Tibial stress fracture

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

New recruit to National service. Intense training and low impact fall 2-3 months ago. Palable mass on shin.

Patient Data

Age: 18 years
Gender: Female
x-ray

Exuberant callus formation at the site of a oblique fracture of the upper third of the tibial shaft.  The fracture has united.  No mal-alignment.

Normal fibula.

Case Discussion

A very delayed presentation of a fracture from repeated stress to the tibia.   

The fracture has fairly nicely healed with bony union despite no medical intervention.

National service and military recruits are one of the commonest groups to acquire stress fractures from short explosive periods of training with the repetitive stress this incurs.

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