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Tibial Stress Fracture, Sports Medicine

Andrew J.M. Gregory, MD, FAAP, FACSM Reviewed 04/2019


Stress fracture of the tibia refers to an overuse injury of the bone as a result of repetitive loading that overwhelms its capacity to heal and must be differentiated from medial tibial stress ...


  • Primarily based on history and physical examination and a high index of suspicion based on risk factors

  • X-rays can be helpful if positive but are often unremarkable.

  • Hallmark is point tenderne...


  • Treatment of most stress fractures of the tibia is the same as other stress fractures, which is to remove the offending activity (usually impact activity).

  • However, the treatment of anterior ...


  • Low-risk stress fractures of the tibia: Ongoing activity modification and pain management is usually sufficient.

  • High-risk stress fractures of the tibia require intermedullary nailing and ...


Mollon B, da Silva V, Busse JW, et al. Electrical stimulation for long-bone fracture-healing: a meta-analysis of randomized controlled trials. J Bone Joint Surg Am.  2008;90(11):2322–...


  • Busse JW, Kaur J, Mollon B, et al. Low intensity pulsed ultrasonography for fractures: systematic review of randomised controlled trials. BMJ.  2009;338:b351.

  • Kaeding CC, Yu JR,...


  • Distinguish low-risk from high-risk stress fracture based on imaging and exam.

  • Tenderness to palpation is the main physical examination finding.

  • MRI is the imaging study of choice.

  • Evalua...

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