下肢疲勞性骨折之危險因子

10.6162/SRR.2009.101.30

錢思佑；張怡雯

壓力性骨折 ； 生物力學 ； 肌肉疲勞 ； 過度訓練

大專體育

101期（2009 / 04 / 01）

217 - 223

繁體中文

「疲勞性骨折」主要為骨骼在長期接受反覆負荷下，無法承受連續的受力，因而導致骨骼部分或完全斷裂的現象。目前有關疲勞性骨折的文獻多屬於案例報告或是流行病學上的統計報告，對於其發生的因子少有相關之研究。本篇主要對疲勞性骨折之相關文獻作統整與歸納，探討影響下肢疲勞性骨折的危險因子。綜合過去的研究，發現肌肉疲勞造成避震功能喪失、動作改變、不正常的生物力學因素與生化狀態的失調，皆是造成疲勞性骨折的危險因子。同時，運動類型與狀態的改變以及過度訓練，在過去研究中，被認為是造成疲勞性骨折的重要因素。由於造成疲勞性骨折的發生不是單一因素，若能夠針對其中的危險因子作有效的預防，相信可以降低下肢疲勞性骨折之發生機率。

1. Barrow, G. W.,Saha, S.(1988).Menstrual irregularity and stress fractures in collegiate female distance runners.American Journal of Sports Medicine,16(3),209-216.
2. Bennell, K. L.,Malcolm, S. A.,Thomas, S. A.,Ebeling, P. R.,McCrory, P. R.,Wark, J. D.,Brukner,P. D.(1995).Risk factors for stress fractures in female track-and-field athletes: A retrospective analysis.Clinical Journal of Sport Medicine,5(4),229-235.
3. Boden, B. P.,Osbahr, D. C.,Jimenez, C.(2001).Low-risk stress fractures.American Journal of Sports Medicine,29(1),100-111.
4. Eisele, S. A.,Sammarco, G. J.(1993).Fatigue fractures of the foot and ankle in the athlete.Journal of Bone & Joint Surgery-American Volume,75(2),290-298.
5. Fyhrie, D. P.,Milgrom, C.,Hoshaw, S. J.,Simkin, A.,Dar, S.,Drumb, D.,Burr, D. B.(1998).Effect of fatiguing exercise on longitudinal bone strain as related to stress fracture in humans.Annals of Biomedical Engineering,26(4),660-665.
6. Gefen, A.(2002).Biomechanical analysis of fatigue-related foot injury mechanisms in athletes and recruits during intensive marching.Medical & Biological Engineering & Computing,40(3),302-310.
7. Giladi, M.,Milgrom, C.,Simkin, A.,Danon, Y.(1991).Stress fractures: Identifiable risk factors.American Journal of Sports Medicine,19(6),647-652.
8. Hetsroni, I.,Finestone, A.,Milgrom, C.,Ben-Sira, D.,Nyska, M.,Mann, G.,Almosnino, S.,Ayalon, M.(2008).The role of foot pronation in the development of femoral and tibial stress fractures: A prospective biomechanical study.Clinical Journal of Sport Medicine,18(1),18-23.
9. James, C. R.,Dufek, J. S.,Bates, B. T.(2006).Effects of stretch shortening cycle exercise fatigue on stress fracture injury risk during landing.Research Quarterly for Exercise & Sport,77(1),1-13.
10. Korpelainen, R.,Orava, S.,Karpakka, J.,Siira, P.,Hulkko, A.(2001).Risk factors for recurrent stress fractures in athletes.American Journal of Sports Medicine,29(3),304-310.
11. Lehman, R. C.,Torg, J. S.,Pavlov, H.,DeLee, J. C.(1987).Fractures of the base of the fifth metatarsal distal to the tuberosity: A review.Foot & Ankle,7(4),245-252.
12. Lu, W. W.,Luk, K. D.,Cheung, K. C.,Gui-Xing, Q.,Shen, J. X.,Yuen, L.,Ouyang, J.,Leong, J. C.(2004).Microfracture and changes in energy absorption to fracture of young vertebral cancellous bone following physiological fatigue loading.Spine,29(11),1196-1201.
13. Matheson, G. O.,Clement, D. B.,McKenzie, D. C.,Taunton, J. E.,Lloyd-Smith, D. R.,MacIntyre, J. G.(1987).Stress fractures in athletes: A study of 320 cases.American Journal of Sports Medicine,15(1),46-58.
14. McBryde, A. M., Jr.(1975).Stress fractures in athletes.Journal of Sports Medicine,3(5),212-217.
15. Milgrom, C.,Finestone, A.,Sharkey, N.,Hamel, A.,Mandes, V.,Burr, D.,Arndt, A.,Ekenman, I.(2002).Metatarsal strains are sufficient to cause fatigue fracture during cyclic overloading.Foot & Ankle International,23(3),230-235.
16. Milgrom, C.,Radeva-Petrova, D. R.,Finestone, A.,Nyska, M.,Mendelson, S.,Benjuya, N.,Simkin, A.,Burr, D.(2007).The effect of muscle fatigue on in vivo tibial strains.Journal of Biomechanics,40(4),845-850.
17. Milner, C. E.,Hamill, J.,Davis, I.(2007).Are knee mechanics during early stance related to tibial stress fracture in runners?.Clinical Biomechanics,22(6),697-703.
18. Mizrahi, J.,Verbitsky, O.,Isakov, E.(2000).Fatigue-related loading imbalance on the shank in running: A possible factor in stress fractures.Annals of Biomedical Engineering,28(4),463-469.
19. Monteleone, G. P., Jr.(1995).Stress fractures in the athlete.Orthopedic Clinics of North America,26(3),423-432.
20. Sharkey, N. A.,Ferris, L.,Smith, T. S.,Matthews, D. K.(1995).Strain and loading of the second metatarsal during heel-lift.Journal of Bone & Joint Surgery - American Volume,77(7),1050-1057.
21. Silva, M. J.,Touhey, D. C.(2007).Bone formation after damaging in vivo fatigue loading results in recovery of whole-bone monotonic strength and increased fatigue life.Journal of Orthopaedic Research,25(2),252-261.
22. Voss, L. A.,Fadale, P. D.,Hulstyn, M. J.(1998).Exercise-induced loss of bone density in athletes.Journal of the American Academy of Orthopaedic Surgeons,6(6),349-357.
23. Warden, S. J.,Hurst, J. A.,Sanders, M. S.,Turner, C. H.,Burr, D. B.,Li, J.(2005).Bone adaptation to a mechanical loading program significantly increases skeletal fatigue resistance.Journal of Bone & Mineral Research,20(5),809-816.
24. Weist, R.,Eils, E.,Rosenbaum, D.(2004).The influence of muscle fatigue on electromyogram and plantar pressure patterns as an explanation for the incidence of metatarsal stress fractures.American Journal of Sports Medicine,32(8),1893-1898.
25. 劉先翔(1997)。運動疲勞性骨折。大專體育，29，100-104。