Dr. Kevin Zhu, a hard-to-find "fatigue fracture", said that he once met a middle-aged patient who went to see a doctor everywhere because of his foot pain. Many doctors probably didn't X-ray him because he didn't have any trauma, so they couldn't find the real cause of his foot pain.
Until I finally wandered to his clinic, I found a very thin crack in the second metatarsal through X-ray, which was different from the fracture caused by general trauma. It was concluded that it was a fatigue fracture of the second metatarsal, which really found the reason and solved his troubles.
What exactly is fatigue fracture? What's the difference with ordinary fractures? In fact, from the X-ray film, it can be found that the "position" of general injured fracture and fatigue fracture is different!
The emphasis of the two is different. "Ordinary fracture" is caused by the torsion and impact of external force, while "fatigue fracture" is caused by the accumulation of long-term pressure, which makes the bones not have enough time to recover. For example, fatigue fracture will occur in some specific positions, metatarsal and calf are the two most common parts, and careful observation will also reveal strange lines different from ordinary fractures. At this time, with an accurate bone scan, the real cause can be inferred.
From the X-ray film, we can see the difference between general traumatic fracture and fatigue fracture! (Schematic diagram) It will naturally be damaged if it is used for a long time. "The same wall is damaged. The damage marks caused by sledgehammer striking are absolutely different from those caused by natural disintegration caused by time factors; The damage condition of a car that broke down in a car accident is different from that of a car that drives slowly and can no longer drive. Dr. Zhu Kaiwen used a simple and clear metaphor to let everyone quickly understand the difference between ordinary fractures and fatigue fractures. The cause of "foot fatigue fracture" is closely related to these two factors:?
1. occupation
Compared with other serious orthopedic diseases, foot fatigue fracture is not a big problem, as long as it can be fully rested and fixed and can be cured without taking medicine. However, due to specific occupations, foot fatigue fractures are common in the following ethnic groups:
Soldiers are prone to fatigue and fracture because of duty. Not only do they not get enough rest time, but they often use the affected parts, so they are also called "marching feet" or "recruits' feet".
Athletes like jan frodeno, the world-famous three major railway champions, or Cheryl Youtai, an outstanding athlete who once broke the Japanese marathon record, have also suffered from fatigue fractures. Because fatigue fracture needs a period of rest and protection, which has a great influence on athletes' precious sports career, professional athletes have professional coaches and a set of training plans to prevent injuries caused by overtraining. However, due to the rapid development of sports performance and fierce competition, this kind of fatigue fracture is still heard from time to time.
Athletes are prone to fatigue and fracture. (schematic diagram) 2. Bone quality
When it comes to measuring bone mass, most people directly think of "bone density". The World Health Organization defines osteoporosis by the level of bone mineral density, while China uses bone mineral density to judge the quality of bones.
In fact, the quality of bones is not only considered by "bone density", but also by the brittleness, elasticity and shape of bones. Although it sounds abstract, it is difficult to measure because of abstraction, so there is no fair index to calibrate these contents so far. This is why some people have good bone density, but because of their fragile bones and poor elasticity, they are prone to fracture once they collide.
In addition, a person's congenital constitution will also affect the bone quality, such as the absorption capacity of protein, calcium, vitamin D and other nutrients, the secretion of female estrogen, taking ibuprofen painkillers or some anti-inflammatory drugs, and whether there is a habit of moderate exercise.
Once the bone quality is poor, accidental falling and slight external impact will still cause slight damage to the bone, although no fracture has been caused yet. In addition, if you don't have proper rest, you will be more prone to fatigue and fracture under accumulated pressure.
"Proper rest" gives bones time to heal themselves so that they can walk a longer way. (Schematic diagram) Dr. Kevin Chu also pointed out that in fact, fatigue fracture is a kind of fracture caused by overuse and lack of rest. The simplest way to treat fatigue fracture is to take conservative treatment, plaster the affected area or fix it with auxiliary devices, and force it to rest, and it will gradually heal.
Like the above-mentioned middle-aged patients, when the second metatarsal fatigue fracture is diagnosed, as long as they put on plaster shoes and rest for two or three months, they will slowly heal themselves. Generally speaking, fatigue fracture is not common, but when there is unknown pain in the foot, don't ignore it, because "pain" is an important message from the body.
In addition to actively looking for a doctor to confirm symptoms, we should also be patient with the doctor's correct treatment, because the bones on the X-ray film look lifeless and mechanical, but don't forget that the bones are actually alive, so they can be modified, and because they are alive, new tissues come in and old tissues go out, and the bones will be completely replaced every few years, just like snakes shed their skins. In the process of bone metabolism, if the external force exerted on the bone is greater than its self-repair ability, then fracture will occur.
Although doctors can provide correct treatment, more often, patients must be more patient with their bodies and spend time waiting for their bodies to heal themselves.
Text/Peng Xingru? Figure/Wu