Delayed union stress fractures of the anterior tibia: conservative management.

Abstract

A conservative method of treating four delayed union stress fractures of the anterior mid-tibia is described, with an illustrative case history. Once diagnosed each of the patients was treated in a pneumatic lower leg brace with modified rest. The mean (range) age of the patients was 28 (24-32) years and all were involved in professional or amateur sports. The mean (range) duration of symptoms before diagnosis and definitive treatment of the four fractures was 9 (3-14) months. Use of this technique avoided the need for surgery in this group of patients and allowed return to unrestricted activity an average of 12 months from presentation. The treatment is cost effective and avoids the often uncertain results and morbidity associated with surgery for these difficult stress fractures.