We studied eight patients who had a stress fracture of the medial
malleolus. The main symptom was localized pain on the medial side of the
ankle. The initial radiographs revealed the lesion for only three patients;
for the other patients, the diagnosis was made with the use of isotope
scans and was confirmed with computerized tomography scans, magnetic
resonance images, or subsequent plain radiographs. One vertical fracture
was treated initially with compression with AO screws. On the basis of our
experience with stress fractures in other bones, drilling was performed to
enhance the formation of bone in two patients who had delayed healing and
who had had symptoms for eight and twelve months. The fractures healed four
and five months after the drilling. The five patients who were managed
non-operatively had to avoid running and jumping for at least three months
(average, four months) so that healing could take place. All five of these
fractures healed within five months.