Stress fractures in the elderly: different pathogenetic features compared with young patients
Stress fractures in the elderly: different pathogenetic features compared with young patients
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DOI：
10.1007/s40520-013-0105-y
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发表时间：
2013-10-01
影响因子：
4
通讯作者：
Tarantino, Umberto
中科院分区：
文献类型：
--
作者：
Iundusi, Riccardo;Scialdoni, Alessandro;Tarantino, Umberto
应力性骨折主要发生在下肢，这是循环次最大应力的结果。最常受这种特定类型骨折影响的是年轻运动员，军人或患有代谢性骨病如骨质疏松症的老年人。考虑到受影响患者的异质性，可以推测存在不同的致病机制。在年轻人中，骨组织虽然代谢完整，但也由于肌肉疲劳而无法承受长期承受的应力。这导致宏观结构失效和“疲劳”断裂的发展。相反，在老年患者中，有许多生理条件决定了骨代谢的改变。这是骨小梁和皮质骨结构变化的主要原因，这反映在生物力学强度降低。此外，肌肉的情况，如肌纤维萎缩，是不能正确地支持骨组织，导致发展不足骨折。
Stress fractures mainly occur in the lower limb as a result of cyclic submaximal stresses. Most commonly affected by this specific type of fractures are young athletes, military or elderly subjects with metabolic bone diseases like osteoporosis. In consideration of the heterogeneity of affected patients is presumable that there are different pathogenic mechanisms. In young person bone tissue, although metabolically intact, is not able to withstand the stresses to which it is chronically subjected, also because of muscle fatigue. This leads to a macrostructural failure and to the development of "fatigue'' fractures. Instead, in elderly patients, there are numerous physiological conditions that determine a bone metabolism alteration. This is the main reason for the structural changes in trabecular and cortical bone, which is reflected in reduced biomechanical strength. In addition, muscular situation, such as muscle fiber atrophy, is unable to correctly support bone tissue, leading to the development of insufficiency fractures.