title: Stress fractures of the foot and ankle.
abstract: Stress fractures occur as a result of microscopic injuries sustained when bone is subjected to repeated submaximal stresses. Overtime, with repeated cycles of loading, accumulation of such injuries can lead to macro-structural failure and frank fracture. There are numerous stress fractures about the foot and ankle of which a trauma and orthopaedic surgeon should be aware. These include: metatarsal, tibia, calcaneus, navicular, fibula, talus, medial malleolus, sesamoid, cuneiform and cuboid. Awareness of these fractures is important as the diagnosis is frequently missed and appropriate treatment delayed. Late identification can be associated with protracted pain and disability, and may predispose to non-union and therefore necessitate operative intervention. This article outlines the epidemiology and risk factors, aetiology, presentation and management of the range of stress fractures in the foot and ankle.
authors.affiliation: Speciality Registrar Trauma & Orthopaedics, West Herts NHS Trust, United Kingdom. Electronic address: matthewwelck@doctors.org.uk.
authors.forename: M J
authors.initials: MJ
authors.lastname: Welck
authors.affiliation: Core Surgical Trainee, West Herts NHS Trust, United Kingdom.
authors.forename: T
authors.initials: T
authors.lastname: Hayes
authors.affiliation: Speciality Registrar Trauma & Orthopaedics, West Herts NHS Trust, United Kingdom.
authors.forename: P
authors.initials: P
authors.lastname: Pastides
authors.affiliation: Speciality Registrar Trauma & Orthopaedics, Royal National Orthopaedic NHS Trust, United Kingdom.
authors.forename: W
authors.initials: W
authors.lastname: Khan
authors.affiliation: Consultant Trauma & Orthopaedics, West Herts NHS Trust, United Kingdom.
authors.forename: B
authors.initials: B
authors.lastname: Rudge
mesh_terms: D016512:Ankle Injuries / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D002111:Calcaneus / Q000293:injuries; D057210:Delayed Diagnosis / Q000517:prevention & control*; D005360:Fibula / Q000293:injuries; D018409:Foot Injuries / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D015775:Fractures, Stress / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D008682:Metatarsal Bones / Q000293:injuries; D017410:Practice Guidelines as Topic; D013977:Tibia / Q000293:injuries; D061665:Time-to-Treatment
keywords: Aetiology; Education; Foot and ankle; Management; Stress fracture