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Stressbrudd

Sist oppdatert: Sist revidert:
Sist revidert av:


Definisjon:
Tretthetsbrudd forekommer oftest i underekstremitetene og skyldes langvarige og gjentatte belastninger
Forekomst:
Forekommer hyppigst blant idrettsutøvere der løping og hopping utgjør en stor del av trenings- og konkurranseaktiveten
Symptomer:
Debuterer med ganske akutte smerter, uten forutgående traume, er sterke, forverres ved belastning og forsvinner i hvile
Funn:
Lokalisert ømhet og ev. noe hevelse over bruddstedet
Diagnostikk:
Diagnosen stilles ved røntgen, ev. MR tidlig i forløpet
Behandling:
Den initiale behandlingen består i å redusere aktiviteten til et nivå med smertefri funksjon, i noen tilfelle kan operasjon bli aktuelt
  1. Anderssen Ø, Engebretsen L, Larmo A. Stressfraktur i calcaneus. Tidsskr Nor Laegeforen. 2022 Feb 28;142(4). Norwegian. PMID: 35239271.
  2. Patel DS, Roth M, Kapil N. Stress fractures: diagnosis, treatment, and prevention. Am Fam Physician. 2011 Jan 1;83(1):39-46. PMID: 21888126. PubMed  
  3. Wright AA, Taylor JB, Ford KR, et al. Risk factors associated with lower extremity stress fractures in runners: a systematic review with meta-analysis. Br J Sports Med 2015; 49:1517. British Journal of Sports Medicine  
  4. Martinez JM. Stress fractures. Medscape, last updated May 11, 2015. emedicine.medscape.com  
  5. Weiss Kelly AK, Hecht S. The Female Athlete Triad. Pediatrics. 2016;138(2):e20160922. PubMed  
  6. Wright AA, Hegedus EJ, Lenchik L, et al. Diagnostic accuracy of various imaging modalities for suspected lower extremity stress fractures: a systematic review with evidence-based recommendations for clinical practice. Am J Sports Med 2016; 44:255. PubMed  
  7. Schneiders AG, Sullivan SJ, Hendrick PA, et al. The ability of clinical tests to diagnose stress fractures: a systematic review and meta-analysis. J Orthop Sports Phys Ther 2012; 42: 760-71. PubMed  
  8. deWeber K. Overview of stress fractures. UpToDate, last updated Dec 10, 2020. UpToDate  
  9. Ahn JM, El-Khoury G. Radiologic evaluation of chronic foot pain. Am Fam Physician 2007; 76: 975-83. American Family Physician  
  10. Poolman RW, Agoritsas T, Siemieniuk RAC, et al. Low intensity pulsed ultrasound (LIPUS) for bone healing: a clinical practice guideline. BMJ 2017; 356: j576. doi:10.1136/bmj.j576 DOI  
  11. Mallee WH, Weel H, van Dijk CN, van Tulder MW, Kerkhoffs GM, Lin CW. Surgical versus conservative treatment for high-risk stress fractures of the lower leg (anterior tibial cortex, navicular and fifth metatarsal base): a systematic review. Br J Sports Med. 2015;49(6):370-376. PubMed  
  12. Rome K, Handoll HHG, Ashford RL. Interventions for preventing and treating stress fractures and stress reactions of bone of the lower limbs in young adults. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD000450. DOI: 10.1002/14651858.CD000450.pub2. DOI  
  • Terje Johannessen, professor i allmennmedisin, Trondheim (tilpasning til NEL)