A 22-year-old professional soccer player with atraumatic ankle pain

See bjsports-2013-092579 for the question The MRI revealed progressive oedema in the fracture (figure 4A,B). Consequently, it was decided to perform an acute percutaneous internal compression fixation of the fracture by means of an Acutrak screw (figure 5). Since there was a progression of oedema along the fracture line—without real fracture diastasis—the authors chose a single compression screw fixation as the definitive treatment. Postoperatively, the patient was placed in an NWB cast for 2 weeks and a partial weight bearing walker boot for four more weeks. Physiotherapy was started after cast removal and full weight bearing was allowed starting from 6 weeks postoperatively. From the start of week 8 postoperatively, he started training individually with a progressive rehabilitation protocol for four more weeks. Three months postsurgery, he returned to the pitch playing at his preinjury level; he was pain-free and showing a full range of ankle motion. Figure 4 Transtalar body fracture of the ankle with progressive oedema along the fracture line. Figure 5 Percutaneous internal compression screw fixation of the talar body ankle fracture. Reports on stress fractures of the talar body are rare. Rossi et al 1 found three stress fractures of the talar body in 24 562 clinical and radiographic skeletal records. More common, but still rare, are stress fractures of the talar neck or lateral talar process.2 ,3 Only one talar stress fracture without additional anomalies was reported in 1500 stress fractures.4 Stress fractures in athletes are the result of excessive, repetitive cyclic loads on bones that present with a normal form and structure. A stress fracture is considered to be the final stage of cellular events defined as prefailure stress bone response to strains.5 The aetiology is multifactorial, resulting from changes in the individual or athletic training material or programme. Malalignment, lack of flexibility, …