Bilateral tibial stress fracture and stress reaction: A report of 14 cases

Several studies have reported that stress fractures (SFs) and stress reactions (SRs) rarely occur simultaneously in both tibiae. This study of 14 athletes (11 males and 3 females) diagnosed with bilateral tibial SFs or SRs demonstrated that SFs and SRs occurred most frequently in July and September (21 % each). The mean age was 17.0 ± 4.0 and 15.6 ± 2.1 years in the SF and SR groups, respectively. SFs and SRs showed a high incidence in the mid-tibia, with minimal side-to-side difference. Bilateral tibial SFs and SRs were more common in young male athletes, especially in summer. These injuries commonly occurred in the mid-tibia, with minimal side-to-side differences in fracture height. Anterior SFs were treated surgically, whereas posteromedial SFs and SRs were treated conservatively, allowing a return to competition.