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Stress fracture

STRESS FRACTURE

Diagnosis: STRESS (FATIGUE) FRACTURE

Anatomy:
The foot bones comprise the 7 tarsal bones (ossa tarsi), the 5 metatarsal bones (ossa metatarsi) and the 14 bones in the toes (phalanx).
  1. Phalanx media

  2. Tuberositas ossis metatarsalis V

  3. Os cuboideum

  4. Calcaneus

  5. Talus

  6. Os naviculare

  7. Os cuneiforme laterale

  8. Os cuneiforme intermedium

  9. Os cuneiforme mediale

  10. Os metatarsalei

  11. Os sesamoideum

  12. Phalanx proximalis

  13. Phalanx distalis

THE FOOT FROM ABOVE

Cause: Repeated load or strain (walking or running) can in some cases entail the load exceeding the strength of the bone tissue, thus resulting in a stress (or fatigue) fracture. Stress fractures are most often seen in the metatarsal bones, (article) (article).

Symptoms: Pain when applying pressure (direct or indirect tenderness), and when applying load or strain.

Examination: X-ray examination will usually, but not always, reveal a stress fracture. The x-ray examination can be repeated after a few weeks as a number of stress fracture are not easily discernible in the early stages. Bone scintigraphy, ultrasound scanning and MRI examination can often diagnose a stress fracture much earlier than x-ray examination (Ultrasonic image), (Scintigraphy-image).

Treatment: Treatment is primarily relief and rest, and possible bandaging. Surgical intervention is only required in very special cases. It is imperative that shoes are equipped with impact absorbing soles (article).

Rehabilitation:
Rehabilitation is totally dependent upon the type of fracture, and the treatment (conservative or surgical). Until the pain has subsided, the guidelines under rehabilitation, general should be followed.

Complications: If there is not a steady improvement in the condition a medical examination should be performed once more to ensure that the fracture is healing according to plan. In some cases, a false joint can develop which will require surgical treatment.
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