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1.
A 62-year-old man rose from a crouched position with a twisting motion and developed pain in the lower third of his left tibia. 2 weeks later, radiographs were normal. Pain persisted and 3 months later radiographs revealed a longitudinal lucency in the distal tibia on the lateral view and a corresponding thin sclerotic band on the AP view suggesting a stress fracture (Figure). The leg was immobilized in a cast. A CT scan confirmed a healing stress fracture with endosteal and subperiosteal new bone formation. The cast was removed at 6 weeks, radiographs showed healing and the patient has remained asymptomatic. 相似文献
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Melih Malkoc Ozgur Korkmaz Tugrul Ormeci Ismail Oltulu Mehmet Isyar Mahir Mahirogullar? 《International journal of surgery case reports》2014,5(8):500-504
INTRODUCTION
Stress fractures (SF) occur when healthy bone is subjected to cyclic loading, which the normal carrying range capacity is exceeded. Usually, stress fractures occur at the metatarsal bones, calcaneus, proximal or distal tibia and tends to be unilateral.PRESENTATION OF CASE
This article presents a 58-year-old male patient with bilateral posterior longitudinal tibial stress fractures. A 58 years old male suffering for persistent left calf pain and decreased walking distance for last one month and after imaging studies posterior longitudinal tibial stress fracture was detected on his left tibia. After six months the patient was admitted to our clinic with the same type of complaints in his right leg. All imaging modalities and blood counts were performed and as a result longitudinal posterior tibial stress fractures were detected on his right tibia.DISCUSSION
Treatment of tibial stress fracture includes rest and modified activity, followed by a graded return to activity commensurate with bony healing. We have applied the same treatment protocol and our results were acceptable but our follow up time short for this reason our study is restricted for separate stress fractures of the posterior tibia.CONCLUSION
Although the main localization of tibial stress fractures were unilateral, anterior and transverse pattern, rarely, like in our case, the unusual bilateral posterior localization and longitudinal pattern can be seen. 相似文献3.
Minoru Doita Yoshihiro Ando Soichiro Hirata Hitoshi Ishikawa Masahiro Kurosaka 《European spine journal》2009,18(Z2):206-209
A case of bilateral pedicle stress fracture of L4 in a patient with osteoporotic compression fracture of L5 and without a
history of major trauma or surgery is reported, and the literature is reviewed. Bilateral pedicle fracture is a rare entity
and few cases have been reported in the literature. All reported cases had some underlying causative factors like previous
spine surgery or stress related activities. To the best of the authors’ knowledge, only one case of bilateral pedicle stress
fracture without a history of trauma, previous spine surgery, or stress-related activities has been reported. A 77-year-old
woman presented with severe low back pain and radiating pain in the right leg that was exacerbated after standing and walking.
Plain radiograph showed pathological fracture at L5 level. Magnetic resonance imaging (MRI) revealed the compression of dural
sac at L5 level. CT scan taken 3 months after admission revealed bilateral pedicle fractures through L4. The patient was treated
with decompressive laminectomies of L4, followed by posterior spinal fusion with rigid pedicle screw fixation and autogenous
bone graft mixed with hydroxyapatite. The patient achieved pain relief and returned to normal activity. Stress fracture of
the pedicle within the proximal vertebra of an osteoporotic compression fracture of lumbar spine is an uncommon entity. It
may, however, be an additional source of symptoms in patients with osteoporosis who present with further back pain. Surgeons
caring for this group of patients should be aware of this condition. 相似文献
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《Foot and Ankle Surgery》2007,13(3):157-160
In pre-adolescent patients supramalleolar osteotomies have been described to correct deformities following ankle fractures. However, the techniques described involve the harvesting of an iliacal graft. We report on a case of a 14-year-old girl who sustained a complex ankle fracture with a resultant hindfoot varus. The medial opening was maintained by using a plate with a metallic block interposed in the osteotomy plane (Puddu Plate). 相似文献
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Varatharaj Mounasamy Quanjun Cui Khaled J. Saleh William M. Mihalko Thomas E. Brown 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2007,17(5):499-501
Insufficiency fractures of the proximal tibia with non-union, are relatively rare and difficult to treat with ipsilateral osteoarthritis of the knee. We report a case of symptomatic osteoarthritis of the knee, with non-union of a stress fracture of the ipsilateral proximal tibia treated with posterior stabilized total knee arthroplasty with a long stemmed tibial component to stabilize the non-union fragments. 相似文献
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F C Spector J M Karlin S DeValentine B L Scurran S L Silvani 《The Journal of foot surgery》1983,22(4):358-361
Stress fractures in athletes are frequently a misdiagnosed and poorly understood clinical entity. As a rule, their occurrence in the tibia is limited to the junction of the middle and distal third. We describe a distal spiral tibial stress fracture in a jogger and review the pathomechanics, diagnosis, and management of such lesions. 相似文献
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Tachikawa M Enomoto S Enomoto Y Terauchi T Arai T Inoue H Okuda Y 《Masui. The Japanese journal of anesthesiology》2008,57(3):360-362
The authors describe the successful anesthetic management of a patient with Ebstein's anomaly and Wolff-Parkinson-White syndrome who underwent repair for foot joint fracture. Anesthesia was provided by combined spinal-epidural block to minimize hemodynamic changes which cause an increase in right-to-left shunt and hypoxemia. We estimated hemodynamic status using radial arterial pressure, central venous pressure and ECG from the start of anesthesia. During anesthesia, his vital signs were unchanged to any significant degree. The recovery was rapid and the postoperative course was uneventful. 相似文献
8.
Prophylactic intramedullary fixation of the tibia for stress fracture in a professional athlete. 总被引:1,自引:0,他引:1
Prophylactic intramedullary nailing of the tibia for stress fracture was performed successfully in a professional football player, enabling him to resume his career. No similar case has been reported previously. 相似文献
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目的 探讨兔应力性骨折发生过程中胫骨生物力学指标的变化与应力性骨折发生的关系.方法 将36只雄性大耳白兔随机分为6组,进行跑跳训练,根据制定的分组训练时间,于训练任务完成后的第7、14、21、28、35天分别处死动物.光镜下观察胫骨病理变化;生物力学机上行胫骨三点弯曲生物力学测试,描记载荷-变形曲线,并根据该曲线及相应参数分析胫骨生物力学性能.结果 实验组动物训练第2、3、4、5周后最大载荷与对照组动物相比之差异均有统计学意义(P<0.05).实验组动物第1、2、3、4、5周后载荷与变形量之比与对照组动物相比之差异均有统计学意义(P<0.05),最大应力和弹性模量与对照组动物相比之差异则均无统计学意义(P>0.05).结论 应力性骨折的发生是一个由骨细胞直接参与的破骨细胞性重吸收大于成骨细胞性骨形成的生理过程;胫骨结构力学性能的改变是由胶原纤维紊乱、骨皮质厚度降低等所造成,从而导致应力性骨折的发生. 相似文献
14.
经腓骨固定胫骨结合踝关节支架治疗Pilon骨折不愈合 总被引:1,自引:0,他引:1
[目的]介绍经腓骨固定胫骨结合踝关节支架治疗Pilon骨折不愈合的方法并初步探讨其疗效。[方法]1999-2004年共收治Pilon骨折不愈合者6例,男4例,女2例;年龄21-53岁,平均34.7岁。所有骨折均累及胫骨关节面并腓骨骨折,胫骨骨折不愈合,踝关节畸形。通过后外侧入路显露腓骨胫骨,复位满意后选用重建钢板置于腓骨外侧,螺钉通过腓骨钻入胫骨固定。小腿内侧选用踝关节外固定架固定。取自体髂骨植骨于骨断端和胫腓骨间区域以获得骨性愈合和下胫腓融合。[结果]随访8个月-4年,平均22个月。5例获得骨性愈合,平均愈合时间3.5个月。1例因过早去除踝关节支架且负重,出现钢板断裂再折。[结论]对于Pilon骨折不愈合,采用小腿后外侧入路经腓骨固定胫骨结合踝关节支架,是提高复位质量,促进骨折愈合,纠正关节畸形,防止并发症的有效方法,且相对更简便可靠。 相似文献
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Haspl M Jelić M Pećina M 《Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca》2003,70(5):303-305
The authors describe two cases of severely angulated tibial non-unions after proximal tibia stress fractures associated with ipsilateral osteoarthritis treated with modular knee endoprosthesis with a long tibial stem to stabilize non-union fragments. During the procedure, no additional osteosynthesis or bone grafting was added. Both non-unions healed after 6 months with no post-operative complications. The authors suggest implantation of modular knee endoprosthesis, as a single procedure, in treatment of proximal tibia non-union after a stress fracture as a result of severe varus/valgus deformity. It provides a solution for osteoarthritis treatment, axis correction and non-union osteosynthesis. 相似文献
16.
A 12-year-old boy with a severe injury of his right ankle was treated in the accident unit. The local condition was an extensive open wound with parts of the fractured bones prominent. Radiographs showed a severely displaced fracture of the body of the talus associated with a Salter-Harris IV injury of the distal tibia and subluxation of the ankle. After proper debridement the fractured bones were reduced and fixed. Eleven years later both fractures are completely healed without any sign of avascular necrosis, the patient has full painless ankle movement and he can perform his demanding occupation without any problem. 相似文献
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The treatment of open distal tibia fractures remains challenging, particularly when the fracture is infected and involves segmental bone loss. We report the case of a 38-year-old man who sustained an open distal tibiofibular fracture with segmental bone loss and a closed proximal tibial fracture. The fractures were initially fixed with a temporary external fixator. The open distal tibial fracture was infected, and the skin was covered after the wound became culture negative. The tibia was then internally transported with a ring external fixator; the closed fracture of the proximal tibia served as the corticotomy for internal transport without conventional corticotomy. After 5?cm internal transport, the docking site of the distal tibia was fixed with a locking plate and autogenous cancellous bone graft. Bone graft was also used to the distal tibiofibular space to achieve distal tibiofibular synostosis. We describe one treatment option for an infected open fracture of the distal tibia with segmental bone loss that is accompanied by a closed fracture of the proximal tibia. This method can treat two fractures simultaneously. 相似文献
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A double-stress fracture of the tibia in a 10-year-old girl is described. Double-stress fracture of the tibia has previously been described in association with osteoarthritic varus deformity of the knee but not, to our knowledge, in a child. It is important to establish the diagnosis of stress fracture in childhood because the differential diagnosis, both clinically and on imaging, includes malignancy that must be excluded while avoiding unnecessary invasive investigations. The site of the lesions, their appearance on magnetic resonance imaging, the absence of any soft-tissue involvement, and the clinical history made the diagnosis possible. The characteristics of stress fracture shown on magnetic resonance imaging are described. 相似文献
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Damian A. O'Connor Chalikonda V. R. Prasad 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2003,13(3):171-172
We report the case of an extraphyseal ankle fracture involving the medial malleolus in a 12-year-old boy with open growth plates. The child was treated non-operatively and made a full and uneventful recovery. The case presented is unique in that a non-direct impact ankle fracture occurred without violating the growth plate. We examine the injury and, more importantly, analyse the diagnosis, treatment and follow-up of the condition. The injury has not been published in the orthopaedic literature to date and is an original finding. 相似文献