Tibial stress fracture managent

BACKGROUND: Despite the availability of multiple treatment options, management of tibial bone loss continues to be a challenge. Free vascularized fibula graft (FVFG) with a skin paddle offers better advantages over the other methods. We aimed to study the functional outcomes and QALY of patients with large tibial bone defects following FVFG with a locking plate in 26 patients. MATERIALS AND METHODS: We analyzed 26 consecutive patients with large tibial bone defects treated by free vascularized fibular graft (FVFG) and stabilization using a long locking plate between 2009 and 2018...

PURPOSE: Refracture is one of the main complications of bone transport, which brings additional physical and mental burden to surgeries and patients. We aimed to raise a new classification system of refracture-related bone transport based on the Simpson classification and to present our experience on treatment. METHODS: This retrospective analysis included 19 patients with refracture-related bone transport (average age of 37.7 years; 18 men). We developed a modified Simpson classification system to assist decision-making (conservative versus surgical)...

INTRODUCTION: The main differentials of non-traumatic heel pain are plantar fasciitis (PF), plantar heel fat pad atrophy, worn-out footwear, especially asymmetric wear and tear, hyperuricemia, corns, callosities, tumors of the calcaneum, osteomyelitis, calcaneal stress fractures due to overweight or unaccustomed over usage, radiating pain from S1 nerve root compression, and seronegative spondyloarthropathies. Compression of the tibial nerve or the medial calcaneal nerve at or around the flexor retinaculum is the other possibility...

Stress fractures (SFs) result from repetitive mechanical stress on bones, leading to an imbalance in osseous tissue adaptation and resulting in cortical fractures. The majority of SFs occur in the lower limb due to excessive mechanical loads. Long-distance runners are highly susceptible to SFs, especially when there is a significant increase in the load or intensity of their activity. Various intrinsic and extrinsic factors contribute to the development of SFs. Common SF locations in long-distance runners include the tibial shaft, femur, metatarsal, and pelvic region...

BACKGROUND: There has been controversial for the treatment of the posterolateral tibial plateau fractures (PTPF). This study aimed to evaluate clinic outcomes of the lateral locking compression plate (LCP) postposition, analyze the feasibility of LCP postposition through anatomical measurement, and address the potential problems of LCP postposition through the biomechanical assessment. METHODS: 39 patients with PTPF undergoing LCP fixation between June 2019 and June 2022 were retrospectively evaluated...

Chronic exertional compartment syndrome is an incapacitating condition that primarily affects athletes and individuals with high activity levels. The exact etiology of the condition is unknown to date, but multiple factors play a role in its occurrence. The clinical presentation includes pain, tightness, muscle weakness, paresthesia, and cramps. Common tools utilized during the diagnostic approach include intramuscular compartment pressure measurement, advanced imaging to exclude other disorder entities, near-infrared spectrometry, and shear wave elastography, with the clinical diagnosis being the gold standard...

Surgical management of posterolateral tibial plateau (PLTP) fractures is challenging. One reason for this challenge is the lack of suitable internal fixation devices. Our aim was to introduce a novel plate via the anterolateral approach for managing PLTP fractures. The biomechanical testing and finite element analysis (FEA) were performed. PLTP fracture models were created using synthetic tibias (n = 10 within each group). These models were randomly assigned to three groups (groups A-C) and fixed with the lateral locking plate, the posterior buttress plate, and the novel plate, respectively...

INTRODUCTION: Posterior-stabilized (PS) total knee arthroplasty (TKA) prostheses are characterized by an articulation between the polyethylene tibial post and the cam of the femoral component. Tibial post-fractures, traumatic and non-traumatic, are uncommon but catastrophic complications. We report a rare and unusual case of complete atraumatic erosion of the tibial post after PS-TKA. CASE REPORT: We present a case of atraumatic tibial post-failure (complete erosion) in a 73-year-old female after primary TKA...

The use of customized 3D-printed structures has been gaining popularity in non-union management, as it allows for bypassing the defect while promoting osseointegration. Additionally, porous titanium implants minimize stress shielding due to their stiffness and elastic modulus being closer to that of bone. The interconnected channels increase the surface area and provide space for cell adhesion and proliferation. This study presents the case of a 62-year-old female patient with concomitant knee osteoarthritis recalcitrant aseptic atrophic nonunion in the tibial proximal metaphysis...

OBJECTIVE: To evaluate the effectiveness of footwear, foot orthoses and training-related strategies to prevent lower extremity bone stress injury (BSI). DESIGN: Systematic review and meta-analysis. DATA SOURCES: Four bibliographic databases (from inception until November 2021): Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and CINAHL. ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) that assessed the risk of developing a BSI when using particular footwear, foot orthoses or training-related strategies such as muscle strengthening, stretching, and mechanical loading exercises...

For Schatzker type II split-depressed tibial plateau fractures involving the fractures of anterolateral and posterolateral columns (APC), the optimal fixation scheme is controversial. The objectives of this study were: (1) to introduce a newly designed plate for treating APC fractures via biomechanical tests and finite element analysis (FEA), and (2) to compare it with two conventional fixation methods. APC fracture models were created and randomly assigned to three groups (Groups A-C). Group A was fixed with a 3...

The tibial plateau is an important load-bearing surface in the knee, and when fractured, there is subsequent loss of motion and stability. These fractures typically result from axial loading and twisting. Our case outlines a tibial plateau fracture in a 15-year-old soccer player. The physical examination was positive for a decreased range of motion, pain with valgus stress, and positive ballottement. Radiography of the knee revealed joint effusion but no definite fracture. MRI revealed a Schatzker Type III fracture and a partial medial collateral ligament (MCL) tear...

CASE SUMMARY: A 10-year-old spayed female domestic medium hair cat presented after sustaining atraumatic insufficiency fractures of the right calcaneus and the left tibia approximately 6 weeks apart. Chronic alendronate therapy had been ongoing for 9 years for the management of previously diagnosed idiopathic hypercalcemia. The right calcaneal fracture was managed non-operatively due to minimal functional impairment. The left tibial fracture was managed via open reduction and internal fixation with orthogonal plating...

CASE: A 12-year-old skeletally immature girl presented with 1 year of persistent instability after an open reduction and internal fixation (ORIF) for a posterior cruciate ligament (PCL) avulsion fracture. With a period of nonoperative management, her PCL stress radiographic measurements significantly decreased and her posterior tibial slope increased because the primary ORIF effectively led to growth arrest with an early fusion of the posterior tibial physis. At age 13 years when she was skeletally mature, revision PCL and fibular collateral ligament (FCL) reconstructions were performed...

PURPOSE: Tibial stress fracture associated with knee osteoarthritis is an unusual and difficult clinical scenario. There is no clear existing treatment guideline for this uncommon clinical disease. The aim of this study is to review the impact of various treatment options for patients with advanced knee osteoarthritis associated with proximal tibial stress fracture. METHODS: The study was performed using the databases of PubMed and Scopus. Methodological index for non-randomized studies score was used to evaluate the included studies' bias...

Stress fractures are rare, occurring in 1.5/100,000 high school athletes. High impact, repetitive loading participation in woman's sports, and being a white athlete have been identified as risk factors for stress fractures. Mostly treated conservatively, they are more common in the tibia (33%). Stress fractures requiring surgery, which are extremely rare, have been reported in the scaphoid, fifth metatarsal, and neck of femur. Herein, a 16-year-old adolescent patient with obesity presented with atypical knee pain after prolonged exercise...

PURPOSE: To compare return to sport (RTS) rates and complications after nonoperative versus operative management of tibial stress fractures. METHODS: A literature search was conducted per the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using EMBASE, PubMed, and Scopus computerized data from database inception to February 2023. Studies evaluating RTS sport rates and complications after nonoperative or operative management of tibial stress fractures were included...

INTRODUCTION: Stress fractures are common in athletics and military recruits exposed to repetitive mechanical stresses. They are usually located in the weight-bearing lower limb and foot bone, usually in the metatarsals and tibial shaft. The medial femoral condyle is an unusual site for a stress fracture so reporting such a case is imperative. CASE REPORT: We report a case of a medial femoral condyle stress fracture in a young adult without any athletic or military background, which was managed conservatively by cast application...

INTRODUCTION: Fractures of the calcaneus are common, with 65% being intra-articular, which can lead to a major impairment of the patient's quality of life. Open reduction and internal fixation with locking plates can be considered as gold-standard technique but has a high rate of post-operative complications. Minimally invasive calcaneoplasty combined with minimally invasive screw osteosynthesis is largely drawn from the management of depressed lumbar or tibial plateau fractures. The hypothesis of this study is that calcaneoplasty associated with minimally invasive percutaneous screw osteosynthesis presents biomechanical characteristics comparable with conventional osteosynthesis...

Stress fractures consist of a type of bone fracture that occurs due to repetitive mechanical stress instead of acute forceful injuries that cause common fractures. They are quite common among athletes at all competition levels and in army recruits who are expected to undergo extremely demanding exercises. While stress fractures can occur in any long bone, they are usually associated with the most common weight-bearing sites of lower extremities such as phalanges, metatarsals, tarsal bones, the tibia, and fibula...