A comparative overview of metatarsal stress fractures in premenopausal and postmenopausal women: our single-centre exper
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ORIGINAL PAPER
A comparative overview of metatarsal stress fractures in premenopausal and postmenopausal women: our single-centre experience with eighty-one patients Olcay Guler 1,2 & Mehmet Halis Cerci 2 Received: 26 November 2019 / Accepted: 4 March 2020 # SICOT aisbl 2020
Abstract Purpose To compare the demographic, clinical, and laboratory features of metatarsal bone stress fractures encountered in premenopausal and postmenopausal women. Methods This retrospective study was carried out in the orthopaedics and traumatology department of our tertiary care centre. Data were collected from the hospital records of a total of 81 women (average age 42.65 ± 12.97) allocated in premenopausal (n = 36) and postmenopausal (n = 45) groups. These two groups were compared in terms of age, body mass index, side, and level of the metatarsal stress fracture, serum levels of vitamin D, duration of complaint and treatment, and T-scores of femur and vertebra as measured by dual-energy X-ray absorptiometry. Results The average body mass index (BMI) was 27.00 ± 2.49 kg/m2 (range 21.8 to 31.2). The right side was involved in 44 cases (54.3%), while the left side was affected in 37 patients. DXA T-scores were significantly high for group 2 for both femur and vertebra (p < 0.001 for both). Two groups did not exhibit any significant differences in terms of BMI, side of the stress fracture, level and location of the fracture, seasonal distribution, smoking habits, comorbidities, serum levels of vitamin D, durations of complaints, and treatment. Conclusion Our results indicated that there was no difference between 2 groups in terms of serum vitamin D levels; however, postmenopausal women had higher T-scores of femur and vertebra. Identification of patients under higher risk for stress fractures and elucidation of the possible role of menopause necessitate further controlled, randomized trials on larger series. Keywords Stress fracture . Menopause . Metatarsal bone . Osteoporosis
Introduction The stress fractures occur due to the insufficiency of the repair process after a repetitive mechanical overload upon healthy bone tissue or normal stress employed on defective bone tissue [1–3]. Musculoskeletal disorders, biomechanical deformities, level of physical fitness, sleep quality, nutritional status, smoking, and alcohol consumption habits may play a role in the aetiology of stress fractures. In addition to these factors,
* Olcay Guler [email protected] 1
Department of Orthopaedics and Traumatology, Istanbul Istinye University School of Medicine, 34010 Istanbul, Turkey
2
Department of Orthopaedics and Traumatology, Nisa Hospital, Bahcelievler, 34196 Istanbul, Turkey
improper training programs or sports equipment may contribute to the formation of stress fractures [2–4]. The most common sites of occurrence for stress fractures are metatarsal bones, calcaneus, proximal, and distal tibia. Stress fractures most commonly involve the lower extremities, and proximal tibia is the most frequent site. Bilateral involvement can be diagnosed
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