Stress Fracture Of Fibula Research Articles

Stress fractures in a hyperactive 3-year-old girl

A 3-year-old girl was admitted to hospital on June 28, 1996, after a week’s pain in the left leg and a limp. She was not feverish. There was no history of trauma nor of family history of joint disease or bleeding disorder. She was unusually active, being on the move all the time. Examination was inconclusive as she was uncooperative, but she had no restriction of joint movements, although it was clear that her left leg was giving way when she walked. Her limp became steadily worse over the next week. Investigations showed a normal white blood count and an erythrocyte sedimentation rate of 10 mm/h. Radiographs of her left tibia and fibula showed a faint but definite periosteal reaction at the proximal tibial metaphysis. Re-examination showed no tenderness at this site. An isotope bone scan on July 4 showed “intense increased uptake in the proximal third of the left tibia” which, taken with the periosteal reaction, is typical of a stress fracture. By Aug 21, there was mature callus formation at the fracture site (figure). By Oct 24 she had no localised tenderness, but was still limping at times although extremely active; repeat radiographs showed remodelling of the previous stress fracture; quite unexpectedly there was a new healing fracture of the proximal third of the left fibula surrounded by callus. Stress fractures in children are uncommon especially under 5 years; fractures of the tibia are commonest, the usual site being the proximal followed by the distal shaft, followed by the fibula. Hitchens and Lyons noted a fatigue fracture of the medial malleolus in a 9-year-old female roller skater. Sheehan et al reported bilateral fibular stress fractures in a 10-month-old girl due to use of an infant walker; it was thought that repeated sub-acute trauma due to banging her walker into the kitchen cabinets, with consequent transfer of energy to the crossbar and thence to each fibula, was the mechanism. The common factor appears to be continued sudden violent repetitive activity. No such predisposing factors could be found in this patient, apart from her unusual activity.

Stress fractures of the fibula in the first few years of life (report of six cases).

Fibular stress fractures in children in the first few years of life are not well known and are often confused with osteomyelitis or malignant bone tumour. This misdiagnosis is followed by nuclear scan, computerized tomography (CT), magnetic resonance (MR) imaging and even biopsy. All these investigations are unnecessary as plain X-rays show diagnostic radiographic findings and misdiagnosis is highly unlikely when they are evaluated in the context of clinical findings.

Fibular Stress Fracture Associated With Distal Tibiofibular Synostosis in an Athlete

A 19-year-old collegiate football player with progressive ankle syndesmosis ossification developed acute localized fibular tenderness. Roentgenograms demonstrated a fibular stress fracture proximal to the superior extent of the ossific mass. Surgical resection of the mass resulted in uneventful fibular healing, with resolution of acute and chronic symptoms.

Proximal fibular stress fracture in an aerobic dancer

Proximal fibular stress fracture in an aerobic dancer

An unusual stress fracture of the fibula in a long-distance runner

A stress fracture of the proximal fibula in a young long-distance runner is reported. Such fractures are rare. The literature is reviewed and diagnosis and treatment are discussed.

Nontraumatic femur fracture in an oligomenorrheic athlete

Exercise-associated amenorrhea is the cessation of menses in a woman following onset of training or an increase in training intensity. Its physiologic basis is characterized by consistently low levels of gonadotropin and ovarian hormones, but the underlying cause of this phenomenon is unknown. Although osteopenia has been described in amenorrheic women athletes, it has been primarily a laboratory diagnosis. Several recent studies have described a significantly lower bone mineral density (BMD) in the lumbar spine of amenorrheic athletes. Marcus et al. also reported an increased number of metatarsal and tibial stress fractures in a group of amenorrheic women. We report here the first case of a nontraumatic femur fracture in an amenorrheic athlete. A 32-yr-old white female, with four prior fibular stress fractures, suffered a left femoral shaft fracture during the 13th mile of a half-marathon. The fracture was successfully internally fixed. Biochemical studies showed no metabolic abnormality. Bone mineral density of the lumbar spine, femoral neck, tibia, and fibula were below the mean for both eumenorrheic and amenorrheic female athletes. Exercise-associated amenorrhea is a medical problem that may have serious implications for both competitive and high-intensity recreational female athletes.

Stress fracture of the fibula in the first decade of life

Stress fracture of fibula in athletes and ballet dancers is a well recognised entity. Fibular fractures in children in the first decade of life who are not active in sport or ballet dancing are not well known and often diagnosed as osteomyelitis or malignant bone tumour. This misdiagnosis may be followed by CT, nuclear scan or MR. All these investigations are not necessary and biopsy if performed might even be misleading. The plain X-rays show diagnostic radiographic findings and a misdiagnosis is highly unlikely especially when they are evaluated in the context of clinical findings.