Stress Fracture

Patient Information

https://orthoinfo.aaos.org/en/diseases–conditions/stress-fractures-of-the-foot-and-ankle/

https://matthewwelck.com/wp-content/uploads/2019/12/stress-fractures.pdf

GP Information

Background Information

• Stress fractures are relatively common in the foot and may affect all bones, classically the metatarsals or navicular. Caused by excessive weight bearing activity or a recent increase in activity / change in training conditions.
• Patients typically complain of poorly localised, worse on activity, relieved by rest.
• Examination may reveal localised swelling with pain on direct palpation.

Investigation Guidelines

• MRI is the investigation of choice after a failure of conservative management.

Management Recommendations

Conservative measures include

• PRICE
• NSAIDs
• Avoid activities that exacerbate symptoms.
• Patient education.
• Protective boot for up to 6 weeks.
• OTC orthotics if flat footed.
• Excercise to improve strength, balance and core stability.
• Gradual return to activity.

Referral Indications

• Diagnostic uncertainty.
• Failure of conservative measures after a minimum of 6 weeks.