Fatigue fractures – endocrinologist from Mainz provides information

MAINZ: Prof Dr Dr h. c. Christian Wüster is repeatedly confronted with so-called fatigue fractures in his day-to-day practice. In the experience of the specialist in endocrinology, treatment requires special interdisciplinary management and cooperation between orthopaedists, trauma surgeons, osteologists, radiologists and physiotherapists. However, if this co-operation works and the patient cooperates well, the convalescence after a fatigue fracture can be significantly shortened. But what exactly is a fatigue fracture and which people are affected? ‘Fatigue fractures are more common in athletes, soldiers and ballet dancers. Because soldiers are often affected, they are also known as marching fractures,’ explains Prof Dr Dr h. c. Wüster. They are also known as stress fractures or bone bruises. Around ten per cent of recruits suffer fatigue fractures after just three months of basic training. Athletes even show a frequency of 20 per cent.

Where can fatigue fractures occur? Endocrinologist from Mainz provides information

The stress fracture often occurs on the tibia, fibula, metatarsals, tarsals, femoral neck or even the ischium. In order to diagnose a stress fracture, imaging techniques such as computer tomography (CT), magnetic resonance imaging (MRI), X-rays and bone scintigraphy are required, as are laboratory diagnostics and a differential diagnostic osteological examination. This serves, among other things, to exclude malignant diseases.

The main causes of stress fractures are

• prolonged strain,
• sports that are dependent on weight,
• forms of osteoporosis or osteomalacia,
• Calcium metabolism disorders,
• vitamin D deficiency,
• vitamin D receptor defects,
• inadequate energy intake,
• eating disorders (anorexia nervosa) or
• relative energy deficiency syndrome in athletes.

Treatment of fatigue fractures by an endocrinologist in Mainz

In addition to the interdisciplinary medical treatment of fatigue fractures, psychological care for patients with stress fractures is also very useful. Prof Dr Dr h. c. Christian Wüster, for example, reports a high level of suffering that can occur in competitive athletes in particular. The therapy includes optimised energy intake with protein and a high-calorie diet. In addition, dietary supplements such as vitamin D, vitamin K, calcium and magnesium can be prescribed. The osteologist should decide whether a bone-building medication should be used. Such a preparation can shorten the healing process. However, certain osteoporosis therapies have the exact opposite effect. In pre-menopausal women with menstrual cycle disorders, cycle-regulating medication can be useful. In men, testosterone can be prescribed.

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