The procedure may involve pinning the fracture site, and rehabilitation can take up to six months. Prognosis
Anterior tibial stress fractures can have a particularly poor prognosis and can require surgery. On radiographic imaging, these stress fractures are referred to as the "dreaded black line." When compared to other stress fractures, anterior tibial fractures are more likely to progress to complete fracture of the tibia and displacement. Superior femoral neck stress fractures, if left untreated, can progress to become complete fractures with avascular necrosis, and should also be managed surgically. Proximal metadiaphyseal fractures of the fifth metatarsal (middle of the outside edge of the foot) are also notorious for poor bone healing. These stress fractures heal slowly with significant risk of refracture. Epidemiology
In the United States, the annual incidence of stress fractures in athletes and military recruits ranges from 5% to 30%, depending on the sport and other risk factors. Women and highly active individuals are also at a higher risk. The incidence probably also increases with age due to age-related reductions in bone mass density (BMD). Children may also be at risk because their bones have yet to reach full density and strength. The female athlete triad also can put women at risk as disordered eating and osteoporosis can cause the bones to be severely weakened.This type of injury is mostly seen in lower extremities, due to the constant weight-bearing (WB). The bones commonly affected by stress fractures are the tibia, tarsals, metatarsals (MT), fibula, femur, pelvis and spine.
Hand injuries, meanwhile, were more likely to be caused by struggling prey. Stress fractures in dinosaur bones can be identified by looking for bulges on the shafts of bones that face toward the front of the animal. When X-rayed, these bulges often show lines of clear space where the X-rays have a harder time traveling through the bone. Rothschild and the other researchers noted that this "zone of attenuation" seen under the X-ray typically cannot be seen with the naked eye.The researchers described theropod phalanges as being "pathognomonic" for stress fractures, this means they are "characteristic and unequivocal diagnostically." Rothschild and the other researchers examined and dismissed other kinds of injury and sickness as causes of the lesions they found on the dinosaurs bones. Lesions left by stress fractures can be distinguished from osteomyelitis without difficulty because of a lack of bone destruction in stress fracture lesions. They can be distinguished from benign bone tumors like osteoid osteoma by the lack of a sclerotic perimeter. No disturbance of the internal bony architecture of the sort caused by malignant bone tumors was encountered among the stress fracture candidates. No evidence of metabolic disorders like hyperparathyroidism or hyperthyroidism was found in the specimens, either.After examining the bones of many kinds of dinosaur the researchers noted that Allosaurus had a significantly greater number of bulges on the shafts of its hand and foot bones than the tyrannosaur Albertosaurus, or the ostrich dinosaurs Ornithomimus and Archaeornithomimus.