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Low-Risk Stress Fractures

Barry P. Boden, MD^*,, Daryl C. Osbahr and Carlos Jimenez, MAJ, MC, USA

^* Uniformed Services University of the Health Sciences, The Orthopaedic Center, Rockville, Maryland
Coach Michael W. Krzyzewski Human Performance Research Laboratory, Division of Orthopaedic Surgery, Section of Sports Medicine, Duke University Medical Center, Durham, North Carolina
Walter Reed Army Medical Center, Washington, District of Columbia

Address correspondence and reprint requests to Barry P. Boden, MD, Adjunct Assistant Professor, Uniformed Services University of the Health Sciences, The Orthopaedic Center, 9711 Medical Center Drive, #201, Rockville, MD 20850

Stress fractures can occur in almost any bone in the body, with the lower extremity weightbearing bones, especially the tibia, tarsals, and metatarsals, being affected most frequently. Although the cause of these fractures is multifactoral, repetitive physical forces without adequate rest are the primary culprits. Stress fractures may be broadly classified as low-risk or high-risk injuries. Low-risk stress fractures, the topic of this review article, can be diagnosed through a thorough history, physical examination, and radiographs. Nuclear scintigraphy is occasionally necessary for confirmation, especially for fractures of the spine and pelvis. When diagnosed early and treated with restriction of activity, low-risk stress fractures have a favorable prognosis.

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