Stress Fracture
Description:
Stress fractures can occur in any bone in the foot and ankle. They vary in severity from a “stress reaction” in the bone or a visual “crack” seen on x-ray. Unlike the usual bone fracture (complete separation or in multiple pieces), a stress fracture can result from simple over-use, intense exercise or shoe gear with poor support. The most common area for a stress fracture is the top of the foot in the middle (metatarsal bones).
This condition is associated with other foot / ankle conditions such as:
The pain is characterized as sharp with the first few steps in the morning and also in the evening after increased activities or with minor relief as it is “warmed up” during light walking and massage.
Treatment: Conservative Care:
| Weight bearing: | Fractures need protection from motion in most cases in the foot. Keeping pressure off the area is the best way to minimize separation of the bone that is fractured. Crutches, walkers, wheel chairs and strollers depend upon the severity of the fracture. |
| Arch support: | Temporary arch supports, supportive athletic shoes, or a custom made insole cushion in the shoe will all provide additional rest to the injured area. Custom molded orthotics are the best solution for immediate and long term treatment. |
| Ice: | Insolated cold packs applied on and off of the injury for 72 hours helps to reduce swelling and discomfort. Then alternating ice and heat every 15 to 20 minutes will help with the bruising and continued swelling. |
| Medication: | Anti-inflammatory medication (e.g. Ibuprofen, Naprosyn) aspirin products, and Acetaminophen can help with the chronic pain, but are not much help with the acute pain. Multivitamins especially ones rich in C and D with calcium will help the healing process. |
| Casting: | Casts are used for protection of the fracture area. Casts can be removable with Velcro straps or molded to the foot and ankle with plaster or fiberglass. Non-weight bearing ranges from 3 to 6 weeks. |
Surgical Options:
Surgery is uncommon for this condition unless it becomes chronic and conservative treatment (as above) failed. Several procedures are performed to take the stress off the problem area(s). Post-operative recovery can range from a few days to a few weeks of partial weight bearing in a walking cast.
