rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2020-102-105rsp-2850Research ArticleРЕВМООРТОПЕДИЯ И РЕАБИЛИТАЦИЯORTHOPEDIC RHEUMATOLOGY AND REHABILITATIONОтдаленные результаты консервативного лечения стрессовых переломов костей нижних конечностейLong-term results of medical treatment for lower extremity stress fracturesРязанцевМ. С.RyazantsevM. S.

Михаил Сергеевич Рязанцев

29110, Москва, Орловский пер., 7

Mikhail Ryazantsev

7, Orlovsky Lane, Moscow 129110

Ryaz.doc@yandex.ruЗариповА. Р.ZaripovA. R.

29110, Москва, Орловский пер., 7; 2 117189, Москва, ул. Миклухо-Маклая, 6

7, Orlovsky Lane, Moscow 129110; 6, Miklukho-Maklay St., Moscow 117198

АфанасьевА. П.AfanasyevA. P.

29110, Москва, Орловский пер., 7

7, Orlovsky Lane, Moscow 129110

МайсиговМ. Н.MaysigovM. N.

29110, Москва, Орловский пер., 7

7, Orlovsky Lane, Moscow 129110

МагнитскаяН. Е.MagnitskayaN. E.

29110, Москва, Орловский пер., 7

7, Orlovsky Lane, Moscow 129110

ИльинД. О.IlyinD. O.

29110, Москва, Орловский пер., 7

7, Orlovsky Lane, Moscow 129110

ЛогвиновА. Н.LogvinovA. N.

29110, Москва, Орловский пер., 7; 2 117189, Москва, ул. Миклухо-Маклая, 6

7, Orlovsky Lane, Moscow 129110; 6, Miklukho-Maklay St., Moscow 117198

ФроловА. В.FrolovA. V.

29110, Москва, Орловский пер., 7; 2 117189, Москва, ул. Миклухо-Маклая, 6

7, Orlovsky Lane, Moscow 129110; 6, Miklukho-Maklay St., Moscow 117198

КоролевА. В.KorolevA. V.

29110, Москва, Орловский пер., 7; 2 117189, Москва, ул. Миклухо-Маклая, 6

7, Orlovsky Lane, Moscow 129110; 6, Miklukho-Maklay St., Moscow 117198

Европейская клиника спортивной травматологии и ортопедии (ECSTO)РоссияEuropean Clinic of Sports Traumatology and Orthopedics (ECSTO)Russian FederationЕвропейская клиника спортивной травматологии и ортопедии (ECSTO); ФГАОУ ВО Российский университет дружбы народовРоссияEuropean Clinic of Sports Traumatology and Orthopedics (ECSTO); Peoples’ Friendship University of RussiaRussian Federation202020022020581102105Copyright © Рязанцев М.С., Зарипов А.Р., Афанасьев А.П., Майсигов М.Н., Магнитская Н.Е., Ильин Д.О., Логвинов А.Н., Фролов А.В., Королев А.В., 20202020Рязанцев М.С., Зарипов А.Р., Афанасьев А.П., Майсигов М.Н., Магнитская Н.Е., Ильин Д.О., Логвинов А.Н., Фролов А.В., Королев А.В.Ryazantsev M.S., Zaripov A.R., Afanasyev A.P., Maysigov M.N., Magnitskaya N.E., Ilyin D.O., Logvinov A.N., Frolov A.V., Korolev A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2850

Цель исследования — оценить отдаленные результаты консервативного лечения стрессовых переломов нижних конечностей.

Материал и методы

Материал и методы. Наблюдались 55 пациентов, которые прошли курс консервативного лечения в Европейской клинике спортивной медицины и травматологии (ECSTO) в период с 2010 по 2016 г. Средний возраст пациентов составил 37 лет (от 15 до 65 лет). Среди них было 36 (65%) женщин и 19 (35%) мужчин. Отдаленные результаты лечения оценивали по шкалам FAAM (модули ADL + sport) и LEFS.

Результаты и обсуждение

Результаты и обсуждение. При оценке степени стрессовой перестройки по данным магнитно-резонансной томографии (МРТ), при обращении, в соответствии с классификацией, предложенной E.A. Arendt и соавт., выявлено повреждение 2-й стадии у 10 (18%), 3-й стадии — у 14 (26%), 4-й стадии — у 16 (29%) пациентов. Медиана времени от момента обращения до оценки по данным ортопедических шкал составила 3 года (от 1 года до 7 лет). У 25 (47%) пациентов стрессовой перестройке были подвержены II и III плюсневые кости. Причиной стрессовой перестройки чаще всего становился бег (38%), реже ходьба (29%), занятия игровыми видами спорта (18%), фитнес (9%) и другие виды физической активности (6%). При оценке результатов по шкале FAAMADL медиана составила 100 [96; 100] %; по шкале FAAMsport - 100 [91; 100] %. По шкале LEFS у 48 (87%) пациентов получен отличный, у 6 (11%) — хороший и у 1 (2%) — удовлетворительный результат.

Заключение

Заключение. Наиболее частой причиной стрессовых переломов костей нижних конечностей является бег. Данные изменения хорошо поддаются консервативному лечению, которое включает разгрузку поврежденной конечности, физиотерапию, а также индивидуальное ортезирование стоп.

Objective

Objective: to assess the long-term results of medical treatment for lower extremity stress fractures.

Subjects and methods

Subjects and methods. Fifty-five patients who had received a medical treatment cycle in the European Clinic of Sports Traumatology and Orthopedics (ECSTO) in the period 2010 to 2016 were followed up. The patients' mean age was 37 (range 15—65) years. Among them, there were 36 (65%) females and 19 (35%) males. The long-term results of treatment were assessed using the Foot and Ankle Ability Measure (FAAM) scale (ADL + sport modules) and the Lower Extremity Functional Scale (LEFS) scales.

Results and discussion

Results and discussion. Assessing the degree of stress adjustment according to magnetic resonance imaging (MRI), on visiting, in accordance with the classification proposed by E.A. Arendt et al., revealed grades 2, 3, and 4 injuries in 10 (18%), 14 (26%), and 16 (29%) patients, respectively. The median time from the moment of visiting before assessment according to the orthopedic scales was 3 years (1 to 7 years). The second and third metatarsals underwent stress adjustment in 25 (47%) patients. The cause of stress adjustment was most often running (38%), less often walking (29%), playing sports (18%), fitness (9%), and other types of physical activity (6%). Assessing the scores for the FAAM ADL and FAAM sport subscales showed that the median was 100 [96; 100]% and 100 [91; 100]%, respectively. Estimating the scores for the LEFS scale revealed excellent, good, and satisfactory results in 48 (87%), 6 (11%), and in 1 (2%) patients, respectively.

Conclusion

Conclusion. The most common cause of lower extremity stress fractures is running. These changes respond well to medical treatment, which includes injured limb overuse, physiotherapy, and individual ankle-foot orthosis.

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The authors declare that there are no conflicts of interest present.