Stress fracture of the distal tibia post ORIF

Case contributed by RMH Core Conditions
Diagnosis certain

Presentation

Pain left tibia. Previous ORIF complicated by osteomyelitis.

Patient Data

Age: 76
Gender: Male

The plate and screws through the tibia are noted.

A new fracture line extends from the level of the lower margin of the plate and along the posterior cortex.

At this level extending both anteriorly and posteriorly there is also new periosteal new bone and some new endosteal bone. There is no bone destruction to suggest infection, although this cannot be entirely excluded.

Appearance raises the possibility of a stress fracture at the lower margin of the plate.

The fracture described on the CT cannot be seen. Compared with the x-ray there is new periosteal reaction around the distal third of the tibia. It is probably not significantly changed compared with the CT.  Plate and screws unchanged.

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