In orthopedics clinics, there are generally three causes of fractures:

　　1. Violence

　　 mainly refers to various trauma caused by direct violence or indirect violence conduction fracture. The fractures caused by the former occur at the site of direct violence. For example, after the lower leg is directly hit by a heavy object, the tibia and fibula bone fractures at the impacted site. This is a direct violent fracture, and the surrounding soft tissue is also injured at the same time; In addition to the injured part, such as the palm of the hand when falling, violence is transmitted to the proximal end of the limb, and fractures of the distal radius and humerus can occur. Most of the common fractures in the elderly are indirect violent fractures.

　　2. Skeletal diseases

　　Bones have reduced strength after suffering from various diseases, and fractures occur when they encounter slight external forces. This fracture occurs on the basis of bone disease and is called pathological fracture. Fractures that occur on the basis of osteoporosis in the elderly, such as osteomyelitis and bone tumors, also belong to pathological fractures. In clinical practice, patients with osteoporotic fractures of the spine often ask for the cause, often sneezing or bending to lift the kettle.

　　3. Accumulated strain

　　Long-term, repetitive, slight direct or indirect external force concentrated on a certain point of the bone, which can be stimulated by repetitive force Stress fracture (stress) fracture), also known as fatigue fracture. Stress fractures often occur after a long distance march or long-distance running, and the parts are mostly under the weight of the body and some bones that are often repeatedly affected by muscle strength, such as: the second metatarsal and the lower 1/3 of the fibula, in addition , Lumbar spine, ribs.

　　 The earliest mentioned stress fracture occurred in the Prussian army in 1855, when it appeared on the metatarsal bones of recruits and was called "marching fracture" (march fracture). In recent years, due to the rapid increase in the number of people participating in leisure and competitive sports, this type of stress fracture that only occurred in recruits in the past has also generally appeared on ordinary people and athletes. The reason for this is that the exerciser''s muscles are fatigued, muscle contraction is reduced, it is difficult to withstand the stress on the bones during exercise, and the structure of bone tissue is changed under the dual effects of long-term repeated stress and extraordinary load, especially with osteoporosis. Patients are prone to stress fractures.

　　The symptoms of stress fractures will gradually appear within two to three weeks of the onset of the disease. Unlike other chronic injury symptoms caused by overuse, the symptoms of stress fractures mostly stay in the same location and the pain is more obvious. Patients often experience forefoot pain after prolonged or strenuous exercise, which can disappear after a few seconds of rest. In the subsequent training, the pain occurs earlier and heavier and heavier, making it impossible to exercise, touching the swollen area can cause pain, Even lying in bed will feel pain. In the early stage of the disease, X-ray examination usually cannot show fractures, so it is easy to miss or misdiagnose, and it is necessary to review the film after two weeks; CT examination can intuitively display the location and scope of the fracture, and it is also important for follow-up after injury; MRI can clearly show the fracture line, edema and bleeding of the medullary cavity and surrounding soft tissue, so it is of great significance for the early diagnosis of stress fracture.

　　Treatment of stress fractures, including braking, rest, medicine, etc., reliable external fixation treatment is conducive to fracture recovery. After the fracture is healed, you should pay attention to mastering the amount of exercise and the essentials of exercise according to your physical fitness, fully preparing for activities, avoiding running and jumping sports in excellent venues, paying attention to nutritious, balanced and comprehensive diet, and supplementing vitamin D and calcium appropriately. For patients with delayed or non-union of bone, surgical treatment may be considered.