Stress fractures of the foot and ankle

Abstract

Among athletes, stress fractures are common injuries, many of which occur about the foot and ankle. Typically they develop when a specific bone is subjected to repetitive loads that create microfractures at a rate faster than the body's ability to compensate and repair them. The stresses are affected by training volume and intensity, as well as biomechanical factors specific to the athlete. The athlete's healing ability is dependent on the overall metabolic status and the local environment of the bone that is fractured. Treatment varies depending on the location of the fracture, as some bones have a predisposition to slow healing times and complications, and other heal quite readily without aggressive treatment. Regardless, when treating stress fractures it is always necessary to tailor the program to the specific athlete, as well as to identify both intrinsic and extrinsic factors that may have contributed to the injury and may predispose the athlete to recurrence. High risk locations of stress fractures of the foot and ankle include the anterior cortex of the tibial diaphysis, the medial malleolus, the navicular body, the proximal fifth metatarsal, and the tibial sesamoid of the hallux.