Fibular stress fractures in runners

The incidence of stress fractures of the fibula and tibia is increasing with the growing emphasis on and participation in jogging and aerobic exercise. The diagnosis requires a high level of suspicion on the part of the clinician. A thorough history and physical examination with appropriate x-ray examination and often technetium 99 methylene diphosphonate scan are required for the diagnosis. With the advent of the scan, earlier diagnosis is possible and earlier return to activity is realized. The treatment is complete rest from the precipitating activity and a gradual return only after there is no longer any pain on deep palpation at the fracture site. X-ray findings may persist 4 to 6 months after the initial injury.