RESUMO
A 16-year-old female patient showed up at the orthopaedics unit complaining of intolerable pain on her left hip. While being questioned and her clinical history written down, she shared that as part of her daily exercise routine, she ran 10 miles (16 km) daily at a speed of 9.5-10.5 mph (15-17 km/hour). MRI was consequently ordered, confirming the presence of a stress fracture. Therefore, immediate suspension of physical activity was indicated, followed by the prescription of crutches as well as restricted weight bearing. Gradually, she recovered complete functionality and approximately a month after she had entirely healed. While on a skiing trip, again she abruptly developed an acute pain on her right hip. Another MRI was ordered; its result confirmed a new stress fracture. Her previous treatment has proved so successful, a conservative approach was once again prescribed for her, showing optimum results 6 months later.
Assuntos
Traumatismos em Atletas , Reabsorção Óssea , Tratamento Conservador/métodos , Colo do Fêmur , Fraturas de Estresse , Dor Musculoesquelética/diagnóstico , Adolescente , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/fisiopatologia , Traumatismos em Atletas/terapia , Reabsorção Óssea/diagnóstico , Reabsorção Óssea/tratamento farmacológico , Reabsorção Óssea/etiologia , Muletas , Feminino , Fraturas do Colo Femoral/diagnóstico por imagem , Fraturas do Colo Femoral/etiologia , Fraturas do Colo Femoral/fisiopatologia , Fraturas do Colo Femoral/terapia , Colo do Fêmur/diagnóstico por imagem , Colo do Fêmur/patologia , Fraturas de Estresse/diagnóstico por imagem , Fraturas de Estresse/etiologia , Fraturas de Estresse/fisiopatologia , Fraturas de Estresse/terapia , Humanos , Imageamento por Ressonância Magnética/métodos , Dor Musculoesquelética/etiologia , Corrida , Resultado do TratamentoRESUMO
In this case report, we present an acute rupture in the muscular tendinous junction of a posterior tibialis muscle in a bimalleolar closed ankle fracture after a high-energy trauma in a 30-year-old patient with no significant medical history. Fracture was confirmed by simple X-rays, and was treated with an open reduction in which both of the fractures were treated with osteosynthesis material and reparation of the syndesmosis. If left untreated, this uncommon finding can result in a bad postsurgical outcome; we believe this injury is more common but under-reported in the literature. The surgeon should be aware and look specifically for this type of lesion during the procedure. Finding and treating this injury requires special postoperative care, non-weight-bearing instructions and balanced physiotherapy.