High-risk stress fractures: pathogenesis, evaluation, and treatment.

High-risk stress fractures require precise assessment and treatment because of their propensity for delayed union, nonunion, or complete fracture and their resulting disabling complications. Proper diagnosis necessitates a thorough clinical evaluation, centering on the patient's diet and history, particularly the training regimen. For a definitive diagnosis, plain radiography, ultrasound, bone scintigraphy, magnetic resonance imagery (MRI), and computed tomography (CT) are helpful, and each plays a specific role. High-risk stress fractures typically require aggressive treatment such as nonweight-bearing immobilization coupled with therapy and often surgery.