Type:
Educational Exhibit
Keywords:
Musculoskeletal bone, Bones, Conventional radiography, Education, Education and training
Authors:
A. Chellathurai; Chennai/IN
DOI:
10.26044/ecr2019/C-2998
Background
A stress fracture is the result of repetitive,
prolonged muscular action on a bone that has not accommodated itself to that action.
stress fractures occur in non-weight-bearing bones and showed that stress fractures do not result from impact on a bone.
In most instances,
persons who have stress fractures are engaged in vigorous activity that is either totally new or to which they have not yet become conditioned.
From an etiologic standpoint,
two types of stress fractures are encountered: fatigue fractures and insufficiency fractures.
A fatigue fracture is caused by the application of abnormal muscular stress or torque to a bone that has normal elastic resistance.
The following triad is associated with most fatigue fractures: the activity is (1) new or different for the person,
(2) strenuous,
and (3) repeated with a frequency that ultimately produces signs and symptoms
An insufficiency fracture occurs when normal or physiologic muscular activity stresses a bone that is Stress fractures in lower extremities predominantly involve the metatarsals,
tibia and spine Pelvic stress fractures come next and are usually located at the pubis,
sacrum or femoral neck.
Acetabular stress fractures are rare and therefore unrecognized,
but do occur and may be a cause for activity-related hip pain
Isolated fractures of the cuneiforms are extremely rare,
accounting for only 1.7% of all midfoot fractures.
When cuneiform fractures do occur,
they are often in conjunction with other injuries,
such as fractures to the adjacent cuneiforms,
or are a part of a greater injury complex,
such as Lisfranc fracture dislocations. Isolated medial cuneiform fractures are extremely rare.
These rare fractures are often missed at initial presentation because they are usually not evident on plain radiographs.Therefore,
in the setting of injury to the midfoot with inability to bear weight,
a diagnosis of “midfoot sprain” should be met with a high degree of suspicion.
Most cases of non-displaced medial cuneiform fracture can be treated conservatively with immobilization with a short leg cast for a period of approximately 6 weeks.