemeijer ◽  
Gregory R. Waryasz ◽  
Daniel Guss ◽  
Seth O’Donnell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stress Fracture ◽  
Plate Fixation ◽  
Distal Tibia ◽  
Case Series ◽  
Ankle Arthrodesis ◽  
Stress Fractures ◽  
Index Procedure ◽  
Fibular Osteotomy ◽  
Tibial Stress Fracture

Background: End-stage ankle arthritis is frequently treated with either tibiotalar or tibiotalocalcaneal (TTC) arthrodesis, but the inherent loss of accommodative motion increases mechanical load across the distal tibia. Rarely, patients can go on to develop a stress fracture of the distal tibia without any antecedent traumatic event. The purpose of this study was to determine the incidence of tibial stress fracture after ankle arthrodesis, highlight any related risk factors, and identify the effectiveness of treatment strategies and their healing potential. Methods: A retrospective chart review was performed at 2 large academic medical centers to identify patients who had undergone ankle arthrodesis and subsequently developed a stress fracture of the tibia. Any patient with a tibial stress fracture before ankle arthrodesis, or with a nontibial stress fracture, was excluded from the study. Results: A total of 15 out of 1046 ankle fusion patients (1.4%) developed a tibial stress fracture at a mean time of 42 ± 82 months (range, 3-300 months) following the index procedure. The index procedure for these 15 patients who went on to subsequently develop stress fractures included isolated ankle arthrodesis (n = 8), ankle arthrodesis after successful subtalar fusion (n = 2), primary TTC arthrodesis (n = 2), and ankle arthrodesis subsequent to successful subtalar fusion with resultant ankle nonunion requiring revision TTC nailing (n = 3). Four patients had undergone fibular osteotomy with subsequent onlay strut fusion, and 5 had undergone complete resection of the lateral malleolus. Stress fracture location was found to be at the level of the fibular osteotomy in 2 patients and at the proximal end of an existing or removed implant in 9. Fourteen of the 15 patients had a nondisplaced stress fracture and were initially treated with immobilization and activity modification. Of these, 3 failed to improve with nonoperative treatment and subsequently underwent operative fixation (intramedullary nail in 2; plate fixation in 1). Only 1 of the 15 patients presented with a displaced fracture and underwent immediate plate fixation. All patients reported pain improvement and were ultimately healed at final follow-up. Conclusion: In this case series review, we found a 1.4% incidence of tibial stress fracture after ankle arthrodesis, and both hardware transition points and a fibular resection or osteotomy appear to be risk factors. Operative intervention was required in approximately 25% of this population, but the majority of tibial stress fractures following ankle fusion were successfully treated nonoperatively, and ultimately all healed. Level of Evidence: Level IV, retrospective case series.

scholarly journals Isolated Fibular Stress Fractures: Demographic and Radiographic Factors

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0037
Author(s):  
Nana O. Sarpong ◽  
Matthew Levitsky ◽  
Michael Held ◽  
Justin K. Greisberg ◽  
J. Turner Vosseller
Keyword(s):  
Risk Factors ◽  
Stress Fracture ◽  
Demographic Data ◽  
Case Series ◽  
Stress Fractures ◽  
Prior History ◽  
Retrospective Case ◽  
Distal Fibula ◽  
Retrospective Case Series ◽  
Short Period

Category: Ankle, Trauma Introduction/Purpose: Fibular stress fractures are rare injuries that are incompletely understood in terms of pathogenesis and predisposing factors. While stress fractures all involve relative stress concentration in a finite area leading to local mechanical failure, the risk factors for this injury have not been assessed. Their relative rarity has made understanding of these risk factors difficult. In a retrospective case series, we sought to define demographic and radiographic risk factors for isolated fibular stress fractures. Methods: We retrospectively reviewed the records of 13 patients with isolated fibular stress fractures at our institution between January 2010 and November 2018. We collected and analyzed baseline demographic data and radiographic parameters including prior history of fracture, location of stress fracture, bone quality, and heel alignment. Results: The cohort consisted of 6 men and 7 women with a mean age of 41.8 years at the time of diagnosis of the fibular stress fracture. The average BMI in the cohort was 28.5 kg/m2. The location of the stress fracture was in the distal third of the fibula in 69.2% (9/13), proximal third in 23.1% (3/13), and middle third in 7.7% (1/13). There was no evidence of osteopenia on radiographic analysis in any patients, by assessment of the senior author and attending radiologist at our institution. Isolated stress fractures in the distal third of the fibula were observed more commonly in women. Distal fibula stress fractures were associated with physiologic hindfoot valgus, while proximal fractures were seen with a varus hindfoot. Conclusion: In this retrospective case series of a rare injury, isolated stress fractures in the distal third of the fibula were the most common fibular stress fracture. Proximal fibular stress fractures were associated with a varus hindfoot. All fractures in this case series healed with immobilization in a walking boot with or without a short period of nonweightbearing.

scholarly journals Vitamin D and Stress Fractures in Sport: Preventive and Therapeutic Measures—A Narrative Review

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 223
Author(s):  
Beat Knechtle ◽  
Zbigniew Jastrzębski ◽  
Lee Hill ◽  
Pantelis T. Nikolaidis
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Stress Fracture ◽  
Stress Fractures ◽  
Blood Levels ◽  
White Ethnicity ◽  
Calcium Stress ◽  
Potential Risk Factors ◽  
Therapeutic Measures ◽  
Classical Ballet

There are numerous risk factors for stress fractures that have been identified in literature. Among different risk factors, a prolonged lack of vitamin D (25(OH)D) can lead to stress fractures in athletes since 25(OH)D insufficiency is associated with an increased incidence of a fracture. A 25(OH)D value of <75.8 nmol/L is a risk factor for a stress fracture. 25(OH)D deficiency is, however, only one of several potential risk factors. Well-documented risk factors for a stress fracture include female sex, white ethnicity, older age, taller stature, lower aerobic fitness, prior physical inactivity, greater amounts of current physical training, thinner bones, 25(OH)D deficiency, iron deficiency, menstrual disturbances, and inadequate intake of 25(OH)D and/or calcium. Stress fractures are not uncommon in athletes and affect around 20% of all competitors. Most athletes with a stress fracture are under 25 years of age. Stress fractures can affect every sporty person, from weekend athletes to top athletes. Stress fractures are common in certain sports disciplines such as basketball, baseball, athletics, rowing, soccer, aerobics, and classical ballet. The lower extremity is increasingly affected for stress fractures with the locations of the tibia, metatarsalia and pelvis. Regarding prevention and therapy, 25(OH)D seems to play an important role. Athletes should have an evaluation of 25(OH)D -dependent calcium homeostasis based on laboratory tests of 25-OH-D3, calcium, creatinine, and parathyroid hormone. In case of a deficiency of 25(OH)D, normal blood levels of ≥30 ng/mL may be restored by optimizing the athlete’s lifestyle and, if appropriate, an oral substitution of 25(OH)D. Very recent studies suggested that the prevalence of stress fractures decreased when athletes are supplemented daily with 800 IU 25(OH)D and 2000 mg calcium. Recommendations of daily 25(OH)D intake may go up to 2000 IU of 25(OH)D per day.

scholarly journals Stress fracture of the thoracic spine in a male rugby player: a case report

10.17159/4592 ◽  
2018 ◽  
Vol 30 (1) ◽  
pp. 1-2
Author(s):  
A Shafik
Keyword(s):  
Case Report ◽  
Stress Fracture ◽  
Thoracic Spine ◽  
Case Reports ◽  
Stress Fractures ◽  
Rugby Player ◽  
Anatomical Location ◽  
Anatomic Locations ◽  
Type Of Injury

This case reports a stress fracture of the thoracic spine in a professional rugby player. This is a rare anatomical location for this type of injury in this population and has not previously been described. Physicians should be aware that performance of rugby specific movements may lead to rare stress fractures in certain anatomic locations.

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