Tibial stress fracture9/10/2023 ![]() 5 Various surgical techniques have been described for this, including IM Nailing, plate fixation and excision and drilling, and such interventions often provide definitive correction of the condition. 5 However, for anterior TDSFs, symptoms commonly fail to resolve with conservative measures alone, and operative intervention is often required. 5 This is often the definitive management for posterior TDSFs. 5 This can be supplemented by adjunctive therapies such as ultrasound or pneumatic braces and should be accompanied by a thorough review of diet, health, training methods and footwear. Management of TDSFs is well defined, with modified rest the recognised first-line management option for both types. There are two distinct types of tibial diaphyseal stress fractures (TDSFs): those of the anterior cortex and those of the posterior cortex 5 (Fig. 5 Therefore, medical practitioners need to be able to inform patients on the likelihood and time frame of return to high-demand sports activity after such injuries. 5 As participation in athletic activity continues to grow, the public health impact of these injuries has been predicted to increase. 4 Out of all sporting injuries, stress fractures have one of the longest recovery times with regards to return to sport, with the potential for significant morbidity, failure to return to sport and a high chance of re-injury. 3 The most common site for stress fractures is the tibial diaphysis accounting for up to 75% of all stress fractures. 1 Reported incidences of stress fractures are as high as 1% of the general population 2 and 20% of elite athletes. Stress fractures account for over 10% of all sports injuries seen by medical practitioners and can comprise as much as 30% of all injuries seen in running sports. Tibial diaphyseal stress fractures, return to sport, systematic review Introduction
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