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stress fracture - Coggle Diagram
stress fracture
Stress fracture by type of sport. [5]
Sport Location
Track and Field athletes
Navicular
Tibia
Metatarsals
Distance Runners
Tibia
Fibula
Dancers
Metatarsals
Military recruits
Calcaneus
Metatarsals
treatment
拐杖、輔助鞋(減少weight bearing)
調整活動或停止特定運動(如果個案移動時就會疼痛，受傷處應immobilized)
循序漸進的增加活動強度
增強周遭肌肉力及柔軟度
在復健時，不應有疼痛出現
在活動完成後，疼痛不應加劇
可以加強運動前熱身、運動後可用冰敷
大部分骨頭stress fracture都可透過上面保守治療來解決
risk factors
營養不夠
女性:因骨密度可能較低
footwear、equipment、enviroment
骨密度太低
previous history of stress fracture
太高或太低BMI
characteristic
tenderness
aggravataing factor:activity
水腫
活動時疼痛加劇，休息時緩解
沒有重大事件傷害便引起症狀的產生
differential diagnosis
Tendinopathy
Compartment syndrome
Nerve or artery entrapment syndrome
Shin splints
examination
tenderness
edema
one leg hop test:
分別shin spilints跟stress fracture of tibia
fulcrum test
pathophysiology
repetitive microtrauma
可能因loading或muscle contraction force導致，或是兩者都有
medial tibial syndrome(shin splints):可以算是stress fracture的早期，不處理會逐漸演進到stress fracture
大部分都發生在下肢
tibia:49%
tarsal:25%
metatarsal:9%
femur:9%
fibula:9%
少部份發生ulna
有些人將stress fracture=fatigue fracture