Stress fractures: A review of 180 cases

Objective: To review the cases of stress fracture seen over a 2-year period at a sports medicine clinic. Design: One hundred and eighty cases diagnosed as stress fractures on the basis of clinical picture and radiological evidence were reviewed. The following features of each stress fracture were noted: age, sex, site, sport/activity. Setting: A sports medicine centre in Melbourne, Australia. Patients: The average age was 21.8 years. Seventy eight of these stress fractures were seen in women, 102 in men. Results: The most common sites of stress fractures were the metatarsal bones (n = 42), tibia (n = 36), fibula (n = 30), tarsal navicular(n = 26) and pars interarticularis (n = 17). The most common sport was track (n = 54). Other common sports activities were jogging/distance running(n = 35), dance (n = 12) and Australian football(n = 14). The distribution of sites of stress fractures varied from sport to sport. Among the track athletes (n = 54), navicular(n = 19), tibia(n = 14) and metatarsal (n = 9) were the most common stress fracture sites. The distance runners (n = 35) predominantly sustained tibia (n = 15), and fibula (n = 8) stress fractures, while metatarsal stress fractures (n = 18) were the most common among dancers. The distribution of sports varied with the site of the stress fracture. In the metatarsal stress fractures (n = 42), dance was the most common activity. Distance running (n = 15) and track (n = 14) were the most common sports in the group to have sustained tibia stress fractures (n = 36). Track athletes (n = 14) were particularly prevalent in the navicular stress fracture group (n = 26). Conclusion: The distribution of sites of stress fractures in this study shows some differences from previously published studies.