Interventions for preventing and treating stress fractures and stress reactions of bone of the lower limbs in young adults. Cochrane Database Syst Rev 2:CD000450

Teesside Centre for Rehabilitation Sciences, University of Teesside, James Cook University Hospital, Marton Road, Middlesbrough, Tees Valley, UK, TS4 3BW.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2005; 2(2):CD000450. DOI: 10.1002/14651858.CD000450.pub2
Source: PubMed


Stress fractures are a type of overuse injury. They can be very painful and debilitating. Lower limb stress fractures are common in people undergoing military training and in athletes, particularly long distance runners. Measures to prevent stress fractures include modifications to footwear and changes to training schedules. We found some evidence that shock absorbing boot inserts help prevent stress fractures during military training. It is not clear what is the best design to use. Treatment of stress fractures generally involves a long period of activity restriction. We found some evidence that pneumatic braces may speed recovery of tibial stress fracture.

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Available from: Robert L Ashford
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    • "Fatigue fractures, on the other hand, occurs in normal bone of a healthy individual as a result of excessive and repetitive loading. These fractures are common in athletes, dancers and military personnel and also can result from normal forces on abnormal anatomy [2]. "
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    ABSTRACT: Introduction: Femoral neck stress fractures are not uncommon. Several causes exist about these fractures. Osteomalacia is one of the most common cause of insufficiency fractures and coxa vara can produce a focal concentration of mechanical stress in the femoral neck and may cause stress fractures. This case study is about the co-existence of these two pathologies in a patient with bilateral femoral neck stress fracture. Presentation of case: A 26-year-old woman admitted to our department with a complaint of bilateral groin pain and diagnosed as bilateral coxa vara and osteomalacia. Medical treatment for osteomalacia and staged bilateral Pauwels' osteotomy was performed. After 2 years of follow-up, good result was obtained. Discussion: There are several risk factors for stress fractures and osteomalacia and coxa vara are two of the causes. Osteomalacia results in softening of the bones and coxa vara can produce a focal concentration of stresses in the femoral neck. Conclusion: Joint and bone pain without any trauma should be investigated and bone metabolism disorders should be kept in mind. There might be co-existing factors related with stress fractures, and they must be treated simultaneously.
    Full-text · Article · Oct 2015 · International Journal of Surgery Case Reports
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    • "If the fracture occurs in normal bone of a healthy individual, it is defined as a fatigue fracture . These fractures are common in athletes, dancers, and military personnel [9]. Insufficiency fractures are another type of stress fracture, which is the result of normal stresses on a bone with reduced strength. "
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    ABSTRACT: Introduction Bilateral femoral neck fractures without major trauma are rare and related to several conditions. Insufficiency fractures due to the use of anti-epileptic drug are one of the rare causes. This case study is about bilateral femoral neck insufficiency fractures resulting from chronic use of anti-epileptic drug. Presentation of case A 26-year-old woman was referred to our emergency department with a complaint of bilateral groin pain and a 12-year history of irregular carbamazepine use. The diagnosis was bilateral femoral neck insufficiency fractures due to irregular long-term carbamazepine use. One-stage bilateral dynamic hip screw osteosynthesis was performed. After 2 years of follow up, good result was obtained. Discussion There are several risk factors for insufficiency fracture, and antiepileptic drug related osteoporosis is one of the reason. These drugs have negative effect on bone methabolism and bone mineral density. Conclusion To our knowledge, this is the first case in the literature of bilateral femoral neck insufficiency fracture due to chronic carbamazepine use. Joint and bone pain with a history of long-term use of anti-epileptic drug should be investigated carefully, and insufficiency fractures should be kept in mind.
    Full-text · Article · Dec 2014 · International Journal of Surgery Case Reports
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    • "Stress fractures associated with load carriage For the military, stress fractures are of particular concern due to their protracted recovery periods (Kelly, Jonson, Cohen, & Shaffer, 2000; O'Connor, 2000; Pope, 1999; Rome, Handoll, & Ashford, 2005; Ross, 2002). Stress or fatigue fractures are attributable to repetitive overloading of the bones where the bone remodelling balance is upset and bone remodelling is outpaced by bone stress and fatigue (Knapik et al., 2004; Nordin & Frankel, 2001; Rome et al., 2005). Common stress fracture sites of military personnel include the pelvis, tibia (shaft and condyles), calcaneus and metatarsals (Greaney et al., 1983; Kelly et al., 2000; Milgrom et al., 1985; Pester & Smith, 1992; Pope, Herbert, Kirwan, & Graham, 1999; van Dijk, 2009). "
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    ABSTRACT: This narrative review examines injuries sustained by soldiers undertaking occupational load carriage tasks. Military soldiers are required to carry increasingly heavier occupational loads. These loads have been found to increase the physiological cost to the soldier and alter their gait mechanics. Aggregated research findings suggest that the lower limbs are the most frequent anatomical site of injury associated with load carriage. While foot blisters are common, other prevalent lower limb injuries include stress fractures, knee and foot pain, and neuropathies, like digitalgia and meralgia. Shoulder neuropathies (brachial plexus palsy) and lower back injuries are not uncommon. Soldier occupational load carriage has the potential to cause injuries that impact on force generation and force sustainment. Through understanding the nature of these injuries targeted interventions, like improved physical conditioning and support to specialised organisations, can be employed.
    Full-text · Article · Sep 2013 · International Journal of Injury Control and Safety Promotion
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