An assessment of the diagnosis, treatment, and outcomes of lower extremity stress fractures in pediatric and adolescent populations.

Autor:	Gremillion MJ; Baylor College of Medicine, Houston, TX, USA., Martinez A; Baylor College of Medicine, Houston, TX, USA., Ghanta RB; Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA, USA., Borici N; Baylor College of Medicine, Houston, TX, USA.; Department of Orthopedic Surgery, Texas Children's Hospital, Houston, TX, USA., Kushare I; Baylor College of Medicine, Houston, TX, USA.; Department of Orthopedic Surgery, Texas Children's Hospital, Houston, TX, USA.
Jazyk:	angličtina
Zdroj:	The Physician and sportsmedicine [Phys Sportsmed] 2023 Dec; Vol. 51 (6), pp. 572-581. Date of Electronic Publication: 2022 Nov 15.
DOI:	10.1080/00913847.2022.2143247
Abstrakt:	Objectives: To present one of the first descriptive case series of pediatric and adolescent lower extremity stress injuries, their management, and outcomes in athletes and non-athletes. Methods: The IRB-approved retrospective study included patients under 18 years at a tertiary children's hospital who were diagnosed with a lower extremity stress fracture/reaction. Demographic data, mechanism of injury, physical exam, radiographic findings, treatment, & outcomes were collected. Descriptive statistical analysis was conducted. Results: Ninety-seven patients with stress injuries on clinical exams and on radiographs or MRI were included. The average age when diagnosed was 11.7 years (range 1.1-18 years) and the most common injuries were to the tibia (n = 33, 28.4%) and the least common involved were the cuneiforms (n = 4, 3.4%). Patients under the age of 14 were more likely to experience cuboid and calcaneal stress injuries (mean age 5.5 and 8.3 years respectively). Nineteen patients (19.6%) had high-risk stress fractures, with the average age of 14.9 years versus 11.6 for those with low risk (p-value = 0.01) and return to activity time being 15 weeks compared to 10.5 (p-value = 0.027). The most common forms of treatment were controlled ankle motion (CAM), walker boots (58.6%), and physical therapy (PT) (38.1%). The mean Lower Extremity Function Score of the patient population was 73.8, indicating no clinically important difference from full functionality. Conclusion: Lower extremity stress injuries in this cohort were most seen in the tibia, although patients younger than 14 had a high number of cuboid and calcaneal stress injuries. Those with high-risk stress fractures were older and took longer to recover from when compared to low-risk injuries. Treatment is commonly conservative, with CAM boots and PT being the most frequently utilized interventions and serving as a successful approach to treatment, with patients returning to activity at an average of 11.4 weeks, which is comparable to similar studies.
Databáze:	MEDLINE
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