Stress fractures of the foot and ankle, part 1: biomechanics of bone and principles of imaging and treatment
A stress fracture is a focal failure of bone induced by the summation of repetitive forces, which overwhelms the normal bone remodeling cycle. This review, the first of two parts, discusses the general principles of stress fractures of the foot and ankle. This includes bone structure, biomechanics o...
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| Published in | Skeletal radiology Vol. 46; no. 8; pp. 1021 - 1029 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.08.2017
Springer Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
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| Abstract | A stress fracture is a focal failure of bone induced by the summation of repetitive forces, which overwhelms the normal bone remodeling cycle. This review, the first of two parts, discusses the general principles of stress fractures of the foot and ankle. This includes bone structure, biomechanics of stress applied to bone, bone remodeling, risk factors for stress fracture, and general principles of imaging and treatment of stress fractures. Cortical bone and trabecular bone have a contrasting macrostructure, which leads to differing resistances to externally applied forces. The variable and often confusing imaging appearance of stress fractures of the foot and ankle can largely be attributed to the different imaging appearance of bony remodeling of trabecular and cortical bone. Risk factors for stress fracture can be divided into intrinsic and extrinsic factors. Stress fractures subject to compressive forces are considered low-risk and are treated with activity modification and correction of any modifiable risk factors. Stress fractures subject to tensile forces and/or located in regions of decreased vascularity are considered high risk, with additional treatment options including restricted weight-bearing or surgery. |
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| AbstractList | A stress fracture is a focal failure of bone induced by the summation of repetitive forces, which overwhelms the normal bone remodeling cycle. This review, the first of two parts, discusses the general principles of stress fractures of the foot and ankle. This includes bone structure, biomechanics of stress applied to bone, bone remodeling, risk factors for stress fracture, and general principles of imaging and treatment of stress fractures. Cortical bone and trabecular bone have a contrasting macrostructure, which leads to differing resistances to externally applied forces. The variable and often confusing imaging appearance of stress fractures of the foot and ankle can largely be attributed to the different imaging appearance of bony remodeling of trabecular and cortical bone. Risk factors for stress fracture can be divided into intrinsic and extrinsic factors. Stress fractures subject to compressive forces are considered low-risk and are treated with activity modification and correction of any modifiable risk factors. Stress fractures subject to tensile forces and/or located in regions of decreased vascularity are considered high risk, with additional treatment options including restricted weight-bearing or surgery. A stress fracture is a focal failure of bone induced by the summation of repetitive forces, which overwhelms the normal bone remodeling cycle. This review, the first of two parts, discusses the general principles of stress fractures of the foot and ankle. This includes bone structure, biomechanics of stress applied to bone, bone remodeling, risk factors for stress fracture, and general principles of imaging and treatment of stress fractures. Cortical bone and trabecular bone have a contrasting macrostructure, which leads to differing resistances to externally applied forces. The variable and often confusing imaging appearance of stress fractures of the foot and ankle can largely be attributed to the different imaging appearance of bony remodeling of trabecular and cortical bone. Risk factors for stress fracture can be divided into intrinsic and extrinsic factors. Stress fractures subject to compressive forces are considered low-risk and are treated with activity modification and correction of any modifiable risk factors. Stress fractures subject to tensile forces and/or located in regions of decreased vascularity are considered high risk, with additional treatment options including restricted weight-bearing or surgery.A stress fracture is a focal failure of bone induced by the summation of repetitive forces, which overwhelms the normal bone remodeling cycle. This review, the first of two parts, discusses the general principles of stress fractures of the foot and ankle. This includes bone structure, biomechanics of stress applied to bone, bone remodeling, risk factors for stress fracture, and general principles of imaging and treatment of stress fractures. Cortical bone and trabecular bone have a contrasting macrostructure, which leads to differing resistances to externally applied forces. The variable and often confusing imaging appearance of stress fractures of the foot and ankle can largely be attributed to the different imaging appearance of bony remodeling of trabecular and cortical bone. Risk factors for stress fracture can be divided into intrinsic and extrinsic factors. Stress fractures subject to compressive forces are considered low-risk and are treated with activity modification and correction of any modifiable risk factors. Stress fractures subject to tensile forces and/or located in regions of decreased vascularity are considered high risk, with additional treatment options including restricted weight-bearing or surgery. |
| Audience | Academic |
| Author | Mandell, Jacob C. Khurana, Bharti Smith, Stacy E. |
| Author_xml | – sequence: 1 givenname: Jacob C. surname: Mandell fullname: Mandell, Jacob C. email: jmandell@partners.org organization: Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School – sequence: 2 givenname: Bharti surname: Khurana fullname: Khurana, Bharti organization: Division of Emergency Radiology, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School – sequence: 3 givenname: Stacy E. surname: Smith fullname: Smith, Stacy E. organization: Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28374052$$D View this record in MEDLINE/PubMed |
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| SubjectTerms | Ankle Ankle Injuries - diagnostic imaging Ankle Injuries - therapy Bearing Biomechanical Phenomena Biomechanics Bone biomechanics Bone imaging Bone Remodeling Cancellous bone Care and treatment Compressive properties Cortical bone Failure Feet Foot Injuries - diagnostic imaging Foot Injuries - therapy Fractures Fractures, Stress - diagnostic imaging Fractures, Stress - therapy Humans Imaging Macrostructure Medicine Medicine & Public Health Nuclear Medicine Orthopedics Pathology Radiology Review Article Risk analysis Risk Factors Stress fractures Stresses Surgery Weight-Bearing |
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| Title | Stress fractures of the foot and ankle, part 1: biomechanics of bone and principles of imaging and treatment |
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