应力性骨折76例早期的诊断与治疗分析

Early diagnosis and treatment of 76 cases of stress fracture

目的探讨应力性骨折的早期诊断及治疗。方法我院2004年1月至2010年12月收治的76例应力性骨折患者,均行计算机X射线摄像(CR)和CT检查,23例行MRI检查。67例采用保守治疗,9例行手术治疗。结果 76例应力性骨折发生于胫骨38例,跖骨13例,腓骨10例,股骨9例,股骨颈3例,耻骨2例,跟骨1例。CR检查对早期应力性骨折检出率低,CT、MRI对应力骨折早期诊断有明显优势。67例保守治疗患者平均治疗时间为35天,功能恢复良好;9例手术治疗患者术后3个月复查,患肢功能恢复正常,均未遗留伤残。结论应力性骨折早期诊断主要依靠临床表现和影像学特征,早期保守治疗包括停止训练、休息及石膏制动,必要时采取手术治疗常常有效。

To summarize the early diagnosis and treatment of stress fracture. From January 2004 to December 2010,76 cases of stress fracture admitted in our hospital received computed radiography（CR） and CT examination,in which 23 cases received MRI examination.Sixty-seven patients underwent conservative treatment,and 9 patients underwent surgical treatment. Among the 76 cases,38 cases of stress fracture occurred in tibia,13 cases in metatarsal bone,10 cases in fibula,9 cases in femur,3 cases in femoral neck,2 cases in pubic bone,and 1 case in calcaneus.CR had a low detection rate for early stress fracture.CT and MRI had obvious advantages in early diagnosis of stress fracture.Sixty-seven undergoing conservative treatment with an average therapy time of 35 days recovered well.Nine patients were reexamined 3 months after surgeries.The function of their affected limbs recovered,without any disability. The early diagnosis of stress fracture mainly relies on clinical situation and imaging features.It is effective to implement conservative treatments in the early stage,briefly by stopping training,relaxing and restricting patients＇ activities with plaster.