Stress Fractures Flashcards
excess repetitive stress alters the balance between what cells, which can lead to BSI?
alters the balance of activity between osteoclasts and osteoblasts
what sport has the highest rate of stress fracture? what anatomic location has the highest rate of stress fracture?
- running
- tibia
t/f females have higher stress fracture than males
true
what portion of bone resists tension?
collagen matrix
t/f higher cross sectional area of bone confers higher protection to stress fracture
true
t/f muscle strength is protective against stress fracture but muscle size has no relationship to rate of stress fracture
true
how does cigarette smoking result in higher osteoclastic activity?
cigarette smoking decreases estrogen in a dose dependent manner
t/f large epidemiologic studies have shown no association between stress injury and running surface
true
valgus extension overload can lead to stress fracture of what bone?
olecranon
what are the two most common vertebral levels to be affected by spondylolysis?
L4/L5
which type of radiology study has greater sensitivity than XR in detecting spondylolysis and is becoming the gold standard for diagnosis?
SPECT
what radiographic imaging will you consider in the treatment of spondylolysis to assess healing?
CT
treat the patient with spondylolysis until what time?
they are symptom free
what special sign can be positive in the case of a pubic rami stress fracture?
positive standing sign - inability to stand on the affected ipsilateral leg unsupported
for a compression sided femoral neck stress fracture, you perform weekly radiograph until what time?
patient can walk without cane
how are femoral shaft stress fractures typically managed?
conservatively - start with crutches
which imaging modality is best for assessing bone edema in the case of stress fracture?
MRI
what is the recommended duration of casting for grade 4 posteromedial compression sided tibial stress fracture?
6 weeks cast followed by 6 weeks non impact rehab
t/f medial malleolus stress fracture is inherently unstable
true
what is the general management for fibula stress fracture?
what type of ankle brace can be helpful?
conservative including pneumatic ankle brace
what is the typical time to return to play in calcaneal stress fracture with conservative management?
3-4 weeks
what is the initial management for a tarsal navicular stress fracture?
cast immobilization 6-8 weeks
what is the best predictor of healing in a navicular stress fracture?
improvement/resolution in pain
what is the recommended treatment for most zone 3 fifth MT base stress fractures in the athlete?
intramedullary screw fixation
what is the typical return to play time after surgical intervention for fifth MT base stress fracture?
6-9 weeks
for 1-4 MT stress fractures, what is the usual initial management?
stiff soled shoe or boot
how do you initially manage a sesamoid stres fracture of the first toe?
non weightbearing cast x 6 weeks
what movement of the first MTPJ do you want to avoid in the recovery/treatment of sesamoid stress fracture?
avoid dorsiflexion
