STRESS-FRACTURES IN ATHLETES AND MILITARY RECRUITS - A REVIEW

Stress fracture is an overuse injury caused by muscle forces together with bending and impact forces acting on the bone, which has not adapt ed to the loading. The localization of stress fractures is more common in lower extremities. They are found in many other bones of the body as well. In the history of these patients a considerable amount of run ning exercise is usually found. The symptoms are stress pain and achin g at rest after training. Typical findings are local palpation pain an d edema. Sometimes tender resistance is felt. Clinically used radiolog ical imaging methods are radiographs, scintigraphy and in some cases m agnetic resonance imaging and computed tomography The radiographs are not usually positive until 2 weeks after the onset of symptoms. With a typical history and clinical findings the radiological diagnosis caus es no further problems. The corner stones of the treatment are: early identification of the symptoms, early diagnosis, a sufficiently long t raining pause and in special cases consultation of experts in the fiel d. There are rare stress fractures with increased risk of a delayed un ion, non-union or complete fracture. Surgical treatment may be needed in some cases. The prevention of stress fractures has proved to be dif ficult. The risk of acquiring stress fractures is increased by running with improper shoes and in female athletes with menstrual irregularit ies. If running is changed to some other kind of sport, the incidence stress fractures is lower.