Non-union of a midshaft anterior tibial stress fracture: A frequent complication

Abstract

We report a case of non-union of a midshaft anterior cortex tibial stress fracture and review the literature concerning this pathological entity. This is a relatively rare clinical form of tibial stress fracture which often results in delayed union, non-union or complete fracture. Initial management is as for a conventional stress fracture, associated in some cases, according to certain authors, with pulsing electromagnetic field physiotherapy. If after 4-6 months no sign of union is present, surgical management is indicated, in the form of excision of the fracture site with or without bone graft.

Intra-medullary osteosclerosis of the tibia in children

“…Non-operative treatment failed to ensure healing, and excision with bone grafting was required. Several other cases of non-union of tibial shaft lesions diagnosed as stress fractures have been reported [20][21][22]. Mabit et al and Rettig et al reported 2 similar cases in which excision and grafting was successful after failure of nonoperative treatment and electromagnetic stimulation [21,22].…”

Anterior Tibial Cortex Stress Fracture in a High Demand Professional Soccer Player

“…Repeated compression loading is the pathophysiological mechanism involved according to Mabit et al [7]. In contrary Wagner et al [8] showed that the anterior aspect of the midshaft of the tibia is an area under tension than compression.…”

Ostéosclérose intramédullaire du tibia chez l’enfant

“…Green et al ont décrit 6 prises en charge difficiles de fractures « de stress » correspondant à une hyperostose cortico-médullaire médio-diaphysaire antérolatérale tibiale associée à une solution de continuité antérolatérale comme retrouvée dans notre série, avec échec du traitement orthopédique, ayant nécessité la réalisation d'une excision-greffe de la lésion [19]. D'autres fractures « de stress » diaphysaires tibiales de consolidation difficile sont retrouvées dans la littérature [20][21][22]. Mabit [21,22].…”

“…D'autres fractures « de stress » diaphysaires tibiales de consolidation difficile sont retrouvées dans la littérature [20][21][22]. Mabit [21,22]. Dans notre série, aucune résection-comblement par autogreffe n'a été réalisée.…”