Acta Scientific Orthopaedics (ISSN: 2581-8635)

Case Report Volume 5 Issue 10

Metaphysiodiaphyseal Insufficiency Fracture of Tibia Failure of Biology and Mechanical Stability: A Case Report

Prahalad Kumar Singhi*, Sivakumar Raju, Atmaram Gadgil and Somashekar V

Senior Consultant, Department of Orthopaedics, Preethi Hospitals Pvt. Ltd, Madurai, Tamilnadu, India

*Corresponding Author: Prahalad Kumar Singhi, Department of Orthopeadic, Preethi Hospitals Pvt Ltd, Madurai, Tamil Nādu, India.

Received: June 27, 2022; Published: September 28, 2022


Insufficiency fractures are seen when physiological stress given to pathological bone and needs to be differentiated from fatigue fracture. Management of  these stress fractures depends on etiology, location and radiographic findings. Surgeon should address both biology and stability for satisfactory outcome.

A 54-year-old postmenopausal woman, presented with knee pain diagnosed with tibial meta-diaphyseal insufficiency fracture, treated conservatively with cast, but lost to follow up, subsequently she developed malalignment for which she underwent open reduction deformity correction and fixation elsewhere with an anterolateral plate. Later she presented to us  with deformity, broken plate and non-union. Dual plating with bone grafting was done to achieve desired outcome.

Conclusion: An osteoporotic Insufficiency fracture if not appropriately evaluated and treated may end up in problems. So addressing both biology and stability is key.

Keywords: Metaphysiodiaphyseal Insufficiency Fracture; Failure of Biology; Mechanical Stability


  1. Breithaupt MD. “To the pathology of the human foot”. Med Zeitung 24 (1855): 169.
  2. Carmont RC., et al. “Stress fracture management: current classification and new healing modalities”. Operative Techniques in Sports Medicine 17 (2009): 81-89.
  3. Patel DS., et al. “Stress fractures: diagnosis, treatment, and prevention”. American Family Physician 1 (2011): 39-46.
  4. Evans RK., et al. “Effects of a 4-month recruit training program on markers of bone metabolism”. Medicine and Science in Sports and Exercise 11 (2008): S660-670.
  5. Stevens H., et al. “Methotrexate osteopathy demonstrated by technetium-99m HDP bone scintigraphy”. Clinical Nuclear Medicine 26 (2001): 389-391.
  6. Soubrier M., et al. “Insufficiency fracture. A survey of 60 cases and review of literature”. Joint Bone Spine 70 (2003): 209-218.
  7. Boden B., et al. “Low-risk stress fractures”. The American Journal of Sports Medicine 1 (2001): 100-111.
  8. Boden B. “High-risk stress fractures: Evaluation and treatment”. Journal of the American Academy of Orthopaedic Surgeons 8 (2000): 344-353.
  9. Kaeding C and Miller T. “The comprehensive description of stress fractures: A new classification system”. The Journal of Bone and Joint Surgery American 95 (2013): 1214-1220.
  10. Soubrier M., et al. “Insufficiency fracture. A survey of 60 cases and review of the literature”. Joint Bone Spine 3 (2003): 209-218.
  11. Kaeding CC., et al. “Management of troublesome stress fractures”. Instructional Course Lectures 53 (2004): 455-469.
  12. Anderson M and Greenspan A. “Stress fractures”. Radiology 199 (1996): 1-12.
  13. Coughlin MJ., et al. “Comparison of radiographs and CT scans in the prospective evaluation of the fusion of hindfoot arthrodesis”. Foot and Ankle International 10 (2006): 780-787.
  14. Ishibashi Y., et al. “Comparison of scintigraphy and MRI for stress injuries of bone”. Clinical Journal of Sport Medicine 2 (2002): 79-84.
  15. Shin AY., et al. “The superiority of magnetic resonance imaging in differentiating the cause of hip pain in endurance athletes”. American Journal of Sports Medicine 24 (1996): 168-176.


Citation: Prahalad Kumar Singhi., et al. “Metaphysiodiaphyseal Insufficiency Fracture of Tibia Failure of Biology and Mechanical Stability: A Case Report".Acta Scientific Orthopaedics 5.10 (2022): 144-148.


Copyright: © 2022 Prahalad Kumar Singhi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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