Stress fractures in athletes

Area of Science:

• Sports Medicine
• Orthopedic Surgery
• Biomechanics

Background:

• Stress fractures are common injuries in athletes, impacting performance and career longevity.
• Understanding the epidemiology and risk factors for stress fractures is crucial for prevention and effective treatment.
• Previous research has highlighted the prevalence of stress fractures in specific sports, but comprehensive data across different athletic levels is needed.

Purpose of the Study:

• To analyze the incidence, demographics, affected sites, and treatment outcomes of stress fractures in a large cohort of athletes over a 14-year period.
• To identify risk factors associated with severe stress fractures, including those requiring surgical intervention or resulting in delayed union.
• To compare the characteristics and outcomes of stress fractures across different levels of athletic competition (international, national, recreational).

Main Methods:

• Retrospective analysis of 368 stress fractures treated between 1971 and 1985.
• Data collection included athlete demographics (age, sex, level), fracture site, cause, treatment modality (conservative vs. surgical), and healing outcomes.
• Statistical analysis was performed to determine the distribution of fractures by various factors and identify significant associations.

Main Results:

• A total of 368 stress fractures were treated in 324 athletes, with tibia (182) and metatarsal bones (73) being the most common sites.
• Runners accounted for 72% of cases, with other sports involving running contributing an additional 12%.
• International-level athletes had a higher incidence of multiple fractures, delayed union, and surgical treatment compared to national or recreational athletes.

Conclusions:

• Stress fractures represent a significant injury burden in athletes, particularly in runners.
• Certain fracture sites, like the anterior midtibia and sesamoid bones, are prone to delayed union.
• Athletes at the highest competitive levels face increased risks, necessitating targeted prevention and management strategies.