Best Practice Case Studies-High-Risk Stress Fractures

Pdf Summary

Stress fractures are common overuse injuries typically seen in athletes and military recruits, often affecting the tibia, tarsals, and metatarsals. Incidence can be as high as 20% in runners compared to less than 1% in the general athletic population. These injuries, caused by repetitive submaximal forces, often arise from an imbalance between bone resorption and formation when athletes abruptly increase exercise intensity or duration without adequate rest. Factors such as muscle fatigue and certain sports-specific activities can contribute to the development of stress fractures.  <br /><br />In addition to mechanical forces, systemic factors like hormonal imbalances, nutritional deficiencies, and sleep deprivation can also contribute to stress fractures, particularly in women. The "female athlete triad" (eating disorders, amenorrhea, and osteoporosis) is notably linked with increased stress fracture risk in women. Similarly, male athletes with low testosterone levels may experience increased bone resorption and fracture risk.<br /><br />Diagnosis often begins with a clinical evaluation, including a detailed history, but may require imaging like radiography, scintigraphy, or MRI for confirmation. Low-risk stress fractures usually heal with rest and activity modification. However, high-risk stress fractures, such as those in the femoral neck or anterior tibia, necessitate more aggressive treatment to prevent complications like delayed healing or nonunion.<br /><br />Prevention focuses on correcting training errors and maintaining balance in physical activity levels. Special attention is required for high-risk groups, including athletes with known systemic risk factors or those presenting early symptoms. Treatment protocols may involve rest, mechanical support, or surgical interventions, aimed at facilitating a timely and effective recovery while minimizing the risk of recurrence.

Meta Tag

Edition 2nd Edition

Related Case 2nd Edition, CASE 12

Topic Foot and Ankle

Keywords

2nd Edition

stress fractures

athletes

bone resorption

female athlete triad

hormonal imbalances

nutritional deficiencies

diagnosis

prevention

treatment protocols

high-risk fractures

2nd Edition, CASE 12

Foot and Ankle