Stress Fractures of the Tibia

摘要: The anatomy and biomechanics of the tibia play a critical role in development management tibial stress fractures. Posterior calf musculature relative anterior avascularity lead to high rate nonunion, delayed union, fracture “high-risk” tension-sided cortex Fracture location at compressive side abundant vasculature are favorable characteristics “low-risk” posteromedial differential diagnosis patients with overuse injuries leg includes fracture, medial syndrome, exertional compartment popliteal artery entrapment multiple nerve syndromes, among others. Risk factors for include prior recent increases training intensity and/or duration, improper technique or equipment, female athlete triad, calcium vitamin D deficiency, inadequate caloric intake. history physical examination patient generally indicates focal point tenderness site unremitting pain weight-bearing activity, hop tuning fork testing. Magnetic resonance imaging is modality best diagnostic sensitivity specificity. Non-operative treatment successful low-risk Surgical treatment, including reamed intramedullary rodding tension-band plating, chronic mid-diaphyseal fractures that have failed nonsurgical treatment. These procedures produced union rates, low complication early return sport.