Drie tevoren gezonde personen met een vermoeidheidsfractuur

Klinische les
J.L. Bron, G.B. van Solinge, A.R.J. Langeveld, T.U. Jiya en P.I.J.M. Wuisman

Three previously healthy persons with a stress fracture.

- A 42-year-old man presented with a one-month history of pain in his left knee, due to a fracture of the left medial tibia plateau, following a footrace. A 24-year-old man, also a jogger, had had increasing pain in his right lower leg for 4 months, which turned out to be due to a fracture of the posteromedial border of the tibia at the insertion of the flexor digitorum longus muscle. A 35-year-old woman presented with pain in her left foot and ankle that was due to a march fracture of the second metatarsal bone after over 5 hours of intermittent use of the clutch in a traffic jam. In all 3 patients, temporary cessation of the causative activity was sufficient for complete recovery after 3 months. Stress fractures are easily missed on X-rays. Treatment is conservative and consists of the elimination of causative factors to allow adequate healing. In selected cases, a splint or brace may be indicated. Furthermore, certain high risk and displaced fractures should be considered for surgical fixation. Return to the causative activity should be gradual with attention being paid to other potential risk factors.

Ned Tijdschr Geneeskd. 2007;151:621-6