军训胫骨应力骨折并发急性骨折25例X线分析

目的　研究胫骨应力性骨折并发急性骨折的 X线表现。方法　对军训胫骨应力性骨折并发急性骨折 2 5例的 X线进行分析。结果　 X线特征为胫骨内后 (外 )侧见骨膜增生和 (或 )骨痂形成 ,均系不完全骨折 ,骨折线起源于骨膜增生和 (或 )骨痂高度的中间平面 ,自内后侧向外前方向延伸 ,多数累及增生骨膜和 (或 )骨痂 ,对位对线良好。结论　根据 X线特点 ,结合病史和临床表现对应力性骨折并发急性骨折可作出明确诊断     

军训股骨应力性骨折的CT诊断(附8例X线与CT对照)

目的　总结股骨应力性骨折的CT特征。方法　分析军训所致的 8例股骨应力性骨折的CT资料 ,并与X线片进行对照。结果　股骨周边的环状或半环状单层或双层高密度影是股骨应力性骨折的特征性CT表现 ,部分病例可见骨髓腔密度增高和 (或 )多处骨质不连。结论　根据CT特征 ,对股骨应力性骨折CT能作出明确诊断 ,在诊断及鉴别诊断方面 ,CT优越于普通X线     

胫骨应力性骨折48例X线诊断

1995年2月～1997年5月,我院收治训练致胫骨应力性骨折48例,现将其X线诊断情况报告如下。1　临床资料1.1　一般情况　本组均为男性,年龄16～20岁,平均17.8岁。新兵42例,第2年度兵6例;城镇兵30例,农村兵18例。就诊时间:伤后20d～6个月。致伤部位均位于胫骨后内侧,上段40例,中上1/3处6例,中段2例;右胫骨25例,左胫骨23例。其中继发完全性骨折3例,可疑肿瘤经随访确诊为慢性骨折2例。患者多以小腿疼痛就诊,呈跛行步态,疼痛明显处皮肤发亮,肿胀隆起,有时发红,有灼热感,隆起处质地较硬,高低不平,有压痛。实验室检查:血沉正常,白细胞轻度增高36例。1…     

军训应力性骨折106例影像特征

应力性骨折临床有时容易误诊为骨髓炎或肿瘤性病变。本研究搜集了2002～2006年发生应力性骨折的新入伍战士106例,复习不同部位应力性骨折的影像学资料,结合国内外文献,分析该病的特征及发病原因,旨在提高对本病的认识,科学训练,尽可能避免或减少应力性骨折的发生。     

应力性骨折的X线诊断

应力性骨折又称疲劳性骨折，或行军骨折。是指正常骨骼因轻度损伤的积累，如长期负重、行走等引起的骨折。我院2000年—2002年以来收治17例，现就其X线表现探讨如下。     

耻骨支应力性骨折的X线诊断

目的 探讨耻骨支应力性骨折的X线表现及其诊断价值。方法 回顾性分析66例耻骨支应力性骨折的X线表现。男18例,女48例,年龄18－21岁。其中55例为参加入伍基础训练的新兵,11例为参加高强度正步训练的老兵。结果 单纯耻骨下支骨折62例,其中右侧26例、左侧30例、双侧6例,同侧耻骨上下支双骨折4例。3例发病2周内X线检查为阴性;66例4周至8个月X线检查有明显的透亮骨折线（34例）或（和）致密骨痂（65例）。结论 X线检查是本病首选的影像手段,大多数病例根据X线表现及临床资料可作出正确诊断。     

胫骨应力性骨折的早期X线诊断

胫骨应力性骨折的早期Ｘ线诊断武警山西总队医院放射科曹伟芳米俊杰（太原０３０００６）关键词骨折胫骨Ｘ线应力性骨折亦称疲劳性骨折,发生在胫骨者虽不多见,但部队发病率相对较高,早期因骨折线不能见到而易误诊,甚至被误诊为恶性肿瘤而截肢者亦屡见不鲜［１］。本文...     

新兵军训致胫骨应力骨折48例分析

本文收集我院 1 988年 7月～ 1 998年 7月收治的资料完整的新兵胫骨应力骨折 4 8例 ,结合有关文献 ,就其诊治方法和预防措施作一粗浅探讨 ,现报告如下。1　临床资料1 1　一般资料　本组 4 8例 ,年龄 1 8～ 2 1岁。均发病于新兵 3个月集训期间 ,病史 1 5ｄ～ 6个月 ,平均 70ｄ。均有反复高强度训练史 ,以每天 5ｋｍ越野行军为主 ,其次为三大步伐训练、军体训练 ,1例为“后倒功”训练摔伤患侧小腿就诊。右侧胫骨 2 0例 ,左侧 2 7例 ,双侧 1例 ;胫骨中上段1 /3处 3 2例 ,中段 1 4例 ,中下段 1 /3处 3例 ;其中双侧胫骨罹患 1例均发生于中下段 1…     

胫骨应力性骨折的早期诊断和治疗

临床资料 应力性骨折患者236例,均为男性,年龄16～33岁;其中战士219例,运动员15例。患者都有较大强度训练运动史。初起表现为胫骨患处不适、肿胀、疼痛,后期出现明显肿胀、压痛、纵向叩击痛。其中78例演变为完全性骨折,骨折瞬间有明显疼痛,局部畸形,不能站立,X线显示骨膜增生或骨痂形成,局部骨质硬化或骨小梁致密,横折或斜折,为完全性骨折。保守治疗165例,跟骨牵引32例,局部钻孔减压3例,切开复位钢板内固定45例。     

CR和CT对军训致下肢应力性骨折的诊断价值比较

目的比较CR和CT对军训致下肢应力性骨折诊断意义。方法对40例军事训练中怀疑下肢应力性骨折的战士,行相应部位CR摄像,其中16例同时行CT扫描。结果28例诊断为应力性骨折,其中单独经CR诊断12例,经CR与CT共同诊断12例,CR阴性为CT补充诊断4例;单侧胫骨20例,双侧胫骨2例,蹠骨6例。结论下肢应力性骨折具有特征的CR和CT表现,对诊断下肢应力性骨折各有优点。     

军事训练膝关节应力性损伤部分风险因素探讨

目的：探讨军事训练膝关节应力性损伤的组织特点、风险因素评估、发病及流行趋势。方法：回顾性分析我院2010-12-2012-12军事训练膝关节应力性损伤患者的MR资料共计99例,102个膝关节,对每一例膝关节MR图像的组织结构及信号强度进行分析、比较,根据不同性别、不同年龄组膝关节组织损伤的不同例数进行统计分析。结果：前交叉韧带98例,关节腔积液76例,胫骨近端42例,股骨远端38例,内侧副韧带34例,后交叉韧带31例,外侧副韧带24例,内侧半月板18例,外侧半月板11例。采用SPSS13.0统计学软件,方差分析方法,不同性别膝关节组织损伤病例数之间有显著性差异（P〈0.05）;不同年龄组膝关节组织损伤病例数之间无显著差异性（P〉0.05）;两两比较,〈20岁人群中的部分组织病例数具有差异性。结论：膝关节应力性损伤的风险因素与年龄、性别、训练科目等因素有关,前交叉韧带损伤发生频度最高,其次是滑膜,组织的损伤与不同的应力作用方式有关。     

Altered forefoot function following a military training activity

BackgroundInjury rates are high in populations that regularly undertake weight-bearing physical activity, particularly military populations. Military training activities, that often include load carriage, have been associated with lower limb injury occurrence, specifically stress fractures.Research questionRecent work identified plantar loading variables as risk factors for lower limb stress fractures in Royal Marines recruits that were assessed during barefoot running. This study aimed to quantify how those plantar loading variables changed in Royal Marines recruits following a prolonged military load carriage activity, to further understand potential mechanisms for lower limb stress fractures.MethodsBilateral, synchronised plantar pressure and lower limb kinematic data were recorded during barefoot running at 3.6 m s⁻¹ (±5%) pre- and post- a 12.8-km training activity (∼150 min). The training activity was completed with an average speed typical of walking (1.4 m.s^-1), and 35.5 kg of additional load was carried throughout. Data were collected from 32 male Royal Marines recruits who completed the training activity in week-21 of the 32-week training programme. Plantar pressure variables and ankle dorsiflexion were compared between pre- and post-activity.ResultsPost-activity there was reduced loading under the forefoot and increased loading under the rearfoot and midfoot. There was no change in dorsiflexion touchdown angle, but an increase in peak dorsiflexion and range of motion post-activity.SignificanceThe increased rearfoot loading, reduced forefoot loading and increased ankle dorsiflexion following a prolonged military load carriage activity suggest a reduced transfer of loading from the rearfoot to the forefoot during stance, which may have implications for the development of stress fractures, particularly of the metatarsals.     

Longitudinal stress fractures of the tibia: diagnosis by magnetic resonance imaging

 Objective. Previous works describe magnetic resonance (MR) imaging characteristics of stress fractures. Diagnosis of the atypical, longitudinal type of stress fracture has been reported using computed tomography (CT). This report focuses on MR imaging of longitudinal stress fractures of the tibia. Materials and methods. Six cases are presented in which a longitudinal linear abnormal marrow signal was detected in the middle and distal parts of the tibial shaft. Five patients were imaged using a 1.5 Tesla MR unit. Axial, sagittal and coronal T1 and T2-weighted or fat suppressed proton density fast spin echo images were obtained in all but one patient. One patient was imaged using a 0.5 Tesla MR unit with axial and coronal T1- and T2-weighted sequences. Initial conventional radiographs seen at clinical presentation were interpreted as normal in all cases. Two patients underwent radionuclide bone scan, and one patient was imaged with CT prior to MR imaging. Results. In each instance, MR imaging demonstrated linear marrow signal abnormalities orientated along the long axis of the tibial shaft. Endosteal and periosteal callus was identified on axial images. In all cases, MR imaging clearly demonstrated a fracture extending through one cortex with abnormal signal in both the marrow cavity as well as adjacent soft tissues indicating edema. Conclusion. MR imaging was shown to be excellent for demonstration of fracture lines, callus, and marrow and soft tissue abnormalities seen in association with longitudinal stress fractures.     

不同兵种训练伤流行病学调查

目的：了解步兵、炮兵和特训兵三兵种平时训练伤流行病学特征,为防治伤病提供科学依据。方法：参照《中国人民解放军军事训练伤诊断分类标准》,对1 613例训练伤从兵种、年龄、损伤时间、损伤部位及性质进行比较分析。结果：①步兵年均训练伤发生率为4.9%,炮兵2.5%,特训兵5.2%,步兵、特训兵与炮兵比较,差异显著（P〈0.05）;②全年训练伤发病率以7月份最高;③发生于18～22岁组的训练伤为59.5%,高于其他年龄组;④急性创伤性损伤以骨折多见,慢性疲劳性损伤以腰部劳损多见,训练伤发生率步兵、特训兵以下肢损伤最高,炮兵以腰部损伤最高。结论：步兵和特训兵比炮兵更易发生训练损伤,三兵种的慢性疲劳性损伤发生率均高于急性损伤。     

椎体缺血性压缩骨折的X线、CT诊断

目的：探讨椎体缺血性压缩骨折的X线、CT表现特征及其诊断价值.方法：对30例椎体缺血性压缩骨折的X线、CT表现进行研究,并与100例椎体非缺血性压缩骨折的X线、CT表现进行对照.结果：X线检查30例,显示椎体内横向真空裂隙征24个（78.1%）、空泡征5个（15.6%）、空穴征2个（6.3%）.CT检查10例,显示上述征象者分别为6个（60%）、3个（30%）、1个（10%）.X线正位片真空裂隙宽于侧位片,过伸位或仰卧背部加垫摄片显示更佳.CT除更清楚显示X线所显示的真空裂隙外,尚能显示微小线样裂隙,并真实显示空泡裂隙的数目、病灶范围.100例对照组中无1例显示椎体内真空裂隙征.结论：椎体内空泡裂隙征是椎体缺血性压缩骨折的特征性表现,具有重要的诊断价值.X线与CT结合有助于提高本病的诊断率.     

陆海空新兵基础训练期间军事训练伤的流行病学调查

目的：了解我军各军种训练伤的流行病学特征,初步分析致伤原因。方法：选取陆海空三军参加１９９８年度基础训练的２４４７名新兵,统一进行流行病学调查。结果：陆海空三军总发生率２９．４％,陆军为３２．８％,海军为;２８．２％,空军为２５．０％。陆军与海军和空军有显著性差异,海军与空军无显著性差异。支队间发生率有显著性差异。陆军与海军开训后第７周为发生高峰,海军的高峰期略晚;各部位损伤中以下肢２５．１％的发生率为最高（构成比为８５．４％）;各类型损伤中以过劳性损伤１７．３％的发生率为最高（构成比为５８．９％）。结论：加大训练强度可导致训练伤发生人数的增加,训练伤发生的部位与主要受训部位相一致;训练内容与安排不同,训练伤的发生率不同。     

Computed tomography of stress fracture

An athletic young female developed gradual onset of pain in the right leg. Plain radiographs demonstrated solid periosteal reaction in the tibia compatible with stress fracture. She stopped sport activites but her pain continued. Follow-up radiographs of the tibia revealed changes suspicious for osteoid osteoma. Computed tomography (CT) scan demonstrated periosteal reaction, but in addition, lucent fracture lines in the tibial cortex were evident. CT obviated the need for more invasive diagnostic procedures in this patient. In selected cases CT may be useful to confirm the diagnosis of stress fracture when plain radiographic or routine tomographic studies are not diagnostic.     

Non-union of a midshaft anterior tibial stress fracture: A frequent complication

We report a case of non-union of a midshaft anterior cortex tibial stress fracture and review the literature concerning this pathological entily. This is a relatively rare clinical form of tibial stress fracture which often results in delayed union, non-union or complete fracture. Initial management is as for a conventional stress fracture, associated in some cases, according to certain authors, with pulsing electromagnetic field physiotherapy. If after 4–6 months no sign of union is present, surgical management is indicated, in the form of excision of the fracture site with or without bone graft.     

海勤人员军事训练致肌肉损伤的超声诊断

目的探讨超声检查对海勤人员军事训练所致肌肉损伤的诊断价值。方法对64例由军事训练所致的肌肉损伤患者取合适体位后，在病变部位行纵、横等多方位扫查，并用彩色多普勒观察其内部血流状况。结果完全性肌肉断裂伴血肿14例，超声诊断符合率100％；肌肉部分断裂伴血肿22例，超声诊断符合率95．5％；一般性肌肉损伤28例，初次超声检出率92．9％，复诊检出率100％。结论超声检查对军事训练所致的肌肉损伤诊断准确率高，在临床上具有应用价值。     

脊柱骨折的CT诊断

目的:探讨西藏高原地区脊柱骨折的CT影像表现和诊断价值。方法:对45例脊柱外伤的CT扫描影像表现进行了回顾性的分析。男38例,女7例,年龄21～72岁。结果:CT能够准确地发现脊柱骨折的部位,三柱的损伤情况,椎管狭窄的程度,椎体骨折的类型。本组病例中,颈椎骨折的发生率最低,胸腰椎骨折的发生率最高。结论:在脊柱外伤中CT作为重要的首选检查方法,可快速准确地作出诊断,为临床提供治疗依据。