Πέμπτη 1 Αυγούστου 2019

Treatment and Prognosis of High- and Low-Risk Kaeding Grade II Bone Stress Injuries

imageBone stress injuries (BSI) may be classified as high- or low-risk based on the anatomic location of injury and by grade based on severity. Kaeding grade II (K-GII) BSI are characterized by symptomatic marrow or periosteal edema without a fracture line. This retrospective cohort study aims to compare outcomes between high- and low-risk K-GII BSI. We hypothesize that patients with high- and low-risk K-GII BSI experience similar recovery rates. Data were collected via chart review on all patients at a primary care clinic with a magnetic resonance imaging–confirmed diagnosis of K-GII BSI during a 15-month surveillance period. High- and low-risk patients were compared for two primary outcomes—time to become asymptomatic and time to return to activity—and for the secondary outcome of treatments received. A total of 129 K-GII BSI were sustained by 87 patients. For all patients diagnosed with a K-GII BSI, the mean time to become asymptomatic was 40 ± 27 d, and the mean time to return to activity was 49 ± 31 d. There was no difference in time to become asymptomatic (P = 0.762) or to return to activity (P = 0.164) between high-risk (n = 20) and low-risk (n = 67) patients. Treatment modalities were similar between the two groups. All K-GII BSI healed with nonoperative treatment at similar rates, regardless of classification as high- or low-risk, to include tarsal navicular and talus BSI. Early identification of BSI, before progression to a fracture line, leads to favorable results for both high- and low-risk K-GII BSI.

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