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.