STRESS-FRACTURES IN SKELETALLY IMMATURE PATIENTS

Stress fractures are a common injury in an active population. As child ren become increasingly involved in organized sports, the recognition of stress fractures and differentiation from infections or neoplasms r equires a knowledge of their most common sites, presentation, and clin ical course. We retrospectively reviewed 34 stress fractures in 32. sk eletally immature patients from June 1977 to May 1993. Age, fracture l ocation, treatment, time to union or healing, associated conditions, c omplications, radiographs, and clinical outcome were recorded. Fifty p ercent of patients were involved in sports the most common complaint w as pain with activity. The most common site was the tibia (47%) follow ed by the fibula (21%) and femur (12%). All had resolution of symptoms and returned to normal activity. All but two healed with either activ ity modification or cast immobilization. The radiographic findings inc luded early periosteal callus formation that rapidly consolidated to n ew bone on serial studies, A careful history, physical examination. an d radiographs can help diagnose most common stress fractures in the sk eletally immature individual and can differentiate stress Fractures fr om infection or neoplasm with appropriate conservative treatment.