Outcomes of tibial stress fractures

NewsBot · Mar 12, 2018

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Outcomes of Surgical Treatment for Anterior Tibial Stress Fractures in Athletes: A Systematic Review
Zaira S. Chaudhry, MPH, Steven M. Raikin, MD, Marc I. Harwood, MD, ...
The American Journal of Sports Medicine March 12, 2018

Background:
Although most anterior tibial stress fractures heal with nonoperative treatment, some may require surgical management. To our knowledge, no systematic review has been conducted regarding surgical treatment strategies for the management of chronic anterior tibial stress fractures from which general conclusions can be drawn regarding optimal treatment in high-performance athletes.

Purpose:
This systematic review was conducted to evaluate the surgical outcomes of anterior tibial stress fractures in high-performance athletes.

Study Design:
Systematic review; Level of evidence, 4.

Methods:
In February 2017, a systematic review of the PubMed, MEDLINE, Cochrane, SPORTDiscus, and CINAHL databases was performed to identify studies that reported surgical outcomes for anterior tibial stress fractures. Articles meeting the inclusion criteria were screened, and reported outcome measures were documented.

Results:
A total of 12 studies, published between 1984 and 2015, reporting outcomes for the surgical treatment of anterior tibial stress fractures were included in this review. All studies were retrospective case series. Collectively, surgical outcomes for 115 patients (74 males; 41 females) with 123 fractures were evaluated in this review. The overall mean follow-up was 23.3 months. The most common surgical treatment method reported in the literature was compression plating (n = 52) followed by drilling (n = 33). Symptom resolution was achieved in 108 of 123 surgically treated fractures (87.8%). There were 32 reports of complications, resulting in an overall complication rate of 27.8%. Subsequent tibial fractures were reported in 8 patients (7.0%). Moreover, a total of 17 patients (14.8%) underwent a subsequent procedure after their initial surgery. Following surgical treatment for anterior tibial stress fracture, 94.7% of patients were able to return to sports.

Conclusion:
The available literature indicates that surgical treatment of anterior tibial stress fractures is associated with a high rate of symptom resolution and return to play in athletes, although the high complication rate and potential need for subsequent procedures are important considerations for surgeons and patients.
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Admin2 · Mar 12, 2018

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NewsBot · Jun 9, 2021

Tibial Stress Fractures in Runners: a Narrative Review for Physiotherapy Management
Dimitrios Lytras et al
Critical Reviews™ in Physical and Rehabilitation Medicine

Background: Stress fractures in runners usually occur due to overtraining after the body fails to repair minor injuries that occur due to submaximal repetitive loads on the bones of the lower limbs. Stress fractures in the bones of the lower limbs account for 80-90% of all stress fractures, while one in two stress fractures of the lower limbs that occur in runners involve fractures of the tibia. Objective: The purpose of this manuscript is to present, based on the existing literature, the most important treatment options applied in the context of physiotherapy intervention in runners with stress fractures in the tibia. Major findings: Restoring stress fractures of the tibia requires cessation of bone strain and abstinence from any sports activity. The return to activity is achieved gradually and includes therapeutic means and modified exercise in conditions of reduced bone load. Physiotherapy contributes significantly to the rehabilitation of athletes with stress fractures of the tibia including both therapeutic exercise and the application of therapeutic means, such as the anti-gravity treadmill, hydrotherapy, therapeutic ultrasound and modified retraining. Conclusions: Current research shows that the correct physiotherapy treatment can reduce pain and inflammation as well as provide faster healing of the fracture. The purpose of physiotherapy intervention is to maintain normal movement, prevent recurrence and restore normal movement as early as possible.
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