Managing common stress fractures: let risk level guide treatment

The repetitive stresses of sports and exercise can produce an array of stress fractures. Most are uncomplicated, but some, such as femoral neck fractures, carry a higher risk of nonunion or complete fracture. The diagnosis is primarily clinical, but imaging with plain radiographs, scintigraphy, CT, or MRI may provide confirmation if necessary. Treatment of uncomplicated fractures centers on rest and reversing training errors or equipment problems. Management of high-risk fractures is more aggressive. Depending on imaging results, most of these require either surgery or several weeks of non-weight bearing immobilization and rehabilitation.