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Published on: April 11, 2018
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Sacral stress fractures in athletes
Eran Beit Ner1,2, Oded Rabau3,4, Saad Dosani5
1Department of Orthopedic Surgery, Yitzhak Shamir Medical Center, Zerifin, Israel. eranbnster@gmail.com.
Summary
Sacral stress fractures, often seen in athletes and military recruits, are multifactorial overuse injuries. Female athletes with low bone density and eating disorders are particularly vulnerable.
Area of Science:
- Sports Medicine
- Orthopedics
- Radiology
Background:
- Sacral stress fractures are understudied overuse injuries.
- Evidence is primarily from case reports and limited series.
Purpose of the Study:
- To analyze and summarize all published cases of sacral stress fractures in athletes.
- To review the existing literature on sacral stress fractures.
Main Methods:
- Systematic literature search of PubMed, Embase, Web of Science, and Cochrane Database.
- Inclusion of studies reporting sacral stress fractures, exclusion of elderly insufficiency fractures.
Main Results:
- 124 cases of sacral stress fractures identified across 49 studies.
- 61% were professional/collegiate athletes, 30% military/police recruits.
- 25% of female athletes had low bone mineral density; 19% had a history of eating disorders.
Conclusions:
- Sacral stress fractures have multifactorial causes, including abnormal loads and low bone mineral density.
- High endurance sports and female athlete triad features are prevalent.
- Conservative treatment (rest, rehabilitation, gradual return to activity) is the primary approach.
