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.