Stress fractures: Current concepts

Abstract

Abstract. 1. Stress fractures result from muscular activity on bones rather than from direct impact upon them. 2. The fatigue variety of stress fracture occurs in normal bone when abnormal muscular tension or torsion is placed upon it. 3. The insufficiency type of stress fracture results when normal muscular stress is placed upon a bone with deficient elastic resistance. 4. Most stress fractures are of the fatigue type, occurring in an individual who engages in repetitive vigorous activity to which he is unaccustomed. 5. The biomechanics, radiologic features, and differential diagnosis were discussed and the literature was reviewed.

The nature of fatigue damage in bone

“…In 1855 Breithaupt, a Prussian Army physician, described the syndrome of a painful, swollen foot associated with marching (25). They are caused by the application of an abnormal muscular stress or torque to a bone which has normal elastic resistance and are most commonly associated with a new, strenuous and repetitive activity (26). This is due to the ability of muscles to adapt more quickly than bones to the new activity, leading to a mechanical imbalance.…”

“…This is due to the ability of muscles to adapt more quickly than bones to the new activity, leading to a mechanical imbalance. The increased muscle force acting on the relatively weaker bone causes deformation, microdamage accumulation and fracture (26,27). They occur in over 40%…”

Leg pain with a periosteal and endosteal reaction

“…They must be suspected when the onset of pain in an area typical for stress fracture can be associated with a specific activity (7), but in many instances this history is absent. From an etiologic standpoint, 2 types of stress factor are encountered: 1) fatigue fractures, caused by the application of abnormal muscular stress or torque to a bone that has normal elastic resistance, and 2) insufficiency fractures, which occur when normal stress is placed on a bone that is deficient in mineral or elastic resistance (1).…”

Pubic Ramus Stress Fracture: Case Report

“…Ağırlıklı olarak atlet, dansçı ve askerlerde gözlenmektedir (1). Yetmezlik kırıkları azalmış kemik direncine bağlı olarak kemiğin normal veya ılımlı bir yük altında kalması neticesinde oluşur (2). Yetmezlik kırığı için risk faktörleri osteoporoz, osteomalazi, hiperparatiroidi, romatoid artrit, uzun süreli kortizon kullanımı, diabetes mellitus, fibröz displazi, renal yetmezlik, daha önceden radyoterapi almaktır (3).…”