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Tibial intramedullary nailing
75%
1685/2261
Posterior tibial plate with bone graft
1%
25/2261
Bone grafting alone
32/2261
Cast treatment
5%
110/2261
Protected weight-bearing with crutches
18%
400/2261
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The patient has a stress fracture of the tibia. Nonoperative treatment with protected weight bearing, cessation of running, and possible use of a bone stimulator is useful early. Once the radiographs show the fracture especially in the anterior cortex of the tibia, surgical treatment is often recommended. This location is uncommon, but at increased risk for nonunion and propagation to complete fracture. An IM nail would allow for fastest weight bearing and return to activity. Anterior tension band plating has also been described, but not posterior. The paper by Varner et al reports on a series of 11 athletes treated with a reamed IM tibial nail for chronic anterior stress fracture. The average return to sports was 4 months.
3.1
(43)
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