scholarly journals Stress Fractures of the Foot and Ankle in Athletes

2018 ◽  
Vol 3 (3) ◽  
pp. 247301141879007
Author(s):  
Philip B. Kaiser ◽  
Daniel Guss ◽  
Christopher W. DiGiovanni
Keyword(s):  
High Risk ◽  
Bone Health ◽  
Operative Management ◽  
Complete Healing ◽  
Stress Fractures ◽  
Foot And Ankle ◽  
Sufficient Time ◽  
Wolff’S Law ◽  
Fracture Assessment ◽  
Repetitive Loading

Stress fractures of the foot and ankle are common injuries in athletes. Management differs considerably based on fracture location and predisposing factors. Repetitive loading of the foot and ankle in athletes should result in physiologic bone remodeling in accordance with Wolff’s law. However, when there is not sufficient time for complete healing to occur before additional loads are incurred, this process can instead lead to stress fracture. Assessment of the athlete’s training regimen and overall bone health is paramount to both the discovery and treatment of these injuries, although diagnosis is often delayed in the setting of normal-appearing initial radiographs. While most stress fractures of the foot or ankle can usually be treated nonoperatively with a period of activity modification, fractures in certain locations are considered “high risk” due to poor intrinsic healing and may warrant more proactive operative management.

Stress Fractures about the Foot and Ankle in Athletes

2013 ◽  
Vol 3 (1) ◽  
pp. 8-19 ◽  
Author(s):  
Stephanie W Mayer ◽  
Patrick W Joyner ◽  
Louis C Almekinders ◽  
Selene G Parekh
Keyword(s):  
High Risk ◽  
Return To Sport ◽  
Risk Groups ◽  
Operative Management ◽  
Stress Fractures ◽  
Foot And Ankle ◽  
Imaging Diagnosis ◽  
Duration Of Symptoms ◽  
High Index Of Suspicion ◽  
Type Of Fracture

ABSTRACT Stress fractures of the foot and ankle are a common problem encountered by athletes of all levels and ages. This review summarizes the history and physical exam findings, radiographic imaging, diagnosis and treatment of stress fractures of the foot and ankle in those participating in athletic activities. These injuries can be divided into low- and high-risk based upon their propensity to heal without complication. A wide variety of nonoperative strategies are employed based on the duration of symptoms, type of fracture, and patient factors such as activity type, desire to return to sport and compliance. Operative management has proven superior in several high risk types of stress fractures. Evidence on pharmacotherapy and physiologic therapy such as bone stimulators is evolving. A high index of suspicion for stress fractures is appropriate in many high-risk groups of athletes with lower extremity pain. Proper and timely workup and treatment is successful in returning these athletes to sport in many cases. Education of athletes as well as their families, training and coaching staff is important. Attention to training regimens, technique, equipment and proper nutrition is paramount in the prevention of these injuries. Mayer SW, Joyner PW, Almekinders LC, Parekh SG. Stress Fractures about the Foot and Ankle in Athletes. The Duke Orthop J 2013;3(1):8-19.

scholarly journals Stress Fractures of the Foot and Ankle in Athletes

2013 ◽  
Vol 6 (6) ◽  
pp. 481-491 ◽  
Author(s):  
Stephanie W. Mayer ◽  
Patrick W. Joyner ◽  
Louis C. Almekinders ◽  
Selene G. Parekh
Keyword(s):  
High Risk ◽  
Stress Fracture ◽  
Specific Treatment ◽  
Return To Sport ◽  
Risk Groups ◽  
Stress Fractures ◽  
Medial Malleolus ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Duration Of Symptoms

Context: Stress fractures of the foot and ankle are a common problem encountered by athletes of all levels and ages. These injuries can be difficult to diagnose and may be initially evaluated by all levels of medical personnel. Clinical suspicion should be raised with certain history and physical examination findings. Evidence Acquisition: Scientific and review articles were searched through PubMed (1930-2012) with search terms including stress fractures and 1 of the following: foot ankle, medial malleolus, lateral malleolus, calcaneus, talus, metatarsal, cuboid, cuneiform, sesamoid, or athlete. Study Design: Clinical review. Level of Evidence: Level 5. Results: Stress fractures of the foot and ankle can be divided into low and high risk based upon their propensity to heal without complication. A wide variety of nonoperative strategies are employed based on the duration of symptoms, type of fracture, and patient factors, such as activity type, desire to return to sport, and compliance. Operative management has proven superior in several high-risk types of stress fractures. Evidence on pharmacotherapy and physiologic therapy such as bone stimulators is evolving. Conclusion: A high index of suspicion for stress fractures is appropriate in many high-risk groups of athletes with lower extremity pain. Proper and timely work-up and treatment is successful in returning these athletes to sport in many cases. Low-risk stress fracture generally requires only activity modification while high-risk stress fracture necessitates more aggressive intervention. The specific treatment of these injuries varies with the location of the stress fracture and the goals of the patient.

Topical oro-dispersible budesonide tablets for stricture prevention after near circumferential ESD for esophageal squamous cell cancer – a case report

2021 ◽  
Author(s):  
Daniel Mathies ◽  
Tsuneo Oyama ◽  
Ingo Steinbrück ◽  
Franz Ludwig Dumoulin
Keyword(s):  
Case Report ◽  
High Risk ◽  
Endoscopic Resection ◽  
Squamous Cell ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Complete Healing ◽  
Esophageal Squamous Cell Cancer ◽  
Stricture Formation ◽  
Local Injections

Abstract Background Endoscopic resection is the treatment of choice for early esophageal cancers. However, resections comprising more than 70–80 % of the circumference are associated with a high risk of stricture formation. Currently, repetitive local injections and/or systemic steroids are given for prevention. Case report We present here the case of a 78-year-old male patient who had a near circumferential endoscopic submucosal dissection for a pT1a mm, L0, V0, R0, G2 esophageal squamous cell cancer. At the end of endoscopic resection, 80 mg of triamcinolone was injected locally. The patient was then treated with oro-dispersible budesonide tablets (2 × 1 mg/day) and nystatin (4 × 100 000 I.E.) for 8 weeks. This treatment resulted in complete healing without any stricture formation and did not result in any complications. Discussion Treatment with orodispersible budesonide tablets could help prevent strictures after large endoscopic resections in the esophagus.

Stress fractures of the foot and ankle

Injury ◽  
2017 ◽  
Vol 48 (8) ◽  
pp. 1722-1726 ◽  
Author(s):  
M.J. Welck ◽  
T. Hayes ◽  
P. Pastides ◽  
W. Khan ◽  
B. Rudge
Keyword(s):  
Stress Fractures ◽  
Foot And Ankle

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 Effect of Weight-Bearing in Conservative and Operative Management of Fractures of the Base of the Fifth Metatarsal Bone

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Jae-Yong Park ◽  
Hyong-Nyun Kim ◽  
Yoon-Suk Hyun ◽  
Jun-Sik Park ◽  
Hwan-Jin Kwon ◽  
...  
Keyword(s):  
Bone Resorption ◽  
Weight Bearing ◽  
Operative Management ◽  
Foot And Ankle ◽  
Early Weight Bearing ◽  
Group A ◽  
Vas Scores ◽  
American Orthopaedic ◽  
Group B ◽  
Underlying Diseases

Background. There is no established principle regarding weight-bearing in conservative and operative management of fifth metatarsal base fractures. Methods. We reviewed 86 patients with acute fifth metatarsal base fractures. Conservatively treated late or early weight-bearing patients were assigned to Group A or C, respectively. Operatively treated late or early weight-bearing patients were assigned to Group B or D, respectively. Results were evaluated by clinical union, bone resorption, and the American Orthopaedic Foot and Ankle Society (AOFAS) and Visual Analogue Scale (VAS) scores. Results. All 4 groups had bone union at a mean of 6.9 weeks (range, 5.1–15.0). There were no differences between the groups in the AOFAS and VAS scores. In the early weight-bearing groups, there were fewer cases of bone resorption, and the bone unions periods were earlier. Conclusions. Early weight-bearing may help this patient population. Moreover, conservative treatment could be an option in patients with underlying diseases.

Heart transplantation in high risk patients: Post-operative management using OKT3

1990 ◽  
Vol 4 (6) ◽  
pp. 75
Author(s):  
J. Neidecker ◽  
P. Brule ◽  
M. Gressier ◽  
J. Ninet ◽  
D. Bompard ◽  
...  
Keyword(s):  
High Risk ◽  
Heart Transplantation ◽  
Operative Management ◽  
High Risk Patients ◽  
Risk Patients

Stress fractures of the foot and ankle

1998 ◽  
pp. 269-277
Author(s):  
J. Bernard ◽  
L. Zabraniecki ◽  
A. Constantin ◽  
A. Thomas
Keyword(s):  
Stress Fractures ◽  
Foot And Ankle
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