Stress fractures

Stress fractures are common over-use injuries which include fatigue and insufficiency fractures. Athletes, soldiers and osteoporotic patients are some of the individuals at high risk for the development of this injury. Owing to the low sensitivity of plain radiography at the onset of symptoms the diagnosis of this entity may be easily overlooked. Occasionally, some of these fractures, such as tibial fracture in children and fractures in the clavicle and pelvic ring, can be misdiagnosed as tumoral or infectious processes; moreover, although most stress fractures are uncomplicated and can be managed by rest and restriction from precipitating activity, a subset of these fractures can present a high risk for progression to complete fracture or non-union problems. All of this indicates that the various types of stress fracture, owing to their different clinical characteristics and evolution, should be commented on in detail. In this chapter different types of stress fracture are described with special reference to their localization, clinical characteristics, evolution and treatment.