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Stress fracture

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

This a fracture that occurs in the apparently normal bone of a healthy person. This type of fracture is caused by repetitive minor stress, and not a single traumatic incident.

Sites of stress fractures are dependent on the activity that is causing the repeated stress. Some examples of associations between activities and sites of stress fractures are presented below:

Site

Activity

humerus

cricket in adolescence

tibia and fibula

long distance running

metatarsals

marching

pars interarticularis of the fifth lumbar vertebrae

gymnastics

Stress fractures occur as a result of microfracture from repetitive loading below a single load fracture threshold. Histological changes develop prior to a microfracture; if load is not modified a complete fracture will occur (1).

Notes:

  • 'overuse injury to bone' essentially refers to stress fracture
    • note that stress fractures can occur in older patients e.g. insufficiency fracture seen by rheumatologists in osteoporotic patients

Reference:

  • (1) ARC. Sports-Related Musculoskeletal Disorders. Reports on the Rheumatic Diseases 2008;14.

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