SRTESS FRACTURE

A stress fracture is a fissure in the bone. Most commonly occur in a weight bearing bone in the foot when they are exposed to more than usual stress. 

 

Symptoms

Pain is the most common symptom of stress fracture. Pain and swelling that get worse with physical activities and relieved by rest. 

 

Causes

  • Overuse is the most common cause for stress fracture.

  • Non-supporting shoe wear.

  • Intense exercises that include repetitive activities such as running and jumping. ​

  • Osteoporosis that leads to bone weakening that may not be able to handle simple changes in activity may develop stress fractures.

 

Diagnosis

Your doctor will obtain your medical history, examine your foot and inspect your shoe wear. A series of X-rays is ordered to confirm diagnosis. If the bone fissure is small it may not show on the X-rays. An ultrasound or MRI might be helpful to confirm diagnosis as stress fractures commonly shows a collection of blood from the broken bone (subperiosteal hematoma).

 

Treatment

  • Rest: Since stress fractures are mainly caused by overuse or repetitive exercise, a period of rest is needed to allow bone to heal. It is noted that bone healing period takes 6 to 8 week. A low impact exercise can be introduced during the healing period such as swimming and biking.

  • A hard sole shoe such as surgical shoe and in some cases a walking boot is used for daily walking. This is in order to decrease the impact of weight bearing forces on the fractured bone.

  • Over-counter or prescription for Calcium and vitamin D supplements are very helpful for bone to heal.​

  • If bone failed to heal with the conservative measures mentioned above the condition called non-union and surgery might be considered. Surgical intervention is usually involve internal fixation  wit screws and some time bone graft is added to the fracture surface to enhance bone healing.

 

Complications

Failure of the fractured bone to heal (nonunion) or bone healing in abnormal position (malunion) and recurrent fractures.

 

Prevention

  • Proper shoes with rigid or semirigid sole for the type of exercise

  • For Athletes whom had a period of lay-off, a gradual slow return to exercises is advised.

  • Stretching and warming up gradually before running or walking.

  • Stretching and strengthening the muscles in the calf is always advised.

  • Gradual increment of running or walking distance. Avoid incrementing of greater than 10 percent per week

  • Avoid strenuous sprinting exercises.

 

©2020 by JEFF PODIATRY PA.