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Case report
Acute presentation of a proximal fibular stress fracture after a total knee arthroplasty
  1. Shibby Robati1,
  2. Muattaz Kazzam2,
  3. Daniel McIntyre1 and
  4. David G Wood1
  1. 1Orthopaedics, North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, New South Wales, Australia
  2. 2Trauma & Orthopaedics, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
  1. Correspondence to Shibby Robati; s.robati{at}


A 67-year-old woman underwent a routine and uneventful elective total knee arthroplasty for osteoarthritis at our centre. No intraoperative nor immediate postoperative complications were noted clinically nor radiologically. At 5 weeks postoperative, she began to notice some new discomfort in her upper calf area, with no preceding history of trauma. A Doppler ultrasound scan ruled out a deep vein thrombus. Only on further re-imaging of her knee with X-rays and CT was there shown to be a fibular fracture of the proximal third with evidence of callus formation. The pain arising from her stress fracture delayed her rehabilitation slightly, going on to require a successful manipulation under anaesthetic (0°–95°). She went on to have excellent function in her knee and the pain from the stress fracture had settled by 5 months.

  • orthopaedics
  • orthopaedic and trauma surgery

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  • Contributors DGW came up with the idea and inception of the case report and its importance to the clinical community. SR and DGW discussed planning, conduct, conception and design. SR wrote up the case report. MK and DM revised the manuscript with significant additions and DGW reviewed the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.