[Etiopathogenic, diagnostic and therapeutic aspects of stress fractures]

Stress fractures occur with strenuous activity and represent a unique and relatively rare traumatic entity. Their diagnosis is difficult and therapy accompanied with specific problems. The purpose of the presented study is to explain basic characteristics of stress fractures and to approximate possibility of diagnosis and treatment better. Out of 26 fractures, 22 (84.62%) were nondisplaced and managed by bed rest, non-weight bearing or plaster of Paris immobilization for eight to ten weeks. On the other hand, four primarily displaced fractures (15.38%) were successfully treated with rigid internal fixation. Four conservatively managed patients (18.18%), two with fractures of the tibia and two with fractures of the femoral neck, attained a secondary angulation and pseudoarthrosis of the fracture site and, for these reasons, recorded injuries demanded a compensatory surgery management. It is suggested that in case of suspectability of stress fractures it is beneficial to use, parallel to native radiographic study, the bone scan imaging techniques which in the earlier phase of the disease establishes the diagnosis. Treatment of the stress fractures should be, as a rule, conservative. Moreover, "fatigue" fractures of the tibia and femoral neck ask for more continuous observations and a serious access. If non weightbearing regiment and immobilization do not decrease the difficulties; and fracture patterns progress, or if fracture becomes displaced because of delayed diagnosis, open reduction and rigid internal fixation should be done without delay.