中长跑和芭蕾舞运动中胫骨应力骨折的比较

Comparison of Tibial Stress Fracture between Long Distance Runners and Ballet Dancers

胫骨应力骨折（ＳＦ）在芭蕾舞和中长跑运动员中均有一定发病率，作者调查某部新兵２６５人每日５０００米跑步，其胫骨应力骨折病发率为１１．６８％（３１／２６５人），骨折部位多在胫骨中段中后侧。芭蕾舞演员胫骨应力骨折病发率为８％（１５／６０人），骨折部位在胫骨下段前侧。应用新鲜尸体标本作负荷下胫骨多处的应变测定模拟跑步和足跟垫高模仿芭蕾舞时下肢负重位置的应变变化，分别于胫骨中段后侧测得有高压应力和胫骨下段前方有高张应力，此结果与调查中Ｘ线片病变部位相符。作者认为不同的运动使负重时胫骨所处姿势各不相同，而造成胫骨最大应力集中点位置各异，是造成芭蕾舞运动和中长跑运动中应力骨折部位不同的主要原因，预防和治疗工作应根据各自的应力性质和集中点部位来进行防治。

Tibial stress fractures (TSF) are often found in distance runners and ballet dancers.Incidence of TSF in 265 soldiers who ran more than 5000m every day was 11.69% (31/265) ,posterior wall of middle tibia.The incidence of TSF in 60 ballet dancers was 8% (5/60),anterior wall of distal 1/3 of tibia. We measured the strains in 20 locations of 5 fresh cadaver tibia with 150-1200N load,while the tibia was simulated under such position as runners and as dancers.The results showed that there were higher pressure stress in posterior wall of middle tibia of runners and tension stress in anterior wall of dancers. Author concluded that there are 2 different types of stress between runners and dancers due to their different leg motions.The prevention and treatment of stress fracture for runners and dancers should depend on the characteristics of the stress mentioned in the study.