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What causes stress fracture?

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Posted on Mon, 11 May 2015
Question: How is a stress fracture possible after a robotic partial knee replacement and is this a complication of surgery. Where are the possible sites for a tibia stress fracture? Why do I need to wait 10 days to have an X-ray ? This surgery was done on 1/22/15 and I have been complaining about this pain since 4/1/15[at least in this area]. What would your recommendations be?
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Answered by Dr. Goswami Debopom (1 hour later)
Brief Answer:
Very rarely but yes , stress fracture can be due to the surgery.

Detailed Answer:
Welcome to Health Care Magic. Thank you for posting your query.
I can understand your concern.

The possible sites of stress fracture of tibia are-
- the proximal 1/3 rd of the tibia
- posteromedial
- anterior tension type.

Coming to your query about the 10 day wait.

You see, radiographs have a sensitivity of 15-35% for detecting stress fractures on initial examinations, increasing to 30-70% at follow up due to more overt bone reaction.

When stress fracture is suspected, plain radiography should be obtained initially and, if negative, may be repeated after two to three weeks for greater accuracy.

Hence the 10 day wait.

If an urgent diagnosis is needed, a bone scan or magnetic resonance imaging should be considered.

I would suggest you to
- start activity modification like using nonweight-bearing crutches if needed for pain relief.
- I would start tablet Aceclofenac along with tablet ranitidine to relieve pain
- pneumatic bracing can be used to facilitate healing.

Do not worry.
Keep in touch with your orthopaedician. He/she can examine you and guide on the further management.

Hope this helps.
Write back to us.
Regards.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Goswami Debopom

General & Family Physician

Practicing since :2013

Answered : 484 Questions

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What causes stress fracture?

Brief Answer: Very rarely but yes , stress fracture can be due to the surgery. Detailed Answer: Welcome to Health Care Magic. Thank you for posting your query. I can understand your concern. The possible sites of stress fracture of tibia are- - the proximal 1/3 rd of the tibia - posteromedial - anterior tension type. Coming to your query about the 10 day wait. You see, radiographs have a sensitivity of 15-35% for detecting stress fractures on initial examinations, increasing to 30-70% at follow up due to more overt bone reaction. When stress fracture is suspected, plain radiography should be obtained initially and, if negative, may be repeated after two to three weeks for greater accuracy. Hence the 10 day wait. If an urgent diagnosis is needed, a bone scan or magnetic resonance imaging should be considered. I would suggest you to - start activity modification like using nonweight-bearing crutches if needed for pain relief. - I would start tablet Aceclofenac along with tablet ranitidine to relieve pain - pneumatic bracing can be used to facilitate healing. Do not worry. Keep in touch with your orthopaedician. He/she can examine you and guide on the further management. Hope this helps. Write back to us. Regards.