Stress Fracture: A Review of the Pathophysiology, Epidemiology and Management Options - Abstract
Stress fractures of the lower limbs are commonly observed in both military and physically active civilian populations. They represent a breach in the bones capacity to tolerate repetitively applied mechanical loading such that repair is exceeded by structural damage resulting in localized tenderness and pain. Prevention of stress fracture should remain the priority however once diagnosed, effective management, born from a thorough understanding of the pathophysiological inter-actions, is required in order to expedite healing and increase the likelihood of a return to pre injury status. Multi-factorial in causation, they are considered as the physiological consequence of a dynamic interplay between both extrinsic and intrinsic factors. Although stress fractures usually heal without complication, restoration of bone integrity is only part of the rehabilitation process. Comprehensive management should include assessment and consideration of the entire kinetic chain in order to return the injured individual to pre-morbid functional status. However, irrespective, high risk stress fractures are more likely to result in delayed union and as such require extended periods of reduced weight bearing followed by prolonged therapeutic rehabilitation. Description of pathophysiology, epidemiology as well as an overview of management perspectives will be considered in this paper.