[Stress fractures].

Stress fractures are common overuse injuries, ranging between 1.1% and 3.7% of all athletic injuries. Causes are many and usually involve repetitive submaximal stress. There is a wide research evidence showing that training errors cause stress fractures in as many as 22% to 75% of cases. Intrinsic factors such as hormonal imbalance may also contribute to the onset of stress fractures, especially in women. During medical examination, it is essential always to bear in mind the possibility of stress fracture. Clinical diagnosis is therefore the basic procedure, followed by other diagnostic methods in the following order: radiology, scintigraphy, and MRI. Most stress fractures are uncomplicated and can be managed through rest and restriction from precipitating activities for 4-6 weeks. A subset of stress fractures can present a high risk for progression to complete fracture, delayed union, or nonunion. Specific sites for this type of stress fracture are the femoral neck, the anterior cortex of the tibia, the tarsal navicular, the fifth metatarsal (Jones fracture), and the great toe sesamoids. Therefore, high-risk stress fractures require aggressive treatment, and in some cases even surgical intervention is appropriate.