Early return to playing professional football following fixation of 5th metatarsal stress fractures may lead to delayed union but does not increase the risk of long-term non-union

2018 ◽  
Vol 27 (9) ◽  
pp. 2796-2801 ◽  
Author(s):  
David Miller ◽  
Daniel Marsland ◽  
Mary Jones ◽  
James Calder
Keyword(s):  
Delayed Union ◽  
Stress Fractures ◽  
Professional Football ◽  
Non Union ◽  
Early Return

scholarly journals A prospective study on operative management of displaced fracture of midshaft of clavicle

2017 ◽  
Vol 3 (3) ◽  
pp. 619
Author(s):  
Mohammed Ismail Hathiwale ◽  
Prakash A. Sasnur ◽  
Md. Johorul Islam Tapadar
Keyword(s):  
Plate Fixation ◽  
Operative Management ◽  
Delayed Union ◽  
Locking Compression Plate ◽  
Non Union ◽  
Early Return ◽  
Compression Plate ◽  
Clavicle Fractures ◽  
Displaced Fracture ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Clavicle fractures had been traditionally treated non-operatively which resulted in high rates of non-union. The present study has been undertaken to study the role of precontoured locking compression plate in the fixation of mid-third clavicle fractures.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">We reviewed the results of 25 cases of displaced middle third clavicle fractures (Robinson type 2B) which were treated with open reduction and internal fixation with pre-contoured locking compression plate at Al-Ameen Medical College and Hospital</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 25 patients operated with precontoured LCP, 21 were male and 4 were female patients. One patient had hypertrophic scar, one patient had plate prominence, two patients had delayed union and one patient had implant failure, none of them developed non-union. Constant Murley score was excellent in 19, good in 4 and fair in 1 patient and poor in 1 patient. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Precontoured locking compression plate fixation has better functional outcome, immediate pain relief, early return to function and avoids complications of conservative methods.</span></p>

Stress fractures

2011 ◽  
Author(s):  
M. Henry
Keyword(s):  
High Risk ◽  
Traumatic Event ◽  
Weight Bearing ◽  
Delayed Union ◽  
Stress Fractures ◽  
Non Union ◽  
Normal Forces ◽  
Anterior Tibial ◽  
Prolonged Pain ◽  
Tibial Cortex

♦ Stress fractures are fractures occurring as the result of repetitive, submaximal loads, in the absence of a specific precipitating traumatic event.♦ These fractures can be subdivided into two groups on the basis of aetiology. Whereas ‘fatigue fractures’ result from the excessive repetitive (i.e. abnormal) loading of normal bone, ‘insufficiency fractures’ are fractures resulting from normal forces acting on abnormal bone.♦ Early diagnosis allows the initiation of effective treatment that can prevent prolonged pain and disability, as well as avoiding the progression to displacement or a non-union.♦ While management decisions are generally focused on activity modification, protection of weight bearing, and immobilization, there is a subset of fractures at high risk for progression to complete fracture, non-union, or delayed union. These high-risk stress fractures, including tension-side femoral neck fractures and anterior tibial cortex fractures, require aggressive treatment to prevent the sequelae of poor healing.

scholarly journals High union rates following surgical treatment of proximal fifth metatarsal stress fractures

2021 ◽  
Author(s):  
Julian J. Hollander ◽  
Quinten G. H. Rikken ◽  
Jari Dahmen ◽  
Sjoerd A. S. Stufkens ◽  
Gino M. M. J. Kerkhoffs
Keyword(s):  
Surgical Treatment ◽  
Bone Healing ◽  
Methodological Quality ◽  
Literature Search ◽  
Return To Sport ◽  
Delayed Union ◽  
Stress Fractures ◽  
Union Rate ◽  
Non Union ◽  
Non Surgical Treatment

Abstract Purpose The primary purpose of this study was to determine the union rate and time for surgical- and non-surgical treatment of stress fractures of the proximal fifth metatarsal (MT5). The secondary purpose was to assess the rate of adverse bone healing events (delayed union, non-union, and refractures) as well as the return to sports time and rate. Methods A literature search of the EMBASE (Ovid), MEDLINE (PubMed), CINAHL, Web of Science and Google Scholar databases until March 2020 was conducted. Methodological quality was assessed by two independent reviewers using the methodological index for non-randomized studies (MINORS) criteria. The primary outcomes were the union time and rate. Secondary outcomes included the delayed union rate, non-union rate, refracture rate, and return to sport time and rate. A simplified pooling technique was used to analyse the different outcomes (i.e. union rate, time to union, adverse bone healing rates, return to sport rate, and return to sport time) per treatment modality. Additionally, 95% confidence intervals were calculated for the union rate, adverse bone healing rates, and the return to sport rate. Results The literature search resulted in 2753 articles, of which thirteen studies were included. A total of 393 fractures, with a pooled mean follow-up of 52.5 months, were assessed. Overall, the methodological quality of the included articles was low. The pooled bone union rate was 87% (95% CI 83–90%) and 56% (95% CI 41–70%) for surgically and non-surgically treated fractures, respectively. The pooled radiological union time was 13.1 weeks for surgical treatment and 20.9 weeks for non-surgical treatment. Surgical treatment resulted in a delayed union rate of 3% (95% CI 1–5%), non-union rate of 4% (95% CI 2–6%) and refracture rate of 7% (95% CI 4–10%). Non-surgical treatment resulted in a delayed union rate of 0% (95% CI 0–8%), a non-union rate of 33% (95% CI 20–47%) and a refracture rate of 12% (95% CI 5–24%), respectively. The return to sport rate (at any level) was 100% for both treatment modalities. Return to pre-injury level of sport time was 14.5 weeks (117 fractures) for surgical treatment and 9.9 weeks (6 fractures) for non-surgical treatment. Conclusion Surgical treatment of stress fractures of the proximal fifth metatarsal results in a higher bone union rate and a shorter union time than non-surgical treatment. Additionally, surgical and non-surgical treatment both showed a high return to sport rate (at any level), albeit with limited clinical evidence for non-surgical treatment due to the underreporting of data. Level of evidence Level IV, systematic review.

Tibial Stress Fractures in an Active Duty Population: Long-Term Outcomes

2013 ◽  
Vol 22 (01) ◽  
pp. 50-53 ◽  
Author(s):  
Kelly G. Kilcoyne ◽  
Jonathan F. Dickens ◽  
John-Paul Rue
Keyword(s):  
Active Duty ◽  
Stress Fractures ◽  
Long Term Outcomes

Long-Term Results of Radioscapholunate Fusion Following Fractures of the Distal Radius

1997 ◽  
Vol 22 (6) ◽  
pp. 705-710 ◽  
Author(s):  
L. NAGY ◽  
U. BÜCHLER
Keyword(s):  
Long Term Results ◽  
Short Term ◽  
Non Union ◽  
Partial Fusion ◽  
Traumatic Lesions ◽  
Residual Motion ◽  
Radioscapholunate Fusion ◽  
Wrist Fusion

Fifteen patients with radioscapholunate (RSL) fusion for traumatic lesions of the radiocarpal junction, whose short-term results have been previously reported, were reassessed after an average follow-up time of 8 years. Five patients had undergone wrist fusion because of non-union or early progressive arthritis. Of the ten wrists with retained mobility, eight continued to function satisfactorily. Two wrists were painful for reasons other than secondary midcarpal arthritis. Patient satisfaction was comparable in both groups with the wrist score better for wrists with residual motion. The survival of RSL partial wrist fusion corresponded inversely with the number of preceding operations and the range of motion before partial fusion. Secondary midcarpal arthritis, if present, arose early and was well tolerated. Failures were strongly linked to technical mistakes and complications.

scholarly journals Delayed-union and Non-union Fractures of the Lower Extremity

1964 ◽  
Vol 13 (2) ◽  
pp. 108-110
Author(s):  
K. Toguchida ◽  
K. Hasegawa ◽  
K. Yamaguchi ◽  
H. Setani ◽  
Y. Fukushima
Keyword(s):  
Lower Extremity ◽  
Delayed Union ◽  
Non Union

SCAPHOID BONE BRUISING – PROBABLY NOT THE PRECURSOR OF ASYMPTOMATIC NON-UNION OF THE SCAPHOID

2007 ◽  
Vol 32 (3) ◽  
pp. 337-340 ◽  
Author(s):  
N. LA HEI ◽  
I. MCFADYEN ◽  
M. BROCK ◽  
J. FIELD
Keyword(s):  
Bone Marrow ◽  
Clinical Outcomes ◽  
Classification System ◽  
Complete Resolution ◽  
Scaphoid Bone ◽  
Bone Bruise ◽  
Radiological Findings ◽  
Non Union ◽  
Bone Bruising

The MRI finding of bone marrow oedema, without fracture, following trauma to the scaphoid has been called a ‘bone bruise’. A similar injury is found in the knee, considered benign and managed conservatively. In the scaphoid, there is the concern that this lesion may lead to scaphoid non-union. This study addresses that concern. The clinical and radiological findings of 41 patients with a scaphoid bone bruise on MRI are described, an MRI classification system proposed and clinical outcomes investigated. Patients were immobilised for 6 weeks. At 3 months, 8 remained symptomatic and had repeat MRI. Four of these showed complete resolution of the bruise, the others improvement. At 6 months, 2 of the 8 complained of minor, intermittent discomfort but progressed to resolution of symptoms. This study suggests that the scaphoid bone bruise is a benign injury with predictable recovery and is unlikely to result in long-term morbidity in the form of non-union.

scholarly journals Unilateral Pedicle Stress Fracture in a Long-Term Hemodialysis Patient with Isthmic Spondylolisthesis

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Keishi Maruo ◽  
Toshiya Tachibana ◽  
Shinichi Inoue ◽  
Fumihiro Arizumi ◽  
Shinichi Yoshiya
Keyword(s):  
Stress Fracture ◽  
Hemodialysis Patient ◽  
Contralateral Side ◽  
Pedicle Screw Fixation ◽  
Stress Fractures ◽  
Leg Pain ◽  
Isthmic Spondylolisthesis ◽  
Pedicle Fracture ◽  
History Of

Most unilateral pedicle stress fractures occur on the contralateral side of patients with unilateral spondylolysis. However, there are few reports of unilateral pedicle stress fractures in patients with bilateral spondylolysis and spondylolisthesis. We report a unique case of unilateral pedicle stress fracture in a long-term hemodialysis patient with isthmic spondylolisthesis. A 65-year-old man who had undergone hemodialysis presented with lower back pain that had persisted for several years. The patient experienced severe right lower extremity pain with no history of trauma. Computed tomography revealed unilateral pedicle fracture with bilateral L5 spondylolysis and spondylolisthesis with progression of scoliosis. The patient underwent Gill laminectomy of L5 with pedicle screw fixation at L4-S1 and interbody fusion at L5-S1. The patient’s leg pain ceased immediately, and he began walking without leg pain. In our present patient, development of scoliosis caused by destructive spondyloarthropathy may have contributed to a unilateral pedicle fracture.

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