RESUMO

Stress fractures represent the end product of the failure of bone to adequately adapt to the mechanical loads experienced during physical activity. Limited epidemiological data suggest that these are common injuries in the sporting population, particularly in association with weight-bearing activities such as running and dancing. A number of factors may increase the risk of stress fracture, including female gender, genetic determinants, menstrual disturbances, low bone density, body composition, biomechanical variants, nutritional intake, and training errors. Diagnosis of a stress fracture is often made on clinical findings but appropriate imaging techniques may be needed in some cases. Although the majority of stress fractures will heal without complications in a relatively short time frame, there are a number of stress fractures that require specific additional treatment. These include fractures of the femoral neck, anterior tibial cortex, tarsal navicular, proximal fifth metatarsal, and sesamoids. This article reviews stress fractures in athletes concentrating on etiology, epidemiology, risk factors, diagnosis, and treatment. Further details are provided for the difficult stress fractures.