title: Stress fracture of the distal tibia secondary to severe knee osteoarthritis: a case report.
abstract: Stress fracture of the tibia secondary to sports-related activities is relatively common, but rarely occurs secondary to osteoarthritis of the knee. Such fractures usually involve the proximal tibia. We report a 61-year-old woman with osteoarthritis and severe varus deformity of the knee who had a stress fracture of the distal tibial shaft. The patient had declined total knee replacement for severe osteoarthritis. She developed a stress fracture that subsequently malunited. The patient presented late and the diagnosis was not made for several months. The pathomechanics, diagnosis, and management options for this patient are discussed.
authors.affiliation: Foot and Ankle Service, Department of Orthopaedic Surgery, Singapore General Hospital, Singapore. innkuang@hotmail.com
authors.forename: I K
authors.initials: IK
authors.lastname: Tey
authors.forename: K  W
authors.initials: K
authors.lastname: Chong
authors.forename: I
authors.initials: I
authors.lastname: Singh
mesh_terms: D000058:Accidental Falls; D001696:Biomechanical Phenomena; D001858:Bone Nails; D018450:Disease Progression; D005260:Female; D017759:Fractures, Malunited / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D015775:Fractures, Stress / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D016916:Joint Deformities, Acquired / Q000209:etiology; D007719:Knee Joint; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications*; D013978:Tibial Fractures / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery