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Stress fracture and race on foot

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definition:
Fracture that occurs due to excessive mechanical stress on a healthy bone. A stress fracture can affect almost every bone.
 
 
The triggering circumstances:
-The overwork
-An Increase too fast workload
-A Morphotype and footwear
-The Woman 1.2 to 10 times more often than men for the same workload
 
We will share the "triad" of the female athlete combining amenorrhea, eating disorders and osteoporosis.
 
 
The clinical picture:
-appearance A progressively debilitating mechanical pain in the sporting life and daily see at rest, sometimes accompanied by localized edema (swelling).
-The Load testing (in support) and palpation of bone are concerned painful
 
The thing is to think of it, the diagnosis is done by imaging (radiography late, scintigraphy and MRI early).
 
 
Treatment:
Treatment is functional, that is to say, a discharge (relief support) partial or total respect for the pain, with the stoppage of running for 3 to 6 weeks. The recovery will be gradual, with shoes and appropriate corrective insoles.
 
Some clinical forms where the risk of displacement or nonunion (nonunion) often require more stringent immobilization, discharge and sometimes a surgical fixation.
 
                                                                       
The different locations:
 
metatarsals
20% of stress fractures, 50% of stress fractures of the foot M2> M3> M4> M5 and M1, particularly diaphyseal. Differential diagnoses include bursitis (inflammation of a bursa) and Morton's neuroma (inflammatory nodule of a nerve).
 
 
 
Navicular or "tarsal scaphoid"
Described at the right hind leg of racing greyhound (outside of the turn), it relates to the track on the right foot runner (and high jumper of Flop), male and pronator less distance runner. The diagnosis is often very late. Treatment should be stricter (boot and total discharge 4 to 6 weeks) to prevent nonunion whose treatment requires the use of surgery (graft and osteosynthesis).
 
 
Sesamoid of the hallux or "toe"
Concerns over the dancer as the rider. The distinction with sesamoiditis is not easy. Treatment is functional.
 
 
Calcaneus (heel bone)
Described in the military (military march) represents 10-20% of stress fractures. Rare in sports, it is different from Achilles tendinitis. The prognosis is good but the long healing to obtain. We can help with a shock absorbing heel.
 
 
Other fractures of the foot are rare, cuboid, cuneiform, embankments, first phalanx of the great toe, lateral malleolus (cross on uneven ground) and medial. The latter has a high risk of secondary displacement and nonunion (10-15%), requiring a stricter treatment.
 
 
Tibiofibula
Generally transverse, longitudinal exceptionally, it is different from shin splintsInternal although his treatment is no different.
 
 
Femur
For the lower metaphyseal, diaphyseal or neck. Some neck fractures are surgery (risk of secondary displacement).
 
 
Pelvic fracture
Theoretically rare, it would concern 6% of stress fractures in the runner, having a weekly workload of over 100kms. It mainly concerns the pubic bones but also the iliac wing and sacrum.
 

Doctor Yves GUGLIELMETTI. - 2 f├ęvrier 2011.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.

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