Research Update on Stress Riser Fractures

Stress fractures are fatigue-induced fractures which are caused by repetitive force, often from overuse. They are well-established and frequently encountered in the field of orthopedics. Stress fractures occur in the bone because of low-bone strength and high chronic mechanical stress placed on the bone. Stress riser fractures are also stress fractures that occur because of the presence of cortical defects (holes), changes in stiffness, sharp corners, and cracks (fracture lines). Periprosthetic or peri-implant fractures are good examples of stress riser fractures that occur in regions where stress forces are higher than those in the surrounding material. Most stress riser fractures are related to technical errors (iatrogenic causes) and are difficult to manage. It is possible and more effective to prevent the creation of stress riser fractures through better surgical techniques. The proper terminology for stress fractures, stress riser fractures, periprosthetic fractures, peri-implant fractures, interprosthetic fractures, and interimplant fractures is discussed. This review of the current state of knowledge, diagnosis, treatment, and prevention of stress riser fractures is based on clinical evidence and recent literature.