| Abstract | Stres frakture nastaju zbog repetitivnih ponavljajućih sila malih jakosti. Ono može dovesti do loma, ako je veličina individualnog stresa ili učestalost stresa veća nego sposobnost kosti da popravi mikrotraume. Stres frakture donjih ekstremiteta najčešće se javljaju na: vratu femura, pateli, tibiji, distalni dio fibule, calcaneus, talus, navikularne kosti, druga, treća i peta metatarzalne kosti i sezamoidne kosti. Čimbenici koji pogoduju nastanku su: dob i spol, vrsta sportske aktivnosti, biomehanički čimbenici, mišići, greške u treningu, podloga, sportska obuća i izostanak mjesečnice. Najviše podložni tim ozljedama su sportaši koji se bave sportovima gdje su prisutni jaki udarci (trčanje, košarka, nogomet i gimnastika). Kod dijagnoze stres fraktura se koriste: klinička dijagnostika, radiološka dijagnostika, scintigrafija i diferencijalna dijagnostika. U prevenciji je bitna dobra suradnja između liječnika, sportaša i trenera, zatim važno je: pravilna kondicijska priprema, pravovremeno tretiranje ozljeda i rehabilitacijskog programa. Rehabilitacija je proces gdje se ponovno postiže stanje normalnog zdravlja nakon ozljede. Rehabilitacija uključuje: mirovanje i imobilizacija, izometričke vježbe, vježbe balansa i propriocepcije, vježbe zatvorenog i otvorenog kinetičkog lanca, hidroterapija, krioterapija, bandaža s TexUp-om, ortopedski ulošci, elektroterapija, Light Amplification by Stimulated Emission of Radiation, magnetoterapija, masaža i limfna drenaža. U elektroterapiji se koristi: transkutana električna živčana stimulacija, ultrazvuk, interferentne struje i dijadinamske struje. Kirurško liječenje i lijekovi se također koriste kod stres fraktura donjih ekstremiteta. |
| Abstract (english) | Stress fractures occur due to repetitive low-intensity forces. They can lead to a complete fracture, if the intensity of a single stress or the stress frequency supersedes the capacity of the bone to heal the microtraumas. Lower extremities most commonly subject to stress fractures are as follows: femur neck, patella, tibia, distal part of fibula, calcaneus, talus, navicular bones, second, third and fifth metatarsal bone, and sesamoid bone. The risk factors are: age and gender, the type of sports activity, biomechanical factors, muscles, training errors, surface, sports shoes and amenorrhea. These injuries usually happen to athletes engaged in sports involving strong kicks (such as running, basketball, football and gymnastics). The diagnosis of stress fractures encompasses: clinical diagnostics, radiological diagnostics, scintigraphy and differential diagnostics. The prevention requires good co-operation between physicians, athletes and coaches, as well as: adequate conditional preparation, timely treatment of injuries, and rehabilitation programmes. Rehabilitation is the process of regaining health after injury. Rehabilitation involves: inaction and immobilisation, isometric exercises, proprioception and balance exercises, open and closed kinetic chain exercises, hydrotherapy, cryotherapy, TexUp bandage, orthotic insoles, electrotherapy, Light Amplification by Stimulated Emission of Radiation, magnet therapy, massage and lymphatic drainage. The electrotherapy includes: transcutaneous electrical nerve stimulation, ultrasound, interfering current and diadynamic current. Surgical treatment and drugs are also used for lower extremity stress fractures. |
