Farzad Vosoughi, Mohammad Ayati Firoozabadi, Seyed Mohammad Javad Mortazavi
{"title":"Proximal tibial stress fracture in patients with advanced knee osteoarthritis: a narrative review.","authors":"Farzad Vosoughi, Mohammad Ayati Firoozabadi, Seyed Mohammad Javad Mortazavi","doi":"10.1530/EOR-2024-0213","DOIUrl":null,"url":null,"abstract":"<p><p>In patients with knee osteoarthritis, tibial stress fractures are mostly associated with osteoporosis and lower limb malalignment. Nonoperative management may lead to knee stiffness (due to prolonged immobilization), persistence of pain (due to the underlying knee osteoarthritis), and fracture nonunion. Acute unstable tibial stress fractures can be managed with long-stem total knee arthroplasty. Exposing the fracture site should be avoided as much as possible because it may be associated with skin necrosis and delayed union. In irreducible cases or fractures with persistent gaps, fibular osteotomy, by increasing the mobility and compression across the fracture site, may help with fracture reduction and decrease the rate of nonunion.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 10","pages":"763-770"},"PeriodicalIF":4.0000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494058/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Efort Open Reviews","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1530/EOR-2024-0213","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
In patients with knee osteoarthritis, tibial stress fractures are mostly associated with osteoporosis and lower limb malalignment. Nonoperative management may lead to knee stiffness (due to prolonged immobilization), persistence of pain (due to the underlying knee osteoarthritis), and fracture nonunion. Acute unstable tibial stress fractures can be managed with long-stem total knee arthroplasty. Exposing the fracture site should be avoided as much as possible because it may be associated with skin necrosis and delayed union. In irreducible cases or fractures with persistent gaps, fibular osteotomy, by increasing the mobility and compression across the fracture site, may help with fracture reduction and decrease the rate of nonunion.
期刊介绍：
EFORT Open Reviews publishes high-quality instructional review articles across the whole field of orthopaedics and traumatology. Commissioned, peer-reviewed articles from international experts summarize current knowledge and practice in orthopaedics, with the aim of providing systematic coverage of the field. All articles undergo rigorous scientific editing to ensure the highest standards of accuracy and clarity.
This continuously published online journal is fully open access and will provide integrated CME. It is an authoritative resource for educating trainees and supports practising orthopaedic surgeons in keeping informed about the latest clinical and scientific advances.
One print issue containing a selection of papers from the journal will be published each year to coincide with the EFORT Annual Congress.
EFORT Open Reviews is the official journal of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) and is published in partnership with The British Editorial Society of Bone & Joint Surgery.
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