Stress Fractures (Fatigue Fractures, Marsh-Fractures)

Abstract

In consequence of cyclic long-continued or oft-repeated stress like prolonged walking, dancing, or running, infraction or complete fracture can develop on certain sites of the skeleton. There is no specific single causative injury in the history, like in trauma-related fractures. It occurs mostly in two groups of young adults: in those who are not accustomed to sudden physical activity (fresh recruits in the army, etc.) or professional sportsmen with overestimated training programs. Ninety five percent of stress fracture occur in the bones of the lower extremity, most often in the tibia (30–35%, e.g., middistance runners), fibula (20–25%, e.g., ballet dancing, walking, aerobics), in the metatarsal bones (20%, e.g., marching, walking, tennis), femur (10–15%, e.g., ballet, athletics), or pelvis (4–8%, e.g., athletics), but it can affect many other sites, too. Leading symptom is the tenderness above the fracture and pain, which increases at physical activity and decreases at rest (Figs. 5.1–5.6).