Tibial stress fracture in handball player

Abstract

Cilj: Autori predstavljaju slučaj pogrešne dijagnoze stres frakture proksimalnog dijela tibije s naglaskom na dijagnostičkim metodama i metodama liječenja. Prikaz slučaja: Vrhunski međunarodni rukometaš u dobi od 27 godina javio nam se sa stres frakturom prednje strane gornje trećine desne tibije, što je povezano s prekomjernim i repetitivnim stresom na potkoljenicu. Igra poziciju desnog krila, te koristi desnu nogu za odskok. Sportaš nije imao prethodnih ozljeda. Koristili smo novi neoperativni pristup u liječenju vrhunskog rukometaša i proveli detaljno dijagnostičko praćenje ozljede i oporavka. Sportaš je izvrsno reagirao na neoperativni pristup liječenja nakon pogrešne dijagnoze. Dokumentirano praćenje trajalo je 3,5 godina, nakon što je završeno konzervativno liječenje. Zaključak: Naglasak je stavljen na važnost pravovremeno postavljene dijagnoze te odabir adekvatnog liječenja kako bi se smanjilo vrijeme potrebno za oporavak i vraćanje vrhunskog sportaša u formu jednaku onoj prije ozlijede. Nakon detaljnog pretraživanja relevantne literature autori nisu pronašli opis stres frakture kod rukometaša do sada.Aim: Authors present a misdiagnosed case of proximal tibial stress fracture emphasizing diagnostical and treatment methods. Case report: A 27-year-old international top-level handball player, presented to us with a stress fracture of the right proximal anterior tibia in connection with repetitive and excessive stress to lower leg. He plays right wing position and uses his right leg for jumping. There was no history of previous injuries. We used a new nonoperative approach in treating a top-level handball player as well as detailed diagnostic monitoring of both the injury and the recovery. Athlete’s response to the new non-operative approach was excellent after having been misdiagnosed. Documented monitoring lasted for 3.5 years after the conservative treatment had been finished. Conclusion: The emphasis is put on the importance of making a diagnosis at the right time and choosing adequate treatment with the aim of reducing time needed for recovery and returning top-level athletes’ performance to the same level as prior to injury. Based on a detailed search of relevant literature, the authors have found that stress fractures have never before been described in handball players