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Stress fracture of the distal fibula in flatfoot patients: case report.

The increase in proportional loading of the fibula with progression of hindfoot deformity would lead to high fibular loads during rapid walking, resulting in insufficiency fractures. We report an unusual mechanism of such fracture in a textile worker resulting from valgus alignment from a stage III flatfoot deformity. The stress fracture was missed initially and only confirmed by CT examination. The patient responded well to nonoperative treatment and had an excellent recovery with no residual symptoms finally. Fracture of the distal fibula caused by rigid hindfoot valgus in stage III flatfoot deformity is a previously undescribed injury. We report a patient who presented with this injury, the possible mechanisms of such injury, its management and outcome.