BookTimothy L. Miller, Christopher C. Kaeding, editors.
Summary: Now completely revised and expanded, this second edition not only includes updated chapters detailing treatment of the most common and troublesome sites for stress fractures, but also more recent research regarding risk factors for the development of stress fractures. As in the original edition, general principles of evaluation, healing considerations and management strategies are discussed in three thematic sections. However, unlike the previous text, this edition will focus on a holistic approach to the treatment of these increasingly common injuries with new chapters on nutritional optimization of athletes at risk for stress fractures, systemic treatment strategies for healing including vitamin D supplementation and parathyroid hormone stimulation, and surgical and injectable biologic treatment modalities for enhanced bone healing. This edition will also include guidelines for on-the-field and training room management of stress fractures for team physicians. This revision is timely, given the increasing rate and severity of bony stress injuries encountered in elite and professional athletes related to single-sport specialization and the increased popularity of endurance sports such as cross-fit, obstacle course racing, and ultramarathon competitions. It will be an ideal resource for sports medicine practitioners including orthopedic surgeons, primary care sports medicine specialists, athletic trainers, and physical therapists.
Contents:
Intro
Preface
Contents
Contributors
Part I: General Evaluation Principles for Stress Fractures
1: Risk Factors for Developing Stress Fractures
Introduction
Intrinsic Risk Factors
Non-modifiable Intrinsic Risk Factors
Demographics
Gender
Race
Age
Previous History of Stress Fracture
Genetics
Lower Extremity Alignment
Modifiable Intrinsic Risk Factors
Relative Energy Deficiency Syndrome
Low Energy Availability with or Without Disordered Eating
Functional Hypothalamic Amenorrhea
Osteoporosis
Calcium and/or Vitamin D Deficiency Low Body Weight/BMI
Biomechanics and Strengthening
Medication Use
Contraceptives
Other Medications
Substance Abuse
Tobacco and Alcohol Consumption
Extrinsic Risk Factors
Non-modifiable Extrinsic Risk Factors
Time of Season
Modifiable Intrinsic Risk Factors
Training Variables
Equipment Variables (Footwear and Inserts)
Type of Sport
Prediction Algorithms Based on Risk Factors
Conclusion
References
2: Sideline and Training Room Evaluation and Treatment for Suspected Stress Fractures Philosophy Behind the Decision-Making on the Sideline and in the Training Room
Evaluation
History
Physical Examination
Imaging
Stress Fractures of the Hip
History
Physical Examination
Imaging
Return to Play Current Game
Game Day Treatment
Training Room Treatment
Decision Points
Stress Fractures of the Femur
History
Physical Examination
Imaging
Return to Play Current Game
Game Day Treatment
Training Room Treatment
Decision Points
Stress Fractures of the Tibia
History
Physical Examination
Imaging
Return to Play Current Game Game Day Treatment
Training Room Treatment of Stress Fractures
References
3: Pathophysiology and Epidemiology of Stress Fractures
Stress Fracture Pathophysiology
Bone Biology
Bone Pathophysiology in Stress Fracture
Host Risk Factors for the Development of Bone Stress Injury
Bone Mineral Density and Bone Thickness
Genetics
Nutritional Factors
Menstrual Irregularity
Summary
Stress Fracture Epidemiology
Stress Fracture Epidemiology - Military
Stress Fracture Epidemiology - Athletics
Stress Fracture Epidemiology - Tennis Stress Fracture Epidemiology - Pediatric/Adolescent Athletes
Stress Fracture Epidemiology - Other Sports
Stress Fracture Epidemiology - Incidence and Return to Play
Summary - Epidemiology
References
4: Diagnostic Imaging Evaluation of Stress Fractures
Evolution of Imaging
Imaging Techniques
Radiography
Radionuclide Scintigraphy
Ultrasound
Computed Tomography
Magnetic Resonance Imaging
Conclusion
References
5: Classification of Stress Fractures
Defining a Stress Fracture
Features of a Quality Classification System