Bone stress injuries, commonly referred to as stress reactions and stress fractures, represent overuse injuries to bone. These injuries result in physical limitations in activity and can be career-ending for high-level athletes. While bone stress injuries have received increased attention in recent years, international consensus is lacking on definitions, risk factors and strategies for management and prevention. This study aimed to ascertain and improve the level of agreement on bone stress injuries by utilising a three-part modified Delphi approach on (1) pathophysiology, diagnosis, terminology and classification systems; (2) risk factors, screening and prevention; and (3) management and return to sport. A multidisciplinary steering committee initiated the consensus process. A panel of 41 members from six continents was formed to complete three rounds of voting, including experts (scientists and clinicians) and representatives (athletes and coaches). Thirty-three, 28 and 28 panel members completed Delphi rounds 1, 2 and 3, respectively. Consensus was reached on 41 out of 58 statements. Findings from this Delphi study outline a multifactorial approach to identify and manage bone stress injuries and to promote bone health in athletes. This includes recommendations for diagnostic workup and treatment to assist clinicians in caring for patients with bone stress injuries. Finally, this consensus process identifies knowledge gaps and provides a framework for future research to advance the clinical care and prevention of bone stress injuries.

中文翻译：

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关于运动员骨应力损伤的国际德尔菲共识


骨应力损伤，通常称为应力反应和应力性骨折，是指骨骼的过度使用性损伤。这些伤害会导致身体活动受限，并可能结束高水平运动员的职业生涯。虽然近年来骨应力损伤受到越来越多的关注，但国际上对管理和预防的定义、风险因素以及策略缺乏共识。本研究旨在通过对 （1） 病理生理学、诊断、术语和分类系统;（2） 风险因素、筛查和预防;（3） 管理和重返运动。一个多学科指导委员会启动了共识过程。一个由来自六大洲的 41 名成员组成的小组完成三轮投票，其中包括专家（科学家和临床医生）和代表（运动员和教练）。33 名、28 名和 28 名小组成员分别完成了 Delphi 第 1、2 和 3 轮。在 58 项声明中，有 41 项达成了共识。这项 Delphi 研究的结果概述了一种多因素方法来识别和管理骨骼应力损伤并促进运动员的骨骼健康。这包括诊断性检查和治疗的建议，以协助临床医生照顾骨应力性损伤患者。最后，这个共识过程确定了知识差距，并为未来的研究提供了一个框架，以推进临床护理和骨应力损伤的预防。