Non-union of a midshaft anterior tibial stress fracture: A frequent complication

  • C. Mabit
  • C. Pécout
Originals Sports Medicine


We report a case of non-union of a midshaft anterior cortex tibial stress fracture and review the literature concerning this pathological entily. This is a relatively rare clinical form of tibial stress fracture which often results in delayed union, non-union or complete fracture. Initial management is as for a conventional stress fracture, associated in some cases, according to certain authors, with pulsing electromagnetic field physiotherapy. If after 4–6 months no sign of union is present, surgical management is indicated, in the form of excision of the fracture site with or without bone graft.

Key words

Stress fracture Tibia Non-union 


  1. 1.
    Blank S (1987) Transverse tibial stress fracture: a special problem. Am J Sports Med 15: 597–602PubMedGoogle Scholar
  2. 2.
    Brahms MA, Fumich RM, Ippolito VD (1981) Atypical stress fracture in a runner. Am J Sports Med 9: 322–325PubMedGoogle Scholar
  3. 3.
    Burrows HJ (1956) Fatigue infraction of the middle of the tibia in ballet dancer. J Bone Joint Surg [Br] 38: 83–94Google Scholar
  4. 4.
    Friedenberg ZB (1971) Fatigue fractures of the tibia. Clin Orthop 76: 111–115PubMedGoogle Scholar
  5. 5.
    Green NE, Rogers RA, Lipscomb AB (1985) Non union of stress fractures of the tibia. Am J Sports Med 13: 171–176PubMedGoogle Scholar
  6. 6.
    Orava S, Hulkko A (1984) Stress fracture of the mid-tibial shaft. Acta Orthop Scand 55: 35–37PubMedGoogle Scholar
  7. 7.
    Orava S, Hulkko A (1988) Delayed unions and non unions of stress fractures in athletes. Am J Sports Med 16: 378–382PubMedGoogle Scholar
  8. 8.
    Rettig AC, Shelbourne KD, McCarroll JR, Bisesi M, Watts J (1988) The natural history and treatment of delayed union stress fracture of the anterior cortex of the tibia. Am J Sports Med 16: 250–255PubMedGoogle Scholar
  9. 9.
    Stanitsky CL, McMaster JH, Scranton PE (1978) On the nature of stress fractures. Am J Sports Med 6: 391–396PubMedGoogle Scholar
  10. 10.
    Wagner J, Bourgois R, Hermanne A (1982) Comportement mécanique du cadre tibio-péronier dans les genoux varum et valgum. Acta Orthop Belg 48: 57–92PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • C. Mabit
    • 1
  • C. Pécout
    • 1
  1. 1.Unité Fonctionnelle de Pathologie Traumatique du SportHôpital Universitaire DupuytrenLimogesFrance

Personalised recommendations