Stress Fracture in the Foot and Leg

Stress fractures are tiny hairline breaks that can occur in the bones of the foot. They can be caused by overtraining or overuse, improper training habits or surfaces, improper shoes, flatfoot or other foot deformities and osteoporosis. These tiny breaks in the bones of the feet can lead to a complete break if left untreated.

Pain, swelling, redness and bruising can be signs of a stress fracture. The fracture can occur almost anywhere in the foot. X-rays and other studies are used to diagnose the stress fracture. A foot and ankle surgeon should be seen as early as possible to start treatment and possibly shorten the recovery time. Possible treatments include rest and possible immobilization of the foot. In some cases, surgery may be required to stabilize the stress fracture or to repair a stress fracture that has progressed to a fracture.

Association of Vitamin D With Stress Fractures: A Retrospective Cohort Study

Jason R. Miller,, Karl W. Dunn, Louis J. Ciliberti Jr., Rikhil D. Patel,  Brock A. Swanson.  JFAS 2016.

Abstract

Vitamin D is an essential, fat-soluble nutrient that is a key modulator of bone health. Despite the gaining popularity throughout published medical studies, no consensus has been reached regarding a serum vitamin D level that will guarantee adequate skeletal health in a patient with an increased functional demand. The purpose of the present investigation was to examine the serum concentrations of vitamin D in patients with confirmed stress fractures. A total of 124 patients were included in our retrospective cohort study. Of the 124 patients, 53 had vitamin D levels measured within 3 months of diagnosis. An association was seen in patients with a stress fracture and vitamin D level measured, as 44 (83.02%) of the 53 patients had a serum 25-hydroxyvitamin D level <40 ng/mL. Although an association was seen at our institution in patients with stress fractures and a serum vitamin D concentration <40 ng/mL, a larger and prospective investigation is warranted to further understand the effect of vitamin D level and stress fracture prevention in an active, nonmilitary population.

Level of Clinical Evidence: 3