Delayed union stress fractures of the anterior tibia: conservative management

Introduction-A conservative method of treating four delayed union stress fractures of the anterior mid-tibia is described, with an illustrative case history. Methods-Once diagnosed each of the patients was treated in a pneumatic lower leg brace with modified rest. The mean (range) age of the patients was 28 (24-32) years and all were involved in professional or amateur sports. The mean (range) duration of symptoms before diagnosis and definitive treatment of the four fractures was 9 (3-14) months. Results-Use of this technique avoided the need for surgery in this group of patients and allowed return to unrestricted activity an average of 12 months from presentation. Conclusion-The treatment is cost effective and avoids the often uncertain results and morbidity associated with surgery for these difficult stress fractures.