What is a fatigue fracture and what are its characteristics?

Speaking of fatigue fractures, I believe everyone is familiar with them. However, how much do you know about this kind of injury that often occurs during sports? If you don't know much about its mechanism, treatment measures and prevention methods, then take a few minutes to read this article. I believe it will be helpful to you.

What is a fatigue fracture?

Fatigue fractures, also known as march fractures or stress fractures, are mostly caused by long-term non-physiological stress on the skeletal system. They often occur in the tibia, metatarsal bones and radius. There is no typical history of trauma clinically. Early X-rays are usually negative and are easily missed or misdiagnosed.

Fatigue fractures are prone to occur at sites where bone stress is concentrated. They are one of the common training injuries, with a higher incidence in military training, with foreign reports of 31% and domestic reports of 16.9%. They are related to excessive intensity training or improper postures, and are also common in athletes who bear more weight on their feet, such as basketball, football, tennis, track and field, gymnastics athletes and ballet dancers. They can also be seen in middle-aged and elderly people who often insist on high-intensity exercise.

Causes

After a long period of repeated concentrated minor injuries to a local area, trabecular fractures occur first and then repair immediately. If the bone continues to be subjected to external forces during the repair process, the repair process may be hindered and bone absorption may increase. This process is repeated, and eventually a complete fracture will occur because bone absorption is greater than bone repair.

Symptoms

The clinical characteristics are local pain, which worsens after activity, improves after rest, and has no night pain. There may be mild swelling and tenderness in the local area, and the stress test is positive.

1. Metatarsal fatigue fracture: This type of fracture often occurs during recruit training or after a long march, so it is also called a marching fracture.

2. Rib fatigue fractures: Most elderly people suffer from osteoporosis. If they cough for a long time due to chronic bronchitis, the intercostal muscles will contract violently and repeatedly, which may cause rib fatigue fractures.

3. Tibia (fibula) fatigue fracture: Track and field athletes and ballet dancers are prone to fatigue fractures of the lower 1/3 of the fibula or the upper 1/3 of the tibia. This is related to the repeated and violent contraction of the calf muscles and the indirect violence of landing on the sole of the foot after jumping.

Check

X-ray examinations are mostly negative in the first 2 weeks to 4 months, and then may show periosteal hyperplasia, fracture lines, callus or new bone formation. CT scans can show increased density of the bone marrow cavity and local soft tissue thickening, providing an important basis for early diagnosis.

Diagnosis

Fatigue fractures are microfractures of the bone (visible under a microscope). Early X-rays often do not show obvious fractures, but the pain is severe during activities. Since there is no obvious history of trauma and the symptoms are atypical, it is easy to misdiagnose clinically. It should be distinguished from periostitis, osteomyelitis, and osteoma.

treatment

The treatment method is basically the same as that of violent fractures. If the fracture is not displaced or slightly displaced, it is treated by manual reduction, fixation, immobilization and other methods, and rehabilitation exercises are performed in the later stage. If the symptoms are more severe, the fracture ends are ossified or nonunion occurs, and the fracture healing is more difficult, surgical incision reduction or plaster external fixation is required.

After a fatigue fracture occurs, if you do not get a timely rest, the force will continue to exist, and the trabeculae will break, which will lead to a complete fracture. Therefore, patients should rest in time, correct incorrect movements and postures, and avoid repeated stress on the injured area to cause re-injury. Early detection, early treatment and prevention of this disease generally have a good prognosis.

Prevention

The occurrence and development of fatigue fractures is a cumulative injury process from quantitative change to qualitative change. Avoiding bone fatigue damage is the key to preventing fatigue fractures. Exercise should be gradual, and a scientific training plan should be formulated according to one's own situation. The amount of exercise should be controlled to avoid overload exercise that may cause bone damage.

People who exercise more should take in adequate nutrition every day to replenish the calories and water consumed by physical energy, and appropriately increase their intake of calcium and vitamin D. A recent study from Creighton University in the United States shows that even short-term supplementation of calcium and vitamin D can significantly reduce the incidence of stress fractures in athletes.