“…Tibia vara can lead to increased force transmission across the ankle joint by escalating the varus moment between the talus and the medial malleolus (Kor et al 2003 ). Other series report no relationship between malalignment and the incidence of medial malleolar stress fractures (Okada et al 1995 ;Orava et al 1995 ).…”
Section: Aetiology and Injury Mechanismmentioning
confidence: 91%
“…Muscular forces are believed to be no relevant on the medial side of the ankle. The fracture line is vertical or oblique, arising from the junction of the medial malleolus and the tibial plafond (Orava et al 1995 ;Shelbourne et al 1988 ). Shelbourne et al believed that closed chain loading of the foot results in a series of obligatory events that can result in injury to the medial malleolus (Shelbourne et al 1988 ).…”
“…Tibia vara can lead to increased force transmission across the ankle joint by escalating the varus moment between the talus and the medial malleolus (Kor et al 2003 ). Other series report no relationship between malalignment and the incidence of medial malleolar stress fractures (Okada et al 1995 ;Orava et al 1995 ).…”
Section: Aetiology and Injury Mechanismmentioning
confidence: 91%
“…Muscular forces are believed to be no relevant on the medial side of the ankle. The fracture line is vertical or oblique, arising from the junction of the medial malleolus and the tibial plafond (Orava et al 1995 ;Shelbourne et al 1988 ). Shelbourne et al believed that closed chain loading of the foot results in a series of obligatory events that can result in injury to the medial malleolus (Shelbourne et al 1988 ).…”
“…26,27 However, most case reports suggest that most of their patients did not have any mechanical alignment abnormalities. 28,29 Jowett et al 30 did notice that in their series of 5 elite athletes with medial malleolar stress fractures, all had anteromedial ankle impingement. These osteophytes were thought to be caused by repetitive trauma during supination and dorsiflexion of the talus.…”
“…Some nonunions of medial malleolar stress fractures also underwent percutaneous drilling across the fracture site with good success. 28 Shabat et al 24 aggregated the data from 4 case studies and 23 patients 25,28,29,37 in 2002. Although they did not provide any statistical analysis, they did show some differences in those treated with surgery and those treated conservatively.…”
“…In general these involve open-reduction internal fixation procedures (Orava et al 1995;Schils et al 1992;Shelbourne et al 1988) with motion beginning shortly after fixation and progressing to running activities within 6 weeks and full sports participation within 8 weeks. Shorter recovery time was seen in a study reporting a percutaneous cannulated screw recent work has focused on alterations in running technique to reduce the magnitude of impact loads.…”
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