Stress Fracture

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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

  • 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.
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