Fatigue Fractures of Both Tibia and Fibula.

Case i.-E. G., a housewife and part-time domestic, aged 59, suddenly felt pain around the ankle while walking. Later the ankle became swollen but she remained active for six weeks until she attended her doctor, who referred her to Upton Hospital, Slough. On examination, the lower leg and ankle were swollen, with maximal tenderness over the lower tibia and fibula. Ankle movements were restricted slightly and she walked with a limp. Radiographs were taken (see Fig. i). A walking plaster was applied for a month and followed by a crepe bandage. Two months after her first attendance she had no pain or limp and only a little swelling at night. Four years later she had no symptoms and radiographs revealed no trace of fracture. Case 2.-A. L., a housewife, aged 68, noticed the onset of pain over the outer side of the right ankle, also while walking. She regarded this as rheumatism but three weeks later attended her doctor, who referred her to hospital. Radiographs revealed transverse fractures about two inches above the malleoli (see Fig. 2). A walking plaster was applied for six weeks. When the plaster was removed there was no pain, but a little swelling persisted in the ankle region together with a slight limp, and some increased valgus of the right foot was observed.