Tibial Stress Fracture after a Graft Has Been Obtained from the Fibula. A Report of Five Cases

• Published in: Journal of bone and joint surgery. American volume 1996-08, Vol.78 (8), p.1248-51
• Main Authors: EMERY, SANFORD E, HELLER, JOHN G, PETERSILGE, CHERYL A, BOLESTA, MICHAEL J, WHITESIDES, THOMAS E
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Bone Transplantation - adverse effects; Diagnostic Imaging; Female; Fibula - transplantation; Fractures, Stress - diagnosis; Fractures, Stress - etiology; Fractures, Stress - therapy; Humans; Injuries of the limb. Injuries of the spine; Male; Medical sciences; Middle Aged; Tibial Fractures - diagnosis; Tibial Fractures - etiology; Tibial Fractures - therapy; Traumas. Diseases due to physical agents
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/00004623-199608000-00016

Stress fractures of the lower extremity may result from overuse of normal bone or from normal loading of structurally deficient bone. Stress fractures of the pelvis have been reported as a complication after a bone graft has been obtained from the iliac crest. Han et al. reviewed the cases of 160 patients who had had a vascularized bone transfer. Of the 132 patients who had had a fibular transfer, one had a tibial stress fracture but no follow-up information was provided. To our knowledge, no reports have addressed only fatigue failure of the tibia after the attainment of a graft from the fibula. We report the cases of five patients who had a tibial stress fracture after a graft had been obtained from the ipsilateral fibula for use in anterior reconstruction of the spine. Patients who have persistent or recurrent pain in the leg after a graft has been obtained from the fibula should be evaluated for a possible stress fracture of the tibia.