Stress fractures of the foot – current evidence on management

Review written by Ian Griffiths info

Key Points

  1. Stress fractures account for up to 20% of athletic injuries, and the most common bones affected in the foot are the metatarsals and the navicular.
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BACKGROUND & OBJECTIVE

Bone stress injuries account for ~10-20% of all sports injuries, and 80-95% of bone stress injuries occur in the lower extremity (1). They can lead to prolonged and costly periods of time out of sport. As such, early detection and appropriate management is paramount; and this may account for why this topic is so regularly published on. Understanding the pathophysiological mechanism which leads to this issue is important (2), along with an appreciation of some of the commonly suggested risk factors including sex (3), biomechanical factors (4), metabolic status (5), and training habits (6).

Several reviews discussing the diagnosis and management of lower limb stress fractures already exist (7,8) and this article is one of the more recent to attempt to summarize the current evidence, with particular reference to the foot specifically.

Bone stress injuries account for ~10-20% of all sports injuries, and 80-95% of bone stress injuries occur in the lower extremity.
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Within the history taking, questions should also always be asked around the topics of diet/nutrition, menstrual history and any changes in training volume or intensity.

METHODS

The nature of the review was narrative rather than systematic, and as such there was no meta-analysis performed.

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