Case report 624. Stress fracture of distal portion of tibia associated with previously incurred gross fracture of more proximal segment of tibia.

A stress fracture occurring in the distal tibial metaphysis is presented. This fracture occurred in an area of disuse osteoporosis approximately 3 months following a gross traumatic fracture of the more proximal portion of the tibia. A stress fracture of the distal tibial metaphysis occurring secondary to a bimalleolar fracture of the same bone is also cited. The clinical settings in which tibial stress fractures have been reported are reviewed, as well as the difficulties inherent in the diagnosis and management of this entity.