Distal Third Minimally Displaced Stress Fracture of Fibula in a Military Recruit: A Case Report and Review of Literature.

Abstract

Background: Stress fractures frequently occur in athletes and military personnel due to their rigorous training and are typically treated conservatively with immobilization and rehabilitation. However, a displaced distal third stress fracture of the fibula that requires surgical intervention is a rare occurrence.

Case presentation: A 20-year-old male military recruit under training for 1 month presented with a week-long history of pain and swelling in his right ankle and difficulty in walking. A plain radiograph revealed a transverse fracture of the fibula with a minimal displacement, consistent with a Kaeding-Miller type III stress fracture. Although considered low-risk, the fracture was treated surgically with open reduction and internal fixation using a one-third tubular plate due to the rigorous demands of military training and the extended recovery time associated with conservative management. Postoperatively, nonweight bearing with structured rehabilitation was done, and the fracture healed early without complications.

Discussion: A minimally displaced stress fracture of the distal fibula managed operatively is a rare entity with very limited literature published which poses diagnostic and therapeutic challenges. This case demonstrates that minimally displaced fibular stress fractures can be diagnosed using plain radiographs and may necessitate operative reduction and fixation, especially in high-demand athletes and military personnel.