Bones may fracture without trauma

3. November 2014

A stress fracture develops gradually until the bone breaks so much that it starts hurting.

Dr Vahur Metsna, an orthopaedist at East-Tallinn Central Hospital, says that a stress fracture has a typical clinical course and that this is usually the basis for diagnosis. He says that stress fractures are treated by resting the affected extremity, usually for four to eight weeks, bus sometimes for as long as three to four months. If necessary, a cast is used to keep the fractured bone in place, or the patient has to wear a brace.

“Treatment depends on the location of the fracture – it may require the patient not to put any weight on their foot,” he explains. In the case of a Jones fracture, which is common among athletes and whereby the fracture occurs at the base of the fifth metatarsal bone, the foot must be kept in a full resting position.

Surgery may sometimes be necessary, if the ends of the fracture are sclerotic. Metsna admits that patients should not expect the fracture to heal itself without reducing the pressure.

Fractures occur in the feet and shinbones

A stress fracture typically occurs in the bones of the foot, usually in the metatarsal bones, but often also in the shinbones.

A bone fracture usually occurs after a major trauma, e.g. a fall or a strong blow, but a stress fracture develops gradually and the bone finally breaks so much that it starts causing pain. “A stress fracture can result from all sorts of trauma, none of which are able to cause the fracture alone,” says Metsna.

A stress fracture is more common among athletes – both elite athletes who train hard and amateur athletes who suddenly decide to ‘really go for it’. A stress fracture is also called a march fracture, as it can occur in soldiers who cover long distances by foot in one go. Stress fractures are also common among ballet dancers, usually occurring in the shinbones and metatarsal bones. A stress fracture may also occur in people whose feet are deformed and who put more weight on the outside of the foot when they are walking.

Metsna says that ‘ordinary’ people can also suffer from stress fractures, as they can be caused by walking.

The orthopaedist says that stress fractures are a rather frequent diagnosis, adding that such fractures can be prevented by increasing the intensity of exercise gradually – by ca 10% per week.

Runners should change their shoes for a new year after a certain distance, which is 700 kilometres on average. Strengthening the muscles also helps reduce the risk of stress fractures, as strong muscles reduce pressure on the bones.


Source: Eesti Päevaleht