Recurrent Fracture After Anterior Tension Band Plating With Bilateral Tibial Stress Fracture in a Basketball Player: A Case Report

The tibial shaft is the most common location of stress fractures in athletes. Tibial stress fractures are divided into 2 groups, anterior and posterior, based on location. Posterior tibial cortex fractures are more common and respond well to conservative treatment. Fractures in the anterior cortex are less common, accounting for only 4.6% of stress fractures,14 and they often heal poorly because of relatively poor vascularity and constant tension exerted by posterior muscle forces. In the absence of operative treatment, a persistently painful stress fracture may result in delayed union, nonunion, or even complete fracture. Different surgical treatment procedures have been described, but there is no consensus on the best approach for anterior tibial stress fractures. Intramedullary nailing is an established technique for treating delayed or nonunion tibial stress fractures.10 Recently, several authors have reported that anterior tension band plating offers a number of advantages over intramedullary nailing for anterior tibial stress fractures in athletes.3,7,13,20 We report on the surgical treatment, via exchange intramedullary nailing, of a new stress fracture that developed after anterior tension band plating treatment of an existing stress fracture.