This study presents eight patients with stress fracture of the anterolateral cortex of the midshaft of the tibia. All of the patients, ranging in age from 14 to 23 years, were competitive basketball players who experienced pain while running or jumping for an average of 4.4 months before the diagnosis was made. Eight patients were treated with rest and/or pulsing electromagnetic field therapy. Although one of the patients required bone grafting procedure, all eight of these patients showed complete healing and were able to return to full activity after an average of 8.7 months of treatment. They have remained asymptomatic for an average of 14.7 months. The overall time from initial symptoms to return to competition averaged 12.5 months in this group of athletes. The results presented in this paper suggest that rest and pulsing electromagnetic field therapy may result in healing in some patients with delayed union stress fractures of the anterolateral cortex of the midshaft of the tibia. Although this injury is associated with a prolonged healing period, seven of eight patients with adequate followup in our study were able to return to competition without complications following treatment. One patient was asymptomatic for 33 months before experiencing a reinjury. In conclusion, we feel that diagnosis of stress fracture should be primary consideration in basketball players presenting with a prolonged history of pain on the anterolateral aspect of the midthird of the tibia. Once the diagnosis is made we recommend initial treatment consist of rest and external electrical stimulation for a minimum time of 3 to 6 months prior to considering surgical intervention.
In 1950, Wolin and his colleagues described nine patients who exhibited a "meniscoid" lesion of the ankle. He used this term to describe a mass of hyalinized tissue that formed following an inversion sprain of the ankle. This band of tissue was predisposed to trapping between the fibula and the talus. His patients presented with persistent pain and swelling over the anterior aspect of the ankle. In the last 3 years, four patients have presented with this lesion at the Methodist Sports Medicine Center in Indianapolis. They were all soccer players who had experienced repeated ankle sprains accompanied by persistent pain, swelling and trapping. Initially, these patients were treated with physical therapy, taping, and antiinflammatory medication. After 6 months of treatment, they continued to have symptoms and underwent arthroscopic examination. In each case a band of white, fibrous tissue was found during surgery and was removed. After an appropriate period of rehabilitation, all four patients returned to competition with a cessation of symptoms. However, one patient reported recurrent pain on rare occasions.
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