Stress Fracture of the Lateral Cuneiform Bone in a Lacrosse Player

Stress fractures result from repetitive loading and occur in two forms: fatigue fractures and insufficiency fractures. Fatigue fractures, the result of abnormal repetitive stress on normal bone, usually occur when a person engages in an activity for a prolonged period. Insufficiency fractures are the result of normal stresses on abnormally weak bone. The locations in which a stress fracture develops depend on the particular activity involved and the stresses it puts on a particular anatomic structure. Stress fractures of the foot are relatively common. In a prospective fourteen-week study of 295 military recruits, the prevalence of stress fractures was 31%, and 8.7% of these fractures were in the foot1. In a study of athletes with stress fractures, 25% had tarsal stress fractures and 9% had metatarsal stress fractures; the tibia was the bone with the largest number of stress fractures2. The cuneiform bones are not usually affected. We describe a case of a stress fracture of the lateral cuneiform in an athlete. The patient and her mother were informed that data concerning the case would be submitted for publication, and they provided consent. A fifteen-year-old female cross-country runner and lacrosse player presented for evaluation of left foot pain of approximately two weeks’ duration. She could not recall any recent trauma. However, she noted that she had been spending more time than usual during training sessions doing conditioning line drills, called “suicide drills,” before the onset of the pain. During this activity, …