Tibial stress fracture
Introduction
Introduction to humeral stress fracture Stress fracture is a common injury in sports and military training. It is a type of overuse injury. It is also called fatigue fracture. Unlike acute fracture caused by violence, stress fracture is the result of repeated subthreshold damage accumulation. It is characterized by simultaneous destruction and repair of bone. basic knowledge The proportion of the disease: the probability of the population is 0.21% Susceptible people: no special people Mode of infection: non-infectious Complications: fracture
Cause
Causes of humeral stress fracture
(1) Causes of the disease
The disease is caused by excessive use of injuries in sports and military training.
(two) pathogenesis
The humeral stress fracture was first proposed by Alemen in 1929; in 1956, Burrous reported the "sacral fatigue fracture" of five ballerinas. In 1958, Devas reported 17 fractures of the tibia in athletes, 11 of which had fracture lines. In 6 cases, only periosteal reaction occurred. In 1975, Clement suggested that excessive stress first caused fatigue of the calf muscle, which caused it to lose the effect of absorbing stress. Thereafter, the stress directly acts on the tibia, causing periostitis and fracture of the humerus. It can be gradually adapted to the change of stress through the modification of its internal structure. In most cases, it does not cause fracture. Therefore, a type of injury with only subperiosteal hyperplasia and no obvious fracture line is also called stress periostitis. In addition to the stress response of the bone, stress periostitis may also be associated with the pulling of muscle and interosseous membranes, which is actually a type of stress fracture.
Prevention
Tibial stress fracture prevention
Stress fractures are important in prevention. In recent years, there have been many research reports on stress fracture prevention in sports and training at home and abroad, and there are roughly the following aspects.
1. Select venues and improve equipment
Reduce stress damage by selecting sports grounds and improving equipment, such as Greaney (1983) for grass, Mepoil (1991) for padded shoes, and Milgrom (1992) for shock-absorbing shoes. Site selection should avoid decks, concrete pavements. It is hard, but it is better to have a flat soil or gravel site.
2. Scientific arrangement training
Control training intensity to facilitate the balance of stress bone destruction and bone repair. For recruits and young athletes, emphasis should be placed on gradual and progressive exercise. According to the incidence of stress fractures, Scully (1982) proposed periodic training and advocated training. In the third week, upper limbs or other adaptive training was arranged to avoid the peak period of stress fracture of lower limbs. Zhang Liansheng (1992) bone balance training method and Huang Changlin (1994) intensive circulation training method all achieved obvious preventive effects.
3. Improve training skills and stress distribution
By continuously changing the stress concentration zone of the bone during training to achieve the purpose of preventing stress fractures, Liu Daxiong et al. (1996) alternately used flat shoes and wedge shoes in the soldiers' weight-bearing march training, which significantly reduced the stress fracture of the humerus. Incidence rate, in the middle and long-distance running training, you can consciously choose the site with different slopes, so that the stress concentration area of the humerus under load changes continuously to reduce the destructive change of the bone part. It is advocated to alternately arrange the weight-bearing march and running training, which can reduce the stress. The occurrence of sexual injury may not affect the course requirements and overall effect of lower limb training.
4. Preparation before training
Prepare for pre-training activities and relaxation exercises after training to avoid exercise and training under psychological stress and physical fatigue. Zhang Li (1995) applied psychological intervention to allow trainees to maintain a good psychological state and make training injured. The incidence rate was significantly reduced. Li Zuguo (1994) analyzed the risk factors of stress fracture in basic training of recruits, emphasized the harmfulness of training in training with injuries and fatigue. In addition, he should pay attention to medical supervision of sports and training, and often ask trainees. Self-perception, regular inspection of the predilection site of stress fractures, in order to achieve early detection of early damage, timely prevention of stress fractures.
Complication
Complications of humeral stress fracture Complications
Long-term non-healing of the fracture site may occur.
Symptom
Symptoms of humeral stress fracture common symptoms joint swelling periostitis bone pain
The patient has a history of overuse injury such as long-distance running, walking, marching, etc. The initial symptoms are concealed. There is local pain only when the lower limbs are loaded with weight. After the pain is gradually aggravated, the rest can not completely disappear, and there may be a gradual increase in local swelling and tenderness. In addition to individual causes of complete fractures, physical activity is often not limited.
Examine
Examination of humeral stress fracture
There was no positive finding in the early stage of X-ray film, but the long-term adherence to the trainer showed that the X-ray film showed stress fracture.
Diagnosis
Diagnosis and diagnosis of humeral stress fracture
According to the medical history, clinical manifestations and X-ray films can be diagnosed, especially in patients with a history of overuse injury, such as local swelling and pain in the calf, tenderness, no improvement in the prolonged days or worse, although the X-ray film is not positive at this time. It was found that the disease should be highly vigilant and should not be treated as a soft tissue injury.
