Anterior mid-tibial stress fractures. Results of surgical treatment.
OBJECTIVE
An anterior mid-tibial stress fracture is an uncommon, but possibly career threatening condition for an athlete. We wanted to evaluate the results of the surgical treatment of this notorious stress fracture and compare two different surgical methods.


METHODS
Forty-nine anterior mid-tibial stress fractures were treated surgically in 45 patients during the years 1985-2005. All the patients were athletes, mainly runners. The mean age of the patients was 26 years. Thirty-four of the fractures occurred in men and 15 in women. The first method of treatment (anteromedial and lateral drilling) was used in 20 operations and the second method (laminofixation) in 29 operations.


RESULTS
Good results were achieved with drilling in only 50 % of the operations, where as with laminofixation good results were achieved in 93 % of operations. This difference was statistically significant (p = .002). Healing of the stress fracture after laminofixation occurred in less than 6 months. The length of the plate used in the laminofixation had no effect on the end result.


CONCLUSIONS
An anterior mid-tibial stress fracture may often lead to delayed union or non-union in vigorously training athletes. Surgical treatment with laminofixation proved to be superior to tibial fracture site drilling.
Liimatainen
E
E
Department of Orthopaedic Surgery, University Hospital, Turku, Finland.
Sarimo
J
J
Hulkko
A
A
Ranne
J
J
Heikkilä
J
J
Orava
S
S
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D015775:Fractures, Stress / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013978:Tibial Fractures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult