Stress fractures (or fatigue fractures) are covered in this chapter. Stress fractures are assumed to occur due to microcracks from repetitive forces that accumulate to result in a complete bone break, but these fractures can result from a single traumatic event. The most common location for stress fractures is the vertebral column; two common vertebral stress fractures include spondylolysis and clay-shoveler’s fractures. Spondylolysis fractures, which occur on the lumbar vertebrae, are the most often reported stress fractures. Non-activity causes of stress fractures and the closely related stress hernias, called Schmorl’s nodes, have been found in twin studies; these fractures and hernias seem to be correlated with normal anatomical variation found in the vertebral column. These anatomical variations are likely determined by genes.
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