Section modulus is the optimum geometric predictor for stress fractures and medial tibial stress syndrome in both male and female athletes
Section modulus is the optimum geometric predictor for stress fractures and medial tibial stress syndrome in both male and female athletes
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DOI：
10.1177/0363546508314408
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发表时间：
2008-06-01
影响因子：
4.8
通讯作者：
Morgan, David
中科院分区：
文献类型：
--
作者：
Franklyn, Melanie;Oakes, Barry;Morgan, David
背景：各种胫骨尺寸和几何参数与运动员和新兵的应力性骨折有关，但许多力学参数尚未得到研究。假设：久坐的人、患有胫骨内侧应力综合征的运动员和患有应力性骨折的运动员比未受伤的运动员具有更小的胫骨几何尺寸和参数。证据水平，3。方法：使用总共 88 名受试者，将患有胫骨应力性骨折或内侧胫骨应力综合征的男性和女性患者与未受伤的有氧运动对照和未受伤的久坐对照进行比较。所有受试者的胫骨侦察射线照片和横截面计算机断层扫描图像均在胫骨中三分之一和远端三分之一的交界处进行扫描。胫骨尺寸直接从胶片上测量；结果：未受伤的运动男性比久坐和受伤的男性具有更大的胫骨皮质横截面积，导致其他一些横截面几何参数的值更大，特别是截面模量。然而，对于女性来说，横截面积要么没有差异，要么只是略有不同，并且很少有胫骨尺寸或几何参数可以区分未受伤的锻炼者与久坐和受伤的受试者。在女性中，各组之间的主要差异是由于截面模量值不同而导致皮质骨围绕质心的分布。最后，胫骨内侧应力综合征受试者的胫骨横截面尺寸比未受伤的运动受试者更小，这表明胫骨内侧应力综合征不仅是软组织损伤，也是骨损伤。结论：结果表明，对于男性来说，胫骨的横截面积和截面模数是区分运动和损伤状态的关键参数，而对于女性来说，它只是截面模数。
Background: Various tibial dimensions and geometric parameters have been linked to stress fractures in athletes and military recruits, but many mechanical parameters have still not been investigated.Hypotheses: Sedentary people, athletes with medial tibial stress syndrome, and athletes with stress fractures have smaller tibial geometric dimensions and parameters than do uninjured athletes.Study Design: Cohort study; Level of evidence, 3.Methods: Using a total of 88 subjects, male and female patients with either a tibial stress fracture or medial tibial stress syndrome were compared with both uninjured aerobically active controls and uninjured sedentary controls. Tibial scout radiographs and cross-sectional computed tomography images of all subjects were scanned at the junction of the midthird and distal third of the tibia. Tibial dimensions were measured directly from the films; other parameters were calculated numerically.Results: Uninjured exercising men have a greater tibial cortical cross-sectional area than do their sedentary and injured counterparts, resulting in a greater value of some other cross-sectional geometric parameters, particularly the section modulus. However, for women, the cross-sectional areas are either not different or only marginally different, and there are few tibial dimensions or geometric parameters that distinguish the uninjured exercisers from the sedentary and injured subjects. In women, the main difference between the groups was the distribution of cortical bone about the centroid as a result of the different values of section modulus. Last, medial tibial stress syndrome subjects had smaller tibial cross-sectional dimensions than did their uninjured exercising counterparts, suggesting that medial tibial stress syndrome is not just a soft-tissue injury but also a bony injury. Conclusion: The results show that in men, the cross-sectional area and the section modulus are the key parameters in the tibia to distinguish exercise and injury status, whereas for women, it is the section modulus only.