[Stress fractures of the tibia in elderly women]

Five women with stress fractures of the tibia with concomitant osteoarthritis of the knee were treated at the Department of Orthopaedics and Traumatology of the Lublin University of Medical Sciences between 1996 and 2001. The patients' age ranged from 57 to 78 years. Three fractures were located in the proximal part of the tibial shaft and 2 in the distal part of the tibial shaft. Two patients were unable to ambulate and 3 walked with crutches. In 2 cases the fracture healed after immobilisation in a walking cast for a period of 5 and 6 months respectively. Two cases with a concomitant varus or valgus deformity were treated surgically. In a 72-year-old woman the fracture healed 10 months after stabilisation with a locked intramedullary nail. In a 78-year-old woman the fracture healed 7 months after surgical correction of the tibial axis without internal fixation and a simultaneously performed Charnley knee arthrodesis. Immobilisation was achieved by a long plaster cast. A knee endoprosthesis was implanted in this patient a year after the first procedure because of advanced osteoarthrosis. A 72-years-old patient could not be treated because of poor general condition and advanced degenerative changes in both knee joints. All treated patients were pain free and ambulation parameters improved.