Von 1996 bis 2001 wurden 116 männliche und 95 weibliche Leichtathleten untersucht. 19 Sportler (9 %) erlitten Wiederholungsstressfrakturen. Die Häufigkeit von einer oder mehreren Stressfrakturen bei Sportlern mit Stressfrakturanamnese betrug 62 %. Am meisten war die Tibia betroffen (45 %). 77 % der Wiederholungsstressfrakturen traten bei Langstreckenläufern auf. Niedrigeres Körperfett war ein signifikanter Risikofaktor bei weiblichen Sportlern, bei männlichen Sportlern wurden keine Risikofaktoren ermittelt. Introduction: Stress fractures are a common problem in the track and field athlete. Athletes with recurrent stress fractures present an especially difficult situation. Although recurrent fractures occur frequently in the track and field athlete, there is a lack of data on their prevalence, distribution and risk factors. Back to Top | Article Outline Objective: To describe the prevalence, skeletal distribution and risk factors for recurrent stress fractures prospectively over 5 years. Back to Top | Article Outline Methods: All of the UCLA track and field athletes were followed prospectively from the fall of 1996 to the summer of 2001 (N = 211; 116 men, 95 women). If a stress fracture was suspected, X-rays were obtained. If X-rays were negative, MRI was used for diagnosis. For risk factor assessment, athletes had an annual physical and completed a questionnaire assessing nutritional and menstrual history, training mileage and other variables. The following studies were obtained one or more times during the study: dual energy X-ray absorptiometry of the lumbar spine, total hip, femoral neck, whole body, tibia and distal radius; percent body fat and lean body mass; muscle strength testing and flexibility; laboratory studies including hormonal studies and biochemical markers of bone turnover; and a four day food diary. Back to Top | Article Outline Results: There were 19 athletes who sustained recurrent stress fractures, resulting in an overall prevalence of 9%. The prevalence of one or more stress fractures in athletes with a history of stress fracture was 62%. The tibia was the most frequent skeletal site for recurrent injury (p<0.001), accounting for 45% of the recurrent fractures. 76% of the athletes sustained their repeat fracture at a single skeletal site. 77% of recurrent tibia stress fractures occurred in the distance runners. Lower body fat was a significant risk factor for recurrent stress fractures in the female athlete (p<0.007). No risk factors were identified in the male athlete (p<0.05). Back to Top | Article Outline Conclusions: Track and field athletes with a history of one stress fracture are at an increased risk for recurrent stress fractures, most commonly in the tibia. Distance runners are at higher risk than sprinters or jumpers. Lower body fat is a significant risk factor in the female athlete. More research and preventive measures are needed in this area.
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