4 Kang, et al, further emphasized that the type of fracture is the most important factor influencing complication rate, with displaced fractures causing the highest rates. To avoid possible complications such as avascular necrosis, refracture, pseudarthrosis, and prolonged recovery time, early diagnosis of stress fractures is essential. A three- to four-month preparation period for a marathon is common among well-conditioned runners.
In contrast, in the case presented here, an abrupt change in training intensity could not be identified. Sudden and abrupt changes in the athletes’ training regimen were identified as the main factors in the development of stress fractures. Kang, et al, 3 retrospectively reported on seven cases of femoral stress fractures in female athletes. 2 An accumulation of structural damage could result in complete fracture. The characteristics of the loading stimulus (eg, frequency of loading, number of load repetitions) are essential for injury development.
1 In locomotor tasks, such as running, the impact phase constitutes peak magnitudes of force. This is partially explained by the fact that the largest bending moments during movements occur at the proximal femur. A noncontrast computed tomography scan three months after presentation revealed a non-displaced fracture of the right femoral diaphysis extending from middle of the shaft up to the neck (Figure 2) with callus formation around the shaft Diagnosisįemoral fractures are among the most common sites of stress-related injuries. Follow-up MRI six weeks post-treatment demonstrated persistent bone marrow edema, as did a third MRI examination eight weeks after initial imaging. Initial, conservative therapy consisted of six weeks of partial weight-bearing. Magnetic resonance imaging (MRI) revealed intraosseus signal changes on T1 and T2-TIRM sequences in the proximal femoral diaphysis (Figure 1) representing bone marrow edema. Imaging Findingsįindings on radiographs were unremarkable. Lumbar spine and sacroiliac joints were clinically normal. No localized tenderness or swelling were evident. Nonspecific pain in the right thigh could be provoked by forced passive ROM testing of the hip.
#Stress fracture free
Physical examination revealed free range of motion (ROM) of both hips and knee joints. The patient’s pain was increased during hip extension exercises. A seasoned amateur longdistance runner, the patient endorsed a rigorous training protocol. A young adult presented with a three-month history of persistent pain in the right thigh after running a marathon.
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