Stress Fractures about the Foot and Ankle in Athletes

Abstract

ABSTRACT Stress fractures of the foot and ankle are a common problem encountered by athletes of all levels and ages. This review summarizes the history and physical exam findings, radiographic imaging, diagnosis and treatment of stress fractures of the foot and ankle in those participating in athletic activities. These injuries can be divided into low- and high-risk based upon their propensity to heal without complication. A wide variety of nonoperative strategies are employed based on the duration of symptoms, type of fracture, and patient factors such as activity type, desire to return to sport and compliance. Operative management has proven superior in several high risk types of stress fractures. Evidence on pharmacotherapy and physiologic therapy such as bone stimulators is evolving. A high index of suspicion for stress fractures is appropriate in many high-risk groups of athletes with lower extremity pain. Proper and timely workup and treatment is successful in returning these athletes to sport in many cases. Education of athletes as well as their families, training and coaching staff is important. Attention to training regimens, technique, equipment and proper nutrition is paramount in the prevention of these injuries. Mayer SW, Joyner PW, Almekinders LC, Parekh SG. Stress Fractures about the Foot and Ankle in Athletes. The Duke Orthop J 2013;3(1):8-19.