Revisão Revisado por pares

Stress Fractures in Athletes: Risk Factors, Diagnosis, and Management

2004; Slack Incorporated (United States); Volume: 27; Issue: 6 Linguagem: Inglês

10.3928/0147-7447-20040601-15

ISSN

1938-2367

Autores

K. Chung Tuan, Susan Wu, Brian J. Sennett,

Tópico(s)

Occupational Health and Performance

Resumo

Review ArticleStress Fractures in Athletes: Risk Factors, Diagnosis, and Management Kenneth Tuan, MD, , , MD Susan Wu, MD, , and , MD Brian Sennett, MD, , MD Kenneth Tuan, MD , Susan Wu, MD , and Brian Sennett, MD Orthopedics, 2013;27(6):583–593Published Online:June 01, 2004https://doi.org/10.3928/0147-7447-20040601-15Cited by:45PDFView Full Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInRedditEmail SectionsMore1. Matheson GO, Clement DB. McKenzie DC. Taunton JE, Lloyd-Smith DR. Maclntyre JG. Stress fractures in athletes. A study of 320 cases. Am J Sports Med. 1987: 15:46-58. Google Scholar2. Callahan LR. Stress fractures in women. Clin Sports Med. 2(KK); 19:303-314. Google Scholar3. Sallis RE. Jones K. Stress fractures in athletes. How to spot this underdiagnosed injury. Postgrad Med. 1 991 ; 89: 185-188, 191-192. Google Scholar4. Bennell KL. Malcolm SA. Thomas SA, Wark JD, Brukner PD. The incidence and distribution of stress fractures in competitive track and field athletes. A twelve-month prospective study. Am J Sports Med. 1996; 24:211-217. Google Scholar5. Prolzman RR. Griftis CG. Stress fractures in men and women undergoing military training. J Bone Joint Stag Am. 1977: 59:825. Google Scholar6. Knapp TP, Garretl WE Jr. Stress fractures: general concepts. CVm Sports Med. 1997: 16:339-356. Google Scholar7. Perron AD, Brady WJ. Keats TA. Management of common stress fractures. When to apply conservative therapy, when to lake an aggressive approach. Postgrad Med. 2002: 111:9596.99-100.105-106. Google Scholar8. Chamay A. Tschanlz P. Mechanical influences in bone remodeling. Experimental research on Wolff's law. J Biomech. 1972; 5: 173-180. Google Scholar9. Carter DR. Caler WE. Spengler DM. Frankel VH. Uniaxial fatigue of human cortical bone. The influence of tissue physical characieristics. J Biomech. 1981; 14:461-470. Google Scholar10. Burr DB. Remodeling and the repair of fatigue damage. Calcif Tissue Int. 1993; 53(Suppl l):S75-S80. Google Scholar11. Jones BH. Harris JM. Vinh TN. Rubin C. Exercise-induced stress fractures and stress reactions of bone: epidemiology, etiology, and classification. Exert· Sport Sci Rev. 1989; 17:379-422. Google Scholar12. Sterling JC, Edelstein DW. Calvo RD. Webb R II. Stress fractures in the athlete. Diagnosis and management. Sports Med. 1992; 14:336346. Google Scholar13. Frost HM. Some ABC's of skeletal pathophysiology. 5: Microdamage physiology. Calcif Tissue Int. 1991 ; 49:229-231. Google Scholar14. Uhthoff HK. Jaworski ZF. Periosteal stressinduced reactions resembling stress fractures. A radioiogic and histologic study in dogs. Clin Orthop. 1985; 199:284-291. Google Scholar15. Nattiv A, Armsey TD. Stress injury to bone in the female athlete. Clin Sports Med. 1997; 16:197-224. Google Scholar16. Myburgh KH. Hutchins J, Fataar AB, Hough SF. Noakes TD. Low bone density is an enologie factor for stress fractures in athletes. Ann Intern Med. 1990; 1 13:754-759. Google Scholar17. Bennell KL. Malcolm SA. Thomas SA. et al. Risk factors for stress fractures in track and field athletes. A twelve-month prospective study. Am J Sports Med. 1996: 24:810-818. Google Scholar18. Bennell KL, Malcolm SA. Thomas SA, el al. Risk factors for stress fractures in female track-and-field athletes: a retrospective analysis. Clin J Sport Med. 1995: 5:229-235. Google Scholar19. Barrow GW. Saha S. Menstrual irregularity and .stress fractures in collegiate female distance runners. Am J Sports Med. 1988; 16:209-216. Google Scholar20. Friedl KE. Nuovo JA. Patience TH. Dettori JR. Factors associated with stress fracture in young army women: indications for further research. Mil Med. 1992; 157:334-338. Google Scholar21. Warren MP, Brooks-Gunn J. Hamilton LH. Warren LF, Hamilton WG. Scoliosis and fractures in young ballet dancers. Relation to delayed menarche and secondary amenorrhea. N Engl J Med. 1986; 314: 1348- 1353. Google Scholar22. Winfield AC, Moore J, Bracker M. Johnson CW. Risk factors associated with stress reactions in female Marines. Mit Med. 1997; 162:698-702. Google Scholar23. Zeni Al, Street CC, Dempsey RL, Slaton M. Stress injury to the bone among women athletes. PAw Med Rehabil Clin N Am. 2000: 11:929-947. Google Scholar24. Loucks AB, Horvath SM. Athletic amenorrhea: a review. Med Sei Sports Exerc. 1985; 17:56-72. Google Scholar25. Marcus R, Cann C. Madvig P, et al. Menstrual function and bone mass in elite women distance runners. Endocrine and metabolic features. Ann Intern Med. 1 985; 102:158-163. Google Scholar26. Bennell K. Matheson G, Meeuwisse W, Brukner P. Risk factors for stress fractures. Sports Med. 1999;28:91-122. Google Scholar27. Seeman E, Szmukler GI, Formica C, Tsalamandris C. Meslrovic R. Osteoporosis in anorexia nervosa: the influence of peak bone density, bone loss, oral contraceptive use, and exercise. J Bone Miner Res. 1992; 7:1467-1474. Google Scholar28. Drinkwater BL. Nilson K. Ott S, Chesnul CH ??. Bone mineral density after resumption of menses in amenorrheic athletes. JAMA. 1986: 256:380-382. Google Scholar29. Rigotti NA, Neer RM, Skates SJ. Herzog DB, Nussbaum SR. The clinical course of osteoporosis in anorexia nervosa. A longitudinal study of cortical bone mass. JAMA. 1991:265:1133-1138. Google Scholar30. Friberg O. Leg length asymmetry in stress fractures. A clinical and radiological study. J Sports Med Phys Fitness. 1982; 22:485-488. Google Scholar31. Brunet ME. Cook SD, Brinker MR, Dickinson JA. A survey of running injuries in 1505 competitive and recreational runners. J Sports Med Phys Fitness. 1990; 30:307-315. Google Scholar32. Cowan DN, Jones BH, Frykman PN, el al. Lower limb morphology and risk of overuse injury among male infantry trainees. Med Sci Sports Exerc. 1996; 28:945-952. Google Scholar33. Giladi M, Milgrom C, Stein M, et al. External rotation of the hip. A predictor of risk for stress fractures. Clin Orthop. 1987; 216:131-134. Google Scholar34. McKenzie DC, Clement DB, Taunton JE. Running shoes, orthotics, and injuries. Sports Med. 1985; 2:334-347. Google Scholar35. Scott SH, Winter DA. Internal forces of chronic running injury sites. Med Sci Sports Exerc. 1990: 22:357-369. Google Scholar36. Hoffman JR, Chapnik L, Shamis A, Givon U. Davidson B. The effect of leg strength on the incidence of lower extremity overuse injuries during military (raining. Mil Med. 1999; 164:153-156. Google Scholar37. Ekenman I, Tsai-Fellander L, Westblad P. Turan 1, RoIfC. A study of intrinsic factors in patients with stress fractures of the tibia. Foot Ankle Int. 1996; 17:477-482. Google Scholar38. Shaffer RA, Brodine SK, Almeida SA. Williams KM, Ronaghy S. Use of simple measures of physical activity to predict stress fractures in young men undergoing a rigorous physical training program. Am J Epidemiol. 1999; 149:236-242. Google Scholar39. Milgrom C. Simkin A, Eldad A, Nyska M, Finestone A. Using bone's adaptation ability to lower the incidence of stress fractures. Am J Sports Med. 2000; 28:245-25 1. Google Scholar40. Johansson C, Ekenman I, Tornkvist H, Eriksson E. Stress fractures of the femoral neck in athletes. The consequence of a delay in diagnosis. Am J Sports Med. 1990: 18:524-528. Google Scholar41. Maitra RS. Johnson DL. Stress fractures. Clinical history and physical examination. Clin Sports Med. 1997; 16:259-274. Google Scholar42. Beck BR, Ostemig LR. Medial tibial stress syndrome. The location of muscles in the leg in relation to symptoms. / Bone Joint Surg Am. 1994;76:1057-1061. Google Scholar43. Beck BR. Tibial stress injuries. An aetiological review for the purposes of guiding management. Sports Med. 1998; 26:265-279. Google Scholar44. Martire JR. Differentiating stress fracture from periostitis. The finer points of bone scans. Phys Sports Med. 1994;22:71-81. Google Scholar45. Milgrom C, Chisin R, Giladi M, et al. Negative bone scans in impending tibial stress fractures. A report of three cases. Am J Sports Med. 1984; 12:488-491. Google Scholar46. Arendt EA. Griffiths HJ. The use of MR imaging in the assessment and clinical management of stress reactions of bone in high-performance athletes. Clin Sports Med. 1997; 16:291-306. Google Scholar47. Perron AD. Brady WJ. Keats TA. Principles of stress fracture management. The whys and hows of an increasingly common injury. Postgrad Med. 2001 ; 110: 115-118, 123-124. Google Scholar48. Fredericson M. Bergman AG, Hoffman KL, Dillingham MS. Tibial stress reaction in runners. Correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system. Am J Sports Med. 1995;23:472-481. Google Scholar49. Zwas ST, Elkanovitch R, Frank G. Interpretation and classification of bone scintigraphic findings in stress fractures. J Nucl Med. 1987; 28:452-457. Google Scholar50. Geiringer SR. Rehabilitation of StressFractures. Physical Medicine and Rehabilitation: State of the Art Reviews. Philadelphia, Pa: Hanley & Belfus Ine; 1995. Google Scholar51. Geiringer SR. Bowyer BL. Press JM. Sports medicine, I: the Physiatrie approach. Arch Phys Med Rehabil. 1993; 74:S428-S432. Google Scholar52. Dickson TB Jr, Kichline PD. Functional management of stress fractures in female athletes using a pneumatic leg brace. Am J Sports Med. 1987; 15:86-89. Google Scholar53. Whitelaw GP, Wetzler MJ, Levy AS, Segal D, Bissonnette K. A pneumatic leg brace for the treatment of tibial stress fractures. Clin Orthop. 1991;270:301-305. Google Scholar54. Swenson EJ Jr. DeHaven KE, SebastianeIH WJ, Hanks G. Kalenak A, Lynch JM. The effect of a pneumatic leg brace on return to play in athletes with tibial stress fractures. Am J Sports Med. 1997; 25:322-328. Google Scholar55. BTand JC Jr, Brindle T. Nyland J, Cabom DN. Johnson DL. Does pulsed low intensity ultrasound allow early return to normal activities when treating stress fractures'? A review of one tarsal navicular and eight tibial stress fractures. Iowa Orthop J. 1999: 19:26-30. Google Scholar56. Benazzo F, Mosconi M, Beccarisi G, Galli U. Use of capacitive coupled electric fields in stress fractures in athletes. Clin Orthop. 1995; 310:145-149. Google Scholar57. Holmes GB Jr. Treatment of delayed unions and nonunions of the proximal fifth metatarsal with pulsed electromagnetic fields. Foot Ankle Int. 1994; 15:552-556. Google Scholar58. Fullerton LR Jr, Snowdy HA. Femoral neck stress fractures. Am J Sports Med. 1988; 16:365-377. Google Scholar59. Shin AY. Morin WD. Gorman JD, Jones SB, Lapinsky AS. The superiority of magnetic resonance imaging in differentiating the cause of hip pain in endurance athletes. Am J Sports Med. 1996;24:168-176. Google Scholar60. Egol KA, Koval KJ, Kummer F. Frankel VH. Stress fractures of the femoral neck, Clin Orthop. 1998; 348:72-78. Google Scholar61 . Monteleone GP. Stress fractures in the athlete. Orthop Clin North Am. 1995; 26:423-432. Google Scholar62. Beals RK, Cook RD. Stress fractures of the anterior tibial diaphysis. Orthopedics. 1991; 14:869-875. Google Scholar63. Rettig AC. Shelbourne KD, McCarroll JR. Bisesi M, Watts J. The natural history and treatment of delayed union stress fractures of the anterior cortex of the tibia. Am J Sports Med. 1988; 16:250-255. Google Scholar64. Orava S. Hulkko A. Delayed unions and nonunions of stress fractures in athletes. Am J Sports Med. 1988; 16:378-382. Google Scholar65. Khan KM. Brukner PD. Kearney C, Fuller PJ. Bradshaw CJ, Kiss ZS. Tarsal navicular stress fracture in athletes. Sports Med. 1 994; 17:65-76. Google Scholar66. Quirk R. Stress fractures of the navicular. Foot Ankle Int. 1998: 19:494-496. Google Scholar67. Torg JS, Balduini FC. Zelko RR, Pavlov H. Peff TC. Das M. Fractures of the base of the fifth metatarsal distal to the tuberosity. Classification and guidelines for non-surgical and surgical management. J Bone Joint Surg Am. 1984;66:209-214. Google Scholar68. Rosenberg GA, Sferra JJ. Treatment strategies for acute fractures and nonunions of the proximal fifth metatarsal. J Am Acad Orthop Surg. 2000; 8:332-338. Google Scholar69. Thacker SB. Gilchrist J, Stroup DF, Kimsey CD. The prevention of shin splints in sports: a systematic review of literature. Med Sci Sports Exerc. 2002: 34:32-40. Google Scholar70. Schwellnus MP. Jordaan G, Noakes TD. Prevention of common overuse injuries by the use of shock absorbing insoles. A prospective study. Am J Sports Med. 1 990; 1 8:636-641. Google Scholar Previous article Next article FiguresReferencesRelatedDetailsCited by Andrew Naylor T and Naylor S (2021) Distribution and risk factors for stress fractures in competitive figure skaters and association with acute fractures, The Physician and Sportsmedicine, 10.1080/00913847.2021.1981748, 51:1, (45-49), Online publication date: 2-Jan-2023. Kreulen C, Boukhemis K and Giza E (2020) Stress Fractures Baxter's the Foot and Ankle in Sport, 10.1016/B978-0-323-54942-4.00003-8, (22-29), . Truntzer J, Morag G, Abrams G and Safran M (2020) In-Season Management of Injuries in Basketball: A Pragmatic Approach Basketball Sports Medicine and Science, 10.1007/978-3-662-61070-1_48, (617-624), . Chen Q, Song L, Fang J, Qin X, Lv T and Li X (2018) Effectiveness of Diagnosis and Treatment of Spiral Fracture of the Distal Third of the Tibia Combined with Posterior Malleolus Fracture, Journal of the American Podiatric Medical Association, 10.7547/15-181, 108:2, (106-114), Online publication date: 1-Mar-2018. Batson J and Locke M (2018) Foot and Ankle Injuries The Adolescent Athlete, 10.1007/978-3-319-56188-2_14, (275-308), . (2016) Stress Injury, Leg Diagnostic Imaging: Musculoskeletal Trauma, 10.1016/B978-0-323-39253-2.50160-9, (672-677), . Manske R, Porter A, Quillin D, Warden S, Burr D and Brukner P (2016) Repetitive Stress Pathology Pathology and Intervention in Musculoskeletal Rehabilitation, 10.1016/B978-0-323-31072-7.00026-9, (913-937), . Darabos N, Vioreanu M, Stevanovic V, Zupanc O and Longo U (2016) Stress Fractures in Sport (ICL 5) ESSKA Instructional Course Lecture Book, 10.1007/978-3-662-49114-0_5, (53-64), . Burrus M, Werner B, Starman J, Gwathmey F, Carson E, Wilder R and Diduch D (2014) Chronic Leg Pain in Athletes, The American Journal of Sports Medicine, 10.1177/0363546514545859, 43:6, (1538-1547), Online publication date: 1-Jun-2015. Beck B, Rudolph K, Matheson G, Bergman A and Norling T (2015) Risk Factors for Tibial Stress Injuries, Clinical Journal of Sport Medicine, 10.1097/JSM.0000000000000126, 25:3, (230-236), Online publication date: 1-May-2015. Mann G, Hetsroni I, Constantini N, Dolev E, Palmanovich E, Finsterbush A, Keltz E, Mei-Dan O, Eshed I, Marom N, Kots E and Nyska M (2015) Stress Fractures: Diagnosis, Differential Diagnosis, and Treatment Sports Injuries, 10.1007/978-3-642-36569-0_294, (2091-2102), . Haro M, Bruene J, Weber K and Bach B (2015) Stress Fractures of the Femur Stress Fractures in Athletes, 10.1007/978-3-319-09238-6_8, (111-124), . Wang T, Matheson G and Safran M (2015) General Treatment Concepts for Stress Fractures Stress Fractures in Athletes, 10.1007/978-3-319-09238-6_2, (13-31), . Pegrum J, Dixit V, Padhiar N and Nugent I (2015) The Pathophysiology, Diagnosis, and Management of Foot Stress Fractures, The Physician and Sportsmedicine, 10.3810/psm.2014.11.2095, 42:4, (87-99), Online publication date: 1-Nov-2014. Mann G, Hetsroni I, Constantini N, Dolev E, Palmanovich E, Finsterbush A, Keltz E, Mei-Dan O, Eshed I, Marom N, Kots E and Nyska M (2014) Stress Fractures: Diagnosis, Differential Diagnosis, and Treatment Sports Injuries, 10.1007/978-3-642-36801-1_294-1, (1-13), . Touraine S, Parlier-Cuau C, Bousson V, Sverzut J, Genah I, Petrover D and Laredo J (2013) Tibial hyperostosis: A diagnostic approach, European Journal of Radiology, 10.1016/j.ejrad.2013.08.015, 82:12, (2286-2295), Online publication date: 1-Dec-2013. Carroll A, Nash M and Thachil J (2013) Haemophilia stress fractures - an increasing complication with better orthopaedic care, Haemophilia, 10.1111/hae.12123, 19:3, (e178-e180), Online publication date: 1-May-2013. Pegrum J, Crisp T, Padhiar N and Flynn J (2015) The Pathophysiology, Diagnosis, and Management of Stress Fractures in Postmenopausal Women, The Physician and Sportsmedicine, 10.3810/psm.2012.09.1978, 40:3, (32-42), Online publication date: 1-Sep-2012. Schneiders A, Sullivan S, Hendrick P, Hones B, McMaster A, Sugden B and Tomlinson C (2012) The Ability of Clinical Tests to Diagnose Stress Fractures: A Systematic Review and Meta-analysis, Journal of Orthopaedic & Sports Physical Therapy, 10.2519/jospt.2012.4000, 42:9, (760-771), Online publication date: 1-Sep-2012. Beck B, Bergman A, Miner M, Arendt E, Klevansky A, Matheson G, Norling T and Marcus R (2012) Tibial Stress Injury: Relationship of Radiographic, Nuclear Medicine Bone Scanning, MR Imaging, and CT Severity Grades to Clinical Severity and Time to Healing, Radiology, 10.1148/radiol.12102426, 263:3, (811-818), Online publication date: 1-Jun-2012. Başbozkurt M, Demiralp B and Atilla H (2012) Stress Fractures in Military Personnel of Turkish Army Sports Injuries, 10.1007/978-3-642-15630-4_108, (853-857), . Mann G, Constantini N, Nyska M, Dolev E, Barchilon V, Shabat S, Finsterbush A, Mei-Dan O and Hetsroni I (2012) Stress Fractures: Overview Sports Injuries, 10.1007/978-3-642-15630-4_102, (787-813), . Harrast M and Colonno D (2010) Stress Fractures in Runners, Clinics in Sports Medicine, 10.1016/j.csm.2010.03.001, 29:3, (399-416), Online publication date: 1-Jul-2010. Milner C, Hamill J and Davis I (2010) Distinct Hip and Rearfoot Kinematics in Female Runners With a History of Tibial Stress Fracture, Journal of Orthopaedic & Sports Physical Therapy, 10.2519/jospt.2010.3024, 40:2, (59-66), Online publication date: 1-Feb-2010. (2010) Leg DeLee and Drez's Orthopaedic Sports Medicine, 10.1016/B978-1-4160-3143-7.00024-5, (1849-1864), . (2010) Hip, Pelvis, and Thigh DeLee and Drez's Orthopaedic Sports Medicine, 10.1016/B978-1-4160-3143-7.00021-X, (1451-1512), . Albisetti W, Perugia D, De Bartolomeo O, Tagliabue L, Camerucci E and Calori G (2009) Stress fractures of the base of the metatarsal bones in young trainee ballet dancers, International Orthopaedics, 10.1007/s00264-009-0784-3, 34:1, (51-55), Online publication date: 1-Jan-2010. Niva M, Mattila V, Kiuru M and Pihlajamäki H (2009) Bone Stress Injuries Are Common in Female Military Trainees: A Preliminary Study, Clinical Orthopaedics & Related Research, 10.1007/s11999-009-0851-5, 467:11, (2962-2969), Online publication date: 1-Nov-2009. Philipson M and Parker P (2009) Stress fractures, Orthopaedics and Trauma, 10.1016/j.mporth.2009.01.017, 23:2, (137-143), Online publication date: 1-Apr-2009. McMillan A and Payne C (2008) Effect of foot orthoses on lower extremity kinetics during running: a systematic literature review, Journal of Foot and Ankle Research, 10.1186/1757-1146-1-13, 1:1, Online publication date: 1-Dec-2008. CREABY M and DIXON S (2008) External Frontal Plane Loads May Be Associated with Tibial Stress Fracture, Medicine & Science in Sports & Exercise, 10.1249/MSS.0b013e31817571ae, 40:9, (1669-1674), Online publication date: 1-Sep-2008. (2008) Complete and Incomplete Femoral Stress Fractures in the Adolescent Athlete, Orthopedics, 31:6, Online publication date: 1-Jun-2008. Féron J (2008) Fractures de contrainte Conférences d'enseignement 2008, 10.1016/B978-2-84299-908-7.50003-X, (47-63), . Milner C, Hamill J and Davis I (2007) Are knee mechanics during early stance related to tibial stress fracture in runners?, Clinical Biomechanics, 10.1016/j.clinbiomech.2007.03.003, 22:6, (697-703), Online publication date: 1-Jul-2007. Key V (2007) Leg pain in runners, Current Opinion in Orthopaedics, 10.1097/BCO.0b013e3280895b0f, 18:2, (161-165), Online publication date: 1-Mar-2007. Pluim B (2007) The Clinician's Point of View Imaging of Orthopedic Sports Injuries, 10.1007/978-3-540-68201-1_1, (3-6), . McBryde A, Locke M and Batson J (2007) Foot and Ankle Injuries The Adolescent Athlete, 10.1007/978-0-387-49825-6_14, (348-395), . Mandracchia V, Mandi D, Toney P, Halligan J and Nickles W (2006) Fractures of the Forefoot, Clinics in Podiatric Medicine and Surgery, 10.1016/j.cpm.2006.01.009, 23:2, (283-301), Online publication date: 1-Apr-2006. DeFranco M, Recht M, Schils J and Parker R (2006) Stress Fractures of the Femur in Athletes, Clinics in Sports Medicine, 10.1016/j.csm.2005.08.003, 25:1, (89-103), Online publication date: 1-Jan-2006. Mercier L (2006) Sports Medicine Practical Orthopedics, 10.1016/B978-0-323-03618-4.10015-1, (311-340), . Edwards P, Wright M and Hartman J (2017) A Practical Approach for the Differential Diagnosis of Chronic Leg Pain in the Athlete, The American Journal of Sports Medicine, 10.1177/0363546505278305, 33:8, (1241-1249), Online publication date: 1-Aug-2005. Anderson S (2005) Sports Injuries, Disease-a-Month, 10.1016/j.disamonth.2005.10.003, 51:8-9, (438-542), Online publication date: 1-Aug-2005. Anderson S (2005) Sports injuries, Current Problems in Pediatric and Adolescent Health Care, 10.1016/j.cppeds.2004.12.009, 35:4, (110-164), Online publication date: 1-Apr-2005. Murray S, Reeder M, Ward T and Udermann B (2015) Navicular Stress Fractures in Identical Twin Runners, The Physician and Sportsmedicine, 10.3810/psm.2005.01.34, 33:1, (28-33), Online publication date: 1-Jan-2005. Cullen N, Singh D, Clowry O and Dudkiewicz I (2005) Symptomatic non-union of second metatarsal stress fracture following talo-navicular arthrodesis, Foot and Ankle Surgery, 10.1016/j.fas.2005.07.001, 11:4, (203-205), Online publication date: 1-Jan-2005. Request Permissions InformationCopyright 2013, SLACK IncorporatedPDF download

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