PRIJELOMI ZAMORA U AKTIVNIH I REKREATIVNIH SPORTAŠA

Prijelomi zamora su djelomični ili potpuni prijelomi kostiju koji nastaju djelovanjem mnogobrojnih ponavljanih sila slabijih od sile koja je potrebna da slomi kost jednim djelovanjem i kao takvi predstavljaju sindrome prenaprezanja kostiju. Čest su problem sportske medicine, obuhvačajući između 1,1 i 10% svih sportskih ozljeda. Brojni su čimbenici koji pogoduju nastanku prijeloma zamora, a najčešći uzrok, u 22 do 75% slučajeva, su pogreške u treningu, tj. „prerano, previše“. Za postavljanje dijagnoze prijeloma zamora, važno imati na umu mogućnost takvoga stanja. Klinička dijagnoza jest osnovni postupak koji se kasnije, prema potrebi, nadopunjuje i drugim dijagnostičkim metodama: radiografijom, scintigrafijom, kompjutoriziranom tomografijom i magnetskom rezonancijom. Za najveći broj prijeloma zamora dovoljno liječenje jest kratkotrajan prekid sportske aktivnosti u trajanju od 4 do 6 tjedana koji dovodi do nestanka boli te zatim slijedi postupan povratak sportu. Prijelomi zamora pojedinih lokalizacija, vrat i trup bedrene kosti, prednji dio srednje trećine tibije, navikularna kost stopala, baza pete metatarzalne kosti, itd., imaju veći broj komplikacija tijekom liječenja te zahtijevaju posebno, dugotrajnije liječenje, a katkad i kirurško. Konačno, kao i u svim sindromima prenaprezanja, prevencija je ključna riječ.
Stress fractures, which are classified among overuse injuries of bone, may be defined as partial or complete bone fracture that results from repeated application of stress of less strength than the stress required to fracture bone in a single loading. They are common problem in sports medicine comprising between 1.1 to 10% of all athletic injuries. Causes are many, but training errors, i.e. „too soon, too much“, are the most frequently encountered cause of stress fractures, causing stress fractures in as many as 22 to 75% cases. To diagnose a stress fracture, it is essential to have the possibility of such a condition constantly in mind. Clinical examination represents basic diagnostic procedure followed later on by other diagnostic methods: radiography, scintigraphy, computed tomography and magnetic resonance imaging. For the most of stress fractures sufficient treatment is rest from offending athletic activity during 4 to 6 weeks leading to disappearance of pain and gradual return to sport activities. Stress fractures in some localizations, femoral neck (tension side), anterior cortex of the tibia, tarsal navicular, fifth metatarsal, etc., have higher number of complications during the treatment and require additional treatment, and in some cases even surgical intervention is appropriate. Finally, as in the most of the injuries belonging to the overuse group, prevention is the key word.