Stress Fracture

Summary

  • Stress Fractures are common in the feet, particularly the metatarsals, and occur when excessive repetitive force is applied to a localized area of bone.
  • Activities such as walking, running, and repeated jumping can subject the bones of the foot to large forces that may lead to a stress fracture.
  • Low calcium, vitamin D, and osteoporosis can also contribute or lead to stress fractures.

Diagnostic tips

  1. Significant pain in the region, especially on longitudinal stress/pressure.
  2. There are often no signs but there may be some swelling
  3. Difficulty in shoes
  4. Difficulty in walking / exercise
  5. Only painful on activity

Tests and Imaging

  1. X-rays may reveal calluses.
  2. Bone scans and MRIs are more likely to be positive in stress fractures. MRI may reveal odema in bones.
  3. CT scan can usually confirm the diagnosis of stress fracture as well as clearly define the location and size of the fracture.

Immediate Treatment

  1. Advise appropriate shoes and limit activity.
  2. Consider immobilisation.

Possible Referral

  1. Podiatry for bracing/immobilisation, orthoses, footwear advice.
  2. Foot and ankle surgeon for possible internal fixation.

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