Therapy
Depending on the time of diagnosis and the severity of the fatigue fracture, different treatment methods are chosen. If damage to the bone is detected at an early stage, i.e. before the actual fracture has occurred, it is always recommended that the affected extremity be spared, which means a break from training for athletes in any case. Physiotherapy has a supportive effect at such a stage.
If, on the other hand, the fracture has already developed, the corresponding part of the body must be immobilized and relieved with a bandage (more rarely with a plaster cast). Painkillers can also be used. Anti-inflammatory drugs, a local cold therapy and vitamin or calcium preparations also help to alleviate the existing pain somewhat.
An operation is only performed if there is a really serious fracture. Again, there are various procedures that are suitable for therapy: Following these surgical procedures, the extremity is immobilized with a splint bandage. Even though this phase usually “only” lasts about two to four weeks, a complete ability to bear weight is normally only achieved again after about half a year.
In addition to the treatment of the fracture, treatment of an underlying disease may always be necessary.
- The so-called intramedullary nailing
- The screw connection with titanium screws or
- The cancellous bone grafting
A fatigue fracture usually heals well if treated conservatively and in time. However, if the healing of a fatigue fracture takes a long time and after some time the desired results are not achieved, shock wave therapy can be tried as a supporting measure.
In such cases shock wave therapy can be helpful. Shock wave therapy is a non-invasive procedure that uses acoustic pressure waves. These pressure waves release their energy in the depth as soon as they hit the bone.
In the case of a fatigue fracture, the shock wave is specifically directed at the fracture site. This is why we also speak of focused shock wave therapy. The effect is based on the stimulation of bone growth, since the waves cause the bone tissue to produce and release more bone-forming hormones.
The newly formed bone tissue allows the broken bone to grow together again. Consequently, the bone also regains stability. The application of shock wave therapy has no side effects and is very low-risk.
Depending on the strength and repetition of the applied shock wave, slight pain may still occur. However, if shock wave therapy is used to treat a fatigue fracture, the procedure is usually painless. Shock wave therapy should not be used during the period of acute inflammation of the periosteum, which often occurs in conjunction with a fatigue fracture.The treatment usually takes place on an outpatient basis at the orthopedic surgeon, is painless and usually lasts 5-15 minutes per application.
After about 2-5 repetitions, initial successes are often already apparent. Shockwave therapy is therefore a good alternative to surgical treatment of a fatigue fracture. Depending on the response of the patient to shock wave therapy, it can even replace surgery. Since it is an individual health service (= IGel), statutory health insurance companies do not pay for shock wave therapy to treat a fatigue fracture. A reimbursement of costs of such a shock wave therapy remains thus up-to-date unfortunately still another individual case decision.
