Non-union Tibia Stress Facture

James Guetzkow, MD Family Physician, Los Gatos, California

“The patient presented to my office on November 20, 2001 for a prolonged right shin stress fracture. He is a triathlete and originally noticed the onset of pain in the shin in August of 2001, which was diagnosed by his physician as a stress fracture. The patient was treated with a cast from the last week of September, for four weeks. After the cast was removed, a bone scan was done which showed an area of hot spots on the technetium scan, which coincided with his perception of the site of pain in the lower shin.”

“At this point, the pain in the upper shin, which had been present before the application of the cast, has disappeared. One month later, the patient was still experiencing pain in the lower shin with the perception of irregular swelling along the shin bone in that area. There was no externally visible skin sigh other than that. The patient had not been able to exercise on his doctor's orders through the end of the year.”

“The FASTT patch was applied to the lower shin over the area of symptomatic pain and discontinued the following day. The second patch was applied on the third day and left to stand for three more days until it was taken off on Thanksgiving, November 22, 2001. At this point, the patient had no more pain. This had been a pain that had been persistent for three months. The FASTT patch left an area of free rash but was surrounded by erythema, which developed over the 24 hours after the FASTT patch was discontinued on Thanksgiving.”

“On examination in my office today, there is no tenderness or swelling in the area of prior injury and the patient declares there is no pain. An erythematous rash consistent with an allergic topical dermatitis was present surrounding the area that had received the direct herbal medication. The area of direct application however did not have a rash; therefore, it is presumed that he had contact dermatitis through the material of canvas, which contained the herbal medicine and extended out beyond it. The patient's impression was very positive; he felt that it had definitely helped him, and he would be motivated to treat future injuries with the FASTT patch. This appeared to be a success.”