title: Bilateral medial malleolus stress fractures due to osteoarthritis of knee: A case report and review of literature.
abstract: BACKGROUND
  Medial malleolar stress fracture is a relatively uncommon injury but it can occur in athletes participating in running and jumping activities. Stress fractures of pelvis, proximal tibia and metatarsals are well documented in the elderly population but medial malleolus involvement in this subgroup has never been reported.
  
  
  METHODS
  We report a case of bilateral medial malleolus stress fractures secondary to bilateral knee osteoarthritis.
  
  
  CONCLUSIONS
  Osteoporosis and mechanical malalignment have been postulated as the possible risk factors for stress fractures in the elderly population. The pathomechanics and management of the case are discussed here.
  
  
  CONCLUSIONS
  A high index of suspicion is required to identify such fractures. Identification and treatment of the predisposing factors are a very important part of treatment.
authors.affiliation: Department of Trauma & Orthopaedics, Pinderfield General Hospital, Wakefield, West Yorkshire, UK. Electronic address: drashishsoni@gmail.com.
authors.forename: Ashish
authors.initials: A
authors.lastname: Soni
authors.affiliation: Department of Trauma & Orthopaedics, Pinderfield General Hospital, Wakefield, West Yorkshire, UK.
authors.forename: Samuel
authors.initials: S
authors.lastname: Vollans
authors.affiliation: Department of Trauma & Orthopaedics, Pinderfield General Hospital, Wakefield, West Yorkshire, UK.
authors.forename: Kurt
authors.initials: K
authors.lastname: Haendlmayer
authors.affiliation: Department of Trauma & Orthopaedics, Pinderfield General Hospital, Wakefield, West Yorkshire, UK.
authors.forename: Aaron
authors.initials: A
authors.lastname: Ng
keywords: Knee osteoarthritis; Malalignment; Medial malleolus; Stress fracture