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Stress Fracture

Dongsheng Jiang, MS, MD and Joanna Jiang, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Stress fractures are overuse injuries caused by cumulative microdamage from repetitive bone loading

  • Stress fractures occur in different situations:

    • Fatigue fracture: abnormal repetitiv...

DIAGNOSIS

HISTORY

  • Insidious onset of vague bony pain over a period of weeks. Pain is typically worse with physical activity.

  • Initially relieved by rest, then pain persists with rest or slight activity.

  • I...

TREATMENT

  • Low-risk stress fractures: are generally treated nonoperatively with a 2-phase protocol (2):

    1. Cessation of sport activity for 6-8 weeks;

    2. After a period of pain-free rest of 10 to 14 days, g...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Once the patient is pain free, low-impact training can start and be advanced gently as tolerated. 

Patient Monitoring

Imaging every 4 to 6 weeks to assess healing 

DIET

REFERENCES

1
Beck B, Drysdale L. Risk Factors, Diagnosis and Management of Bone Stress Injuries in Adolescent Athletes: A Narrative Review. Sports. 2021;9(4):52.
2
da Rocha Lemos Costa TM, Borba VZC, Cor...

SEE ALSO

Algorithm: Foot Pain 

CODES

ICD10

  • M84.38XA Stress fracture, other site, initial encounter for fracture

  • M84.369A Stress fracture, unsp tibia and fibula, init for fx

  • M84.376A Stress fracture, unspecified foot, init encntr for f...

CLINICAL PEARLS

  • The diagnosis of stress fractures requires a high index of suspicion. X-rays are often negative initially.

  • Identify and treat female athletic triad or underlying metabolic conditions.

  • To...

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