A stress fracture is a fatigue-induced bone fracture caused by repeated stress over time. Instead of resulting from a single severe impact, stress fractures are the result of accumulated injury from repeated submaximal loading, such as running or jumping. Because of this mechanism, stress fractures are common overuse injuries in athletes.Stress fractures can be described as small cracks in the bone, or hairline fractures. Stress fractures of the foot are sometimes called "march fractures" because of the injurys prevalence among heavily marching soldiers. Stress fractures most frequently occur in weight-bearing bones of the lower extremities, such as the tibia and fibula (bones of the lower leg), metatarsal and navicular bones (bones of the foot). Less common are stress fractures to the femur, pelvis, and sacrum. Treatment usually consists of rest followed by a gradual return to exercise over a period of months. Signs and symptoms
Stress fractures are typically discovered after a rapid increase in exercise. Symptoms usually have a gradual onset, with complaints that include isolated pain along the shaft of the bone and during activity, decreased muscular strength and cramping. In cases of fibular stress fractures, pain occurs proximal to the lateral malleolus, that increases with activity and subsides with rest. If pain is constantly present it may indicate a more serious bone injury. There is usually an area of localized tenderness on or near the bone and generalized swelling in the area. Pressure applied to the bone may reproduce symptoms and reveal crepitus in well-developed stress fractures.
Moderate pressure for 10–20 seconds ruptures the cord.After the treatment with collagenase the person should use a night splint and perform digital flexion/extension exercises several times per day for 4 months.In February 2010 the US Food and Drug Administration (FDA) approved injectable collagenase extracted from Clostridium histolyticum for the treatment of Dupuytrens contracture in adults with a palpable Dupuytrens cord. (Three years later, it was approved as well for the treatment of the sometimes related Peyronies disease.) In 2011 its use for the treatment of Dupuytrens contracture was approved as well by the European Medicines Agency, and it received similar approval in Australia in 2013. However, the Swedish manufacturer abruptly withdrew distribution of this drug in Europe and the UK in March 2020 for commercial reasons. (It now is promoted primarily as a dermatological treatment for cellulite aka "cottage cheese thighs"). Collagenase is no longer available on the National Health System except as part of a small clinical trial. Radiation therapy
Radiation therapy has been used mostly for early-stage disease, but is unproven. Evidence to support its use as of 2017, however, was scarce —efforts to gather evidence are complicated due to a poor understanding of how the condition develops over time. It has only been looked at in early disease. The Royal College of Radiologists concluded that radiotherapy is effective in early stage disease which has progressed within the last 6 to 12 months. Alternative medicine
Several alternate therapies such as vitamin E treatment have been studied, though without control groups.