title: [Bilateral stress fracture of the medial malleolus].
abstract: BACKGROUND
  A stress fracture can be defined as a partial or complete fracture of bone that results from repeated application of stress to the bone. Stress fractures are common injuries in athletes with an incidence of 0.12 - 4.4 %. Running and jumping are the most common sporting activities that have resulted in stress fractures. Stress fractures of the medial malleolus are extremely rare. Diagnosis and therapy are often difficult, result in a delayed begin of therapy and are a demanding task in sports medicine. Both surgical and conservative treatment are possible.
  
  
  METHODS
  We present the case of an athlete, who presented stress fractures of both medial malleolus in 21 months.
  
  
  RESULTS
  The patient was treated on one side with arthroscopy and an osteosynthesis and with arthroscopy on the other side. Each time the fracture healed without any problems.
  
  
  CONCLUSIONS
  Based on literature and our patient we believe that surgical and conservative treatment are possible options. However surgical procedures seem to bring back the athlete earlier to sporting activities. Surgery should be considered early in the right patients.
authors.affiliation: Orthopädische Klinik, Universitätsklinikum Göttingen. hannosteckel@aol.com
authors.forename: H
authors.initials: H
authors.lastname: Steckel
authors.forename: H M
authors.initials: HM
authors.lastname: Klinger
authors.forename: M H
authors.initials: MH
authors.lastname: Baums
authors.forename: W
authors.initials: W
authors.lastname: Schultz
mesh_terms: D016512:Ankle Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D001182:Arthroscopy; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D015775:Fractures, Stress / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011859:Radiography; D011877:Radionuclide Imaging; D012420:Running / Q000293:injuries*; D013978:Tibial Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome