Risk factors for recurrent stress fractures in athletes
Risk factors for recurrent stress fractures in athletes
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DOI：
10.1177/03635465010290030901
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发表时间：
2001-05-01
影响因子：
4.8
通讯作者：
Hulkko, A
中科院分区：
文献类型：
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作者：
Korpelainen, R;Orava, S;Hulkko, A
我们的目的是确定导致运动员多发应力性骨折的因素，重点是生物力学因素。我们的假设是踝关节的某些解剖因素与运动员下肢多发应力性骨折的风险有关。31名运动员（19名男性和12名女性）每人至少有三次独立的应力性骨折，以及15名没有骨折的对照组运动员完成了一份调查问卷，主要关注应力性骨折的假定危险因素，如女性的营养、训练史和激素史。采用双能x线骨密度仪测定腰椎和股骨近端骨密度。测量了足部结构、踝关节旋前和旋后、踝关节背屈、前足内翻和外翻、腿长不均匀、髋关节旋转范围、简单和选择性反应时间以及站立平衡等生物力学特征。每位运动员平均发生3.7例骨折（范围3 ~ 6例），共计114例骨折。70%的男性骨折发生在胫骨或腓骨，50%的女性骨折发生在足部和踝关节。大多数患者为跑步者（61%）；平均每周跑步里程为117公里。与多重应力性骨折相关的生物力学因素包括足纵向弓高、腿长不均匀和前足过度内翻。近一半的女性患者（40%）报告月经不规律。每周训练里程高的跑步者被发现有下肢复发性应力性骨折的风险。
Our aim was to identify factors predisposing athletes to multiple stress fractures, with the emphasis an biomechanical factors. Our hypothesis was that certain anatomic factors of the ankle are associated with risk of multiple stress fractures of the lower extremities in athletes. Thirty-one athletes (19 men and 12 women) with at least three separate stress fractures each, and a control group of 15 athletes without fractures completed a questionnaire focusing on putative risk factors for stress fractures, such as nutrition, training history, and hormonal history in women. Bone mineral density was measured by dual-energy x-ray absorptiometry in the lumbar spine and proximal femur. Biomechanical features such as foot structure, pronation and supination of the ankle, dorsiflexion of the ankle, forefoot varus and valgus, leg-length inequality, range of hip rotation, simple and choice reaction times, and balance in standing were measured. There was an average of 3.7 (range, 3 to 6) fractures in each athlete, totaling 114 fractures. The fracture site was the tibia or fibula in 70% of the fractures in men and the foot and ankle in 50% of the fractures in women. Most of the patients were runners (61%); the mean weekly running mileage was 117 km. Biomechanical factors associated with multiple stress fractures were high longitudinal arch of the foot, leg-length inequality, and excessive forefoot varus. Nearly half of the female patients (40%) reported menstrual irregularities. Runners with high weekly training mileage were found to be at risk of recurrent stress fractures of the lower extremities.