Abstract

Altogether 226 stress fractures of the lower leg in 207 athletes were treated during the 14-year period 1971-1985. There were 182 fractures of the tibia and 44 of the fibula, the site of fracture depending on structural and biomechanical factors. 136 stress fractures of the tibia (74.7) occurred in runners and a further 31 cases (17.6) in athletes of other sports after running exercises. Corresponding figures for the fibula were 36 (80.5) and 4 (9.1). Radiographs showed that 95 of the tibial fractures were located on the posteromedial compression side and 5 on the anterior tension side. In the fibula 86 of the fractures were located in the distal third. The weekly distance run before appearance of symptoms was significantly shorter for females than for males, and for children and adolescents compared with adults, and for recreational runners compared with competitive runners. The most common external etiological factors were an increase in the intensity of training, participation in a competition, and hard or icy roads. The healing times for the fibular stress fractures were significantly shorter than those for the tibial stress fractures. Eight tibial stress fractures required operative treatment. Some aspects of the biomechanical and etiological factors as well as the diagnosis, treatment and prevention of the stress fractures of the lower leg are discussed. Verf.-Referat