Hairline Fracture: Causes, Symptoms, Tests & Treatment
Written By: Dr. Mohamed Ghanem
Updated On:January 26, 2025
What is Hairline Fracture?
An internal bone split or significant bruise is referred to as a hairline fracture, also known as a stress fracture. Athletes, particularly those who participate in sports requiring running and jumping, are most susceptible to this injury. Hairline fractures are another complication of osteoporosis.
Overuse or repetitive motions that result in microscopic deterioration to the bone over time are frequent causes of hairline fractures. The likelihood of suffering this injury is frequently influenced by not giving your body enough time to recover between activities.
Hairline Fracture in Foot
Hairline fractures are most common in the bones of the foot and leg. Running and jumping put a lot of pressure on these bones. The second and third metatarsals of the foot are most frequently impacted. This is because they are fragile bones that serve as the point of impact when you run or leap and push off with your foot. Additionally typical is a hairline fracture in your navicular, a bone on the top of the midfoot, your heel, and/or your ankle bones.
Causes of Hairline Fracture
Overuse or repetitive motion is the main cause of hairline fractures. A hairline fracture can happen as a result of an increase in activity, either in frequency or duration. This means that even if you are accustomed to running, abruptly raising your weekly jogging frequency or your distance can result in injury.
Altering your fitness routine is another related cause of a hairline fracture. For instance, even if you are in terrific form and are an amazing swimmer, you could still get hurt if you suddenly start running or another hard sport.
Through a variety of activities, bones adjust to higher stresses by forming new bones to replace the damaged ones. Remodeling is the name of this process. A hairline fracture is more likely to occur when a bone is broken down faster than new bone can grow.
Symptoms of Hairline Fracture
Pain is a hairline fracture's primary symptom. If you continue engaging in weight-bearing activity, this pain may progressively worsen over time. Typically, the pain increases with activity and decreases after rest. Additional signs include swelling, tenderness, and bruising.
When to see a doctor for Hairline Fracture?
There are several first aid procedures you can carry out before you visit the doctor:
- Adopting the RICE approach: Rest, ice, compress, and elevate
- Using nonsteroidal anti-inflammatory medicines
If the pain worsens or doesn't go away with rest, it's critical to consult your doctor for additional treatment. Depending on the extent and location of your injury, your doctor will determine the best course of hairline fracture treatment for you.
Hairline Fracture Risk Factors
Additionally, there are certain risk factors that raise your likelihood of developing a hairline fracture:
- Sports: People who engage in high-impact activities like track and field, basketball, tennis, dance, ballet, long-distance runners, and gymnastics are more likely to sustain a hairline fracture.
- Sex: Women, particularly those without menstrual cycles, are more likely to experience hairline fractures. In fact, the "female athlete triad," a disease that affects female athletes, may put them at higher risk. Here, severe diets and exercise can lead to eating problems, irregular menstruation, and early osteoporosis. A female athlete's risk of injury increases as a result of this.
- Foot issues: Unsafe footwear might result in injuries, as can flat feet, stiff arches, or high arches.
- Weakened bones: Even when engaging in regular, everyday activities, conditions like osteoporosis or drugs that impact bone density and strength can result in hairline fractures.
- Prior hairline fractures: Possessing one hairline fracture raises the possibility of possessing more.
- Nutrient deficiency: Your bones may be more prone to breaking if you don't get enough calcium or vitamin D. For this reason, eating problem sufferers are also in danger. Additionally, since you might not be getting enough vitamin D throughout the winter, there may be a higher chance of this injury.
- Ineffective technique: Bunions, tendonitis, and blisters can change how you run, affecting which bones are affected by specific activities.
- Surface change: Different playing surfaces can put too much stress on the feet and legs' bones. For instance, injuries could occur if a tennis player switched from a grass court to a hard court.
- Inadequate shoes: If you wear bad running shoes, you're more likely to sustain a hairline fracture.
Hairline Fracture Complications
Ignoring a hairline fracture might cause a more serious, more difficult-to-treat fracture or break to develop. The hairline may not heal, leading to a non-union fracture, if untreated or ignored.
Hairline Fracture Diagnosis & Tests
Your medical history and general health will be discussed with your doctor. They will enquire about your diet, medications, and other risk factors as well. After that, they may conduct a number of tests, such as:
- Physical examination: The sore area will be examined by your doctor. They'll likely apply light pressure to see if it hurts. Your doctor's ability to identify a hairline fracture is frequently based on how you feel in response to pressure.
- MRI: An MRI is the most accurate imaging procedure for identifying hairline fractures. Radio waves and magnets are used in this test to produce images of your bones. Before an X-ray can detect a fracture, an MRI will. It will also be more accurate in identifying the kind of fracture.
- X-ray: Hairline fractures are frequently difficult to see on X-rays taken right away after an incident. A callus that has developed around the healing area a few weeks after the injury may make the fracture evident.
- Bone Scan: Receiving a modest dosage of radioactive material through a vein is required for a bone scan. A buildup of this material occurs where bones are healing. However, this test won't clearly verify there is a hairline fracture because it will just show an enhanced blood supply to a certain place. Given that other illnesses can also result in an abnormal bone scan, it is suggestive rather than definitive of a hairline fracture.
Hairline Fracture Treatment
Utilizing crutches to maintain weight off an injured foot or leg may be advised by your doctor. A cast or safety shoes are other options.
It's crucial to alter your activities during this period because a hairline fracture can often take six to eight weeks to fully heal. Swimming and cycling are excellent alternatives to more impact-intensive exercises.
It may be necessary to have surgery on some hairline fractures so that pins or screws can be added to support the bones and hold them together while they mend.
Hairline Fracture Prevention
Hairline fractures can occasionally be challenging to avoid. For instance, in those who do sports with heavy impact or who have particular illnesses, such as osteoporosis.
Broadly speaking, the chance of a hairline fracture can be decreased by:
- utilizing top-notch exercise gear,
- accommodating anatomical abnormalities by wearing insoles,
- ensuring that changes to activity duration, frequency, or intensity are gradual rather than abrupt,
- getting enough rest in between workouts,
- eating a nutritious, balanced diet that includes an appropriate amount of calcium and vitamin D,
- and not ignoring pains related to exercise or delaying seeking medical advice for persistent discomfort.
References
Brockwell, J., Yeung, Y., & Griffith, J. F. (2009). Stress fractures of the foot and ankle. Sports medicine and arthroscopy review, 17(3), 149-159.
Mayer, S. W., Joyner, P. W., Almekinders, L. C., & Parekh, S. G. (2014). Stress fractures of the foot and ankle in athletes. Sports Health, 6(6), 481-491.
Pegrum, J., Dixit, V., Padhiar, N., & Nugent, I. (2014). The pathophysiology, diagnosis, and management of foot stress fractures. The Physician and sportsmedicine, 42(4), 87-99.
Shindle, M. K., Endo, Y., Warren, R. F., Lane, J. M., Helfet, D. L., Schwartz, E. N., & Ellis, S. J. (2012). Stress fractures about the tibia, foot, and ankle. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 20(3), 167-176.
Welck, M. J., Hayes, T., Pastides, P., Khan, W., & Rudge, B. (2017). Stress fractures of the foot and ankle. Injury, 48(8), 1722-1726.
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