Stress Fractures

Stress fractures of the foot and ankle are common injuries sustained by athletes and those participating in repetitive activities. These injuries occur due to the accumulation of stresses causing a “spontaneous fracture” of normal bone. The cyclic loading of forces causes structural fatigue and microdamage, creating an imbalance between repetitive strain and bone remodeling. Changes in the microscopic property of bone including elasticity, osteoclastic activity, and bone porosity further contribute to the pathology of stress fractures. In contrast, insufficiency fractures result from the compromise of weakened bone under normal levels of activity. Intrinsic and extrinsic risk factors including biomechanical considerations, physiological factors, and environmental influences play a role in the development of stress fractures.