Stress fractures of the foot and ankle

Injury. 2017 Aug;48(8):1722-1726. doi: 10.1016/j.injury.2015.06.015. Epub 2015 Sep 15.


Stress fractures occur as a result of microscopic injuries sustained when bone is subjected to repeated submaximal stresses. Overtime, with repeated cycles of loading, accumulation of such injuries can lead to macro-structural failure and frank fracture. There are numerous stress fractures about the foot and ankle of which a trauma and orthopaedic surgeon should be aware. These include: metatarsal, tibia, calcaneus, navicular, fibula, talus, medial malleolus, sesamoid, cuneiform and cuboid. Awareness of these fractures is important as the diagnosis is frequently missed and appropriate treatment delayed. Late identification can be associated with protracted pain and disability, and may predispose to non-union and therefore necessitate operative intervention. This article outlines the epidemiology and risk factors, aetiology, presentation and management of the range of stress fractures in the foot and ankle.

Keywords: Aetiology; Education; Foot and ankle; Management; Stress fracture.

Publication types

  • Review

MeSH terms

  • Ankle Injuries / diagnosis*
  • Ankle Injuries / physiopathology
  • Ankle Injuries / therapy
  • Calcaneus / injuries
  • Delayed Diagnosis / prevention & control*
  • Fibula / injuries
  • Foot Injuries / diagnosis*
  • Foot Injuries / physiopathology
  • Foot Injuries / therapy
  • Fractures, Stress / diagnosis*
  • Fractures, Stress / etiology
  • Fractures, Stress / therapy
  • Humans
  • Metatarsal Bones / injuries
  • Practice Guidelines as Topic
  • Tibia / injuries
  • Time-to-Treatment