{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T13:58:01Z","timestamp":1781272681379,"version":"3.54.1"},"reference-count":41,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Stress fractures are common in young athletes and a major cause of time lost from training. While epidemiological data exist from Western countries, reports from Asian regions, particularly in subtropical settings, are limited, as year-round training may influence injury risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To assess stress fracture characteristics among adolescent and recreational athletes in Okinawa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Descriptive epidemiology study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review of medical records from orthopaedic clinics and sports medicine centers across Okinawa Prefecture, Japan, between 2018 and 2019 was conducted. Athletes aged &lt;50 years who were diagnosed with imaging-confirmed stress fractures were included. Data on age, sex, sport, fracture site, and return to training (RTT) (defined as symptom-free resumption of sport-specific practice) were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 309 stress fractures were identified in 303 athletes (mean age, 15.6 \u00b1 5.9 years; 47% women). The tibia (31%), metatarsals (28%), and tarsal bones (18%) were the most frequently affected sites. Soccer (21%), basketball (21%), and track and field (14%) accounted for the majority of cases. The median RTT time was 7 weeks (interquartile range [IQR], 4-8 weeks). High-risk fracture sites, such as the fifth metatarsal bone and patella, required significantly longer recovery (median, 8 weeks [IQR 4-12 weeks];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This is the first epidemiological study on stress fractures in a subtropical region of Japan. The findings highlight sport- and site-specific patterns and demonstrate that high-risk anatomic sites require prolonged recovery before a safe return. These results provide important evidence for the development of region-specific prevention and rehabilitation strategies for adolescents and recreational athletes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671261447186","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T13:06:23Z","timestamp":1781096783000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence, Anatomic Distribution, and Return to Training After Stress Fractures in Okinawan Athletes"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6567-2113","authenticated-orcid":false,"given":"Fuminari","family":"Uehara","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, University of the Ryukyus, Ginowan city, Okinawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2950-1194","authenticated-orcid":false,"given":"Kotaro","family":"Higa","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of the Ryukyus, Ginowan city, Okinawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3186-0682","authenticated-orcid":false,"given":"Hiroki","family":"Yabiku","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of the Ryukyus, Ginowan city, Okinawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Toma","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of the Ryukyus, Ginowan city, Okinawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinatsu","family":"Azuma","sequence":"additional","affiliation":[{"name":"Center for Hyperbaric Medicine and Environmental Health, University of the Ryukyus, Ginowan city, Okinawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotaro","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of the Ryukyus, Ginowan city, Okinawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465030310063601"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0278-5919(05)70023-5"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu12030743"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2019-101969"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465010290010201"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000739"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514562739"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.42B1.71"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/jisakos-2015-000010"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2005.08.012"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-13-139"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659502300418"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/RMR.0b013e3180421c8c"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1537\/ase.050608"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-024-02051-y"},{"key":"e_1_3_3_17_2","first-page":"1","article-title":"Dual-structure model for the population history of the Japanese","author":"Hanihara K.","year":"1991","unstructured":"Hanihara K. 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