Sy M H, Diouf S, Ndoye A, Coumé M
Centre de Traumatologie et d'Orthopédie (C.T.O.) de Dakar, Dakar, Sénégal.
Rev Chir Orthop Reparatrice Appar Mot. 1995;81(5):445-8.
Transverse stress fractures of the proximal tibia are associated with osteoarthritis of the knee. This uncommon complication is presented in this case report as a non-union form along with a literature review.
A fifty nine year old black African woman who had a thirteen-year history of osteoarthritis in both knees, was seen for increasing pain in the proximal part of the left leg without demonstrative traumatism. This homemaker measured 155 cm for 85 kgs. Clinical and radiological examination revealed a non-united stress fracture of the proximal part of the tibia and bilateral osteoarthritis of the knee with varus deformity (40 degrees on the left). A compression plate with bone grafting was used for treatment of the tibial non-union.
Eleven other cases have been published on the rheumatological and orthopaedical literature. All the twelve patients were female, elderly, overweight, had marked varus deformities and a long history of osteoarthritis of the knee. A non-united stress fracture was a complication of osteoarthritis in four cases and treated with a compression plate.
Stress fractures of the proximal tibia are an unusual mechanical and an uncommon complication of osteoarthritis of the knee. Biomechanic is perhaps one of the possible explication of these tibial stress fractures.
胫骨近端横行应力性骨折与膝关节骨关节炎相关。本病例报告以骨不连形式呈现这一罕见并发症，并进行文献综述。
一名59岁的非洲黑人女性，双膝患骨关节炎13年，因左腿近端疼痛加剧前来就诊，无明显外伤史。这位家庭主妇身高155厘米，体重85公斤。临床和影像学检查显示胫骨近端应力性骨折不愈合以及双膝骨关节炎伴内翻畸形（左侧40度）。采用加压钢板植骨治疗胫骨骨不连。
风湿病学和骨科学文献中还发表了其他11例病例。所有12例患者均为女性，年龄较大，超重，有明显的内翻畸形和长期的膝关节骨关节炎病史。4例骨关节炎患者出现应力性骨折不愈合，并采用加压钢板治疗。
胫骨近端应力性骨折是一种不常见的机械性损伤，也是膝关节骨关节炎的罕见并发症。生物力学可能是这些胫骨应力性骨折的可能原因之一。
