RESEARCH - Early diagnosis key for femoral stress fractures

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Early diagnosis key for femoral stress fractures

Last Updated: 2006-06-30 10:13:33 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Croatian researchers have come up with new

guidelines for treating stress fractures of the femur, or thighbone, that

prevent complications and difficulties that often occur with the condition,

they say.

Stress fractures arise when bones are subjected to repetitive loading but

the forces are not strong enough to causes an immediate break. Femoral

stress fractures are rare, occurring chiefly in athletes and military

recruits, Dr. A. Ivkovic and colleagues from the University of Zagreb

Medical School write in the British Journal of Sports Medicine.

" Nevertheless, they do pose a great challenge for both diagnosis and

treatment, " Ivkovic and his team write. Such fractures have few symptoms, so

diagnosis is frequently delayed, and complications can occur. These may

include delays in healing and recurrence of symptoms, they explain.

The main goal of treatment is for an athlete to avoid the activity that

caused the stress fracture in the first place, while maintaining

conditioning with other types of exercise, after which he or she can

gradually return to normal activity. In the current report, the researchers

describe their approach for treating seven elite athletes, all of whom were

able to return to their sport within 12 to 18 weeks of beginning treatment.

All athletes reported " vague " pain in the back of the thigh, particularly

during and after working out. The researchers describe a series of physical

exams to confirm the presence of the fracture and to check the progress of

healing, including the " hop " test, in which the patient is asked to hop on

the affected leg.

Treatment consisted of four three-week phases. In the first, the patients

used crutches and avoided putting their weight on the affected leg. Next,

they were allowed to walk on the affected leg and to swim and exercise in

the gym, without stressing the affected leg. In the third phase of the

treatment athletes exercised their entire bodies, ran in a straight line

every other day, and used a stationary bicycle. In the fourth phase, they

gradually resumed their normal activity.

At the end of each phase patients were tested again for the presence of the

stress fracture; if the test was positive they repeated a phase.

By following this protocol, Ivkovic and his team conclude, femoral stress

fractures can be treated effectively without complications and

deconditioning.

SOURCE: British Journal of Sports Medicine, June 2006.

http://www.reutershealth.com/archive/2006/06/30/eline/links/20060630elin022.html

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