Abstract des Autors

Discussed is a longitudinal tibial stress fracture, a variant not often described. Suspicion for stress fractures is present with exercise-induced, local pain at the fracture site, partially relieved by rest. X-rays are often normal, bone scintigraphy non-specific. This longitudinal tibial variant was differentiated from a medial tibial stress syndrome with supplementary CT. In most cases relative rest will lead to total healing. The importance of differentiating a tibial stress fracture from other overuse-injuries in the lower leg, is that a tibial stress fracture may complicate into a complete fracture with a bad tendency for recovery and high risc for pseudarthrosis. Therapy therefore is more stringent; when relative rest does not bring sufficient improvement within a number of weeks, complete rest with (cast)immobilization will be necessary. Even surgical therapy may be needed. Whether a longitudinal tibial stress fracture has the same complication rate cannot be concluded from the small number described. Verf.-Referat