Best Practice Case Studies-Case 113 Asset 4 High Grade Stress Fractures

Video Transcription

Video Summary

The session opens the AMSSM National Fellow Online Lecture Series, with housekeeping notes (mute/video off, submit questions via chat, complete the post-lecture evaluation) and promotion of the next talk on February 3. Dr. Kevin Vincent (University of Florida) then presents on diagnosing and managing high-risk stress fractures.<br /><br />He explains stress injury as a continuum from asymptomatic bone edema to a visible fracture line, emphasizing that “stress reaction” on MRI still represents low-grade stress injury. Key causes include insufficient recovery, abnormal loads on normal bone, or normal loads on abnormal bone (e.g., RED-S/female athlete triad, low vitamin D). Muscle flexibility and strength are highlighted as critical for force dissipation; limited ankle dorsiflexion or toe extension can shift forces to bone.<br /><br />Dr. Vincent reviews history and exam clues (insidious onset, night “toothache” throbbing, progression with activity, point tenderness, hop test, fulcrum test for femur). X-rays are often negative; MRI grading predicts healing time. He differentiates low-risk versus critical fractures and details management for high-risk sites including femoral neck (tension vs compression), anterior tibia, medial malleolus, talus, navicular (favoring strict non-weight-bearing casting with high union rates), and proximal fifth metatarsal. He concludes with practical return-to-run planning, expectation management, and addressing biomechanics and training errors—often via specialized physical therapy.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 3

Topic Ankle

Keywords

4th Edition

4th Edition, Case 3

Ankle

AMSSM National Fellow Online Lecture Series

high-risk stress fractures

stress injury continuum

MRI grading and diagnosis

RED-S and female athlete triad

femoral neck stress fracture

navicular stress fracture non-weight-bearing cast

return-to-run rehabilitation and biomechanics