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Stress Fractures of the Lower Extremity - cont.
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Stress fractures of the lower extremity are common overuse injuries and are frequently seen in athletes and military recruits. Female athletes are particularly prone to developing stress fractures, due to mechanical, hormonal and nutritional factors. The diagnosis of stress fractures is based on the history and physical examination. Plain x-ray films may be helpful, but are often negative during the fIrst two weeks of a stress fracture. Most stress fractures can be successfully treated with a period of rest. Certain problematic fractures may require surgical treatment. |
Although the exact mechanism responsible for initiating stress fractures is unclear, two theories have been proposed. One theory claims that excessive forces are transmitted to the bone when the surrounding muscles become fatigued. A second contrasting theory proposes that highly concentrated muscle forces act across a localized area of bone causing stress-related injury to the bone. Young female athletes are especially prone to developing stress fractures. The female athlete triad includes any combination of amenorrhea (absence of normal menstruation), an eating disorder and/or osteoporosis ( demineralization of bone). Many women develop stress fractures as they enter puberty. During this phase of development, female athletes may become obsessed that any gain in weight from fat will adversely affect their performance; therefore, some develop an eating disorder such as anorexia or bulimia to try to control their weight. Up to 20 percent of vigorously exer- |
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Barry P. Boden, M.D., is a practicing orthopedic surgeon in the metropolitan Washington, D.C. area.
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NO.5-FEBRUARY 1999
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5:57
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