Stress fractures are a common overuse injury among athletes. Repetitive loading during weight bearing causes a broad range of stress reactions, from increased bone remodeling to painful fractures. The literature indicates that such injuries are usually treated conservatively with rest or immobilization, but a more aggressive, surgical approach to treatment of stress fractures has also been reported. This study was designed to identify the factors that influence the decision to treat an athlete surgically or conservatively. An analysis of 28 articles was performed. A cross-tabulation design was used to compare 4 categories with the treatment chosen. The categories included severity, anatomical location, and type of stress fracture, as well as the athletic motivation of the individual. All 4 factors were found to influence the treatment of choice, although it was remarkable that only athletes who demonstrated high athletic motivation were treated surgically.
Susan K. Verscheure and Marc R. Hoefelein are with the Exercise and Movement Science Department at the University of Oregon, Eugene, OR 97403.