Musculo-skeletal   [back to the Category]

Stress fractures of the leg   [read the french version]

Author :   Docteur Anne Thiescé

Stress fractures of the leg

Stress fractures of the leg affect the fibula and / or the tibia and are often multiple. They are, together with tibial periostitis, one of the main aetiologies of leg pains. According to studies, they represent 6 to 15% of pathologies found in dancers. Stress fractures of the tibia amount to 22% of stress fractures found in female ballet dancers.

Palpation reveals one, or several, points of exquisite pain in a limited and sometimes tumified area of the leg.

X-rays are only positive in the case of a late diagnosis. Fig 1.

early diagnosis is confirmed by scintigraphy. Hyperfixation is focal or multi-focal which indicates the existence of multiple fractures. Fig 2, Fig 3.

R.M.I may be necessary. Fig 4, Fig 5.

It is imperative that dancing be stopped. Activities can be resumed when there is absolutely no more pain and when a control scintigraphy shows a normalisation of the fixation shown in the early photographs. These stress fractures usually heal well, but sometimes, even with an early diagnosis, recourse to surgical treatment is obligatory

Bibliography:

Garrick J. G., MD, and Requa R. K., MSPH, Ballet injuries, The Am. J Sports Med, Vol 21, No. 4 1993 pp 586-590.

Washington E. L. MD, Musculoskeletal injuries in theatrical dancers, site, frequency, and severity, The Am. J Sports Med., Vol. 6, No. 2 1978 pp 75-98.

Kadel N. J., MD, Teitz C. C., MD and Kronhal R. A., PhD D, Stress fractures in Ballet dancers, The Am. J Sports Med., 1992 Vol. 20, No. 4 1992 pp 445-449.

Thiescé A., Le geste dansé et ses conséquences en rhumatologie. Ed Laboratoires Ciba-Geigy 1996.