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Złamania zmęczeniowe – groźny uraz sportowców

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Na złamania zmęczeniowe, nazywane też przeciążeniowymi, najbardziej narażone są osoby regularnie uprawiające sport. Tego typu złamania nie są skutkiem gwałtownego urazu, ale serii mikrouszkodzeń, do których dochodzi na przestrzeni kilku tygodni lub miesięcy.

Przyczyną złamań zmęczeniowych jest zwykle systematyczne przeciążanie układu kostno-stawowego, które skutkuje licznymi mikrouszkodzeniami w strukturze kości. Zazwyczaj ten rodzaj złamania występuje w obrębie kończyn dolnych, które są szczególnie narażone na przeciążenie. Najczęściej dochodzi do nich w obrębie piszczeli oraz kości śródstopia, a także kości łódkowatej i strzałkowej.

Kto jest narażony na złamania zmęczeniowe?

Złamania zmęczeniowe najczęściej dotykają sportowców, głównie biegaczy, ale także siatkarzy, piłkarzy czy tancerzy. Do tego typu urazu może dojść wskutek zbyt intensywnych i obciążających ćwiczeń, braku rozgrzewki przed treningami czy nieprawidłowego wykonywania ćwiczeń. Do złamania zmęczeniowego może przyczynić się także trenowanie na twardej powierzchni oraz nieodpowiednie obuwie, które niedostatecznie amortyzuje wstrząsy w trakcie uderzania stóp o podłoże podczas biegu.

Złamania zmęczeniowe mogą dotknąć także osoby otyłe i pracujące w pozycji stojącej. Czynnikami zwiększającymi ryzyko złamania zmęczeniowego są nadwaga, schorzenia układu kostno-stawowego, zaburzenia hormonalne, dieta uboga w wapń i witaminę D, palenie wyrobów tytoniowych i nadużywanie alkoholu.

Objawy złamania zmęczeniowego

Pierwszym objawem złamania zmęczeniowego jest miejscowy ból, który pojawia się początkowo jedynie podczas aktywności fizycznej. Z biegiem czasu jednak ból nie ustępuje po przerwaniu aktywności i zaczyna narastać także w stanie spoczynku. W miarę pogłębiania się urazu dolegliwości bólowe utrzymują się nawet kilkanaście dni i nasilają się zwłaszcza podczas chodzenia. Po pewnym czasie w miejscu, w którym doszło do złamania, pojawia się obrzęk, zasinienie lub zaczerwienienie. Występuje także ucieplenie miejsca urazu. Można również wyczuć zgrubienie kości lub nierówność.

Leczenie złamania zmęczeniowego

Leczenie polega przede wszystkim na odciążeniu kończyny na czas regeneracji tkanki kostnej. Konieczna jest tymczasowa rezygnacja z aktywności, która wywołała uraz. By zmniejszyć dolegliwości bólowe, stosuje się leki przeciwbólowe oraz zimne okłady.

W przypadku złamania kości łódkowatej i piszczelowej miejsce urazu może zostać unieruchomione w ortezie lub opatrunku gipsowym. Jeżeli doszło do przemieszczenia odłamków kostnych, konieczna może być operacja. Leczenie chirurgiczne może być również zastosowane w przypadku złamań, w których występuje ryzyko nieprawidłowego zrostu kości. Pełne wygojenie złamania zmęczeniowego kości zajmuje od 4 do 12 tygodni – najczęściej następuje to po 5-6 tygodniach.

Rehabilitacja po złamaniu zmęczeniowym

Złamania zmęczeniowe wymagają podjęcia rehabilitacji. Wdraża się fizykoterapię w celu przyspieszenia regeneracji kości i zmniejszenia obrzęków. Zalecane zabiegi to m.in. laseroterapia, elektroterapia, krioterapia i jonoforeza. Wskazane jest również podjęcie kinezyterapii. Ćwiczenia rozciągające, stabilizujące czy izomeryczne łagodzą dolegliwości bólowe, zapobiegają powstawaniu zakrzepów i zwiększają mobilność kończyny.

Powikłania złamania zmęczeniowego

Złamania marszowe mogą doprowadzić do poważnych powikłań. Wskutek złamania może dojść do uszkodzeń nerwów i stawów, zmniejszenia mobilności, wystąpienia przewlekłego bólu oraz pojawienia się stawu rzekomego. Zbyt późne podjęcie leczenia może doprowadzić nawet do ubytków kości lub martwicy tkanki kostnej.

Źródło: mp.pl

 

Przeczytaj także: Złamanie kostki bocznej – operacja i działania pooperacyjne

 

Przeczytaj bezpłatnie pokrewny artykuł w czasopiśmie „Pielęgniarstwo w Anestezjologii i Intensywnej Opiece”:

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