Fatigue fracture of the proximal fibula with secondary common peroneal nerve injury

Stress fractures of the proximal fibula are uncommon and usually result from axial loading, which is mostly described in runners. We report an unusual mechanism of such a fracture in a circus performer resulting from repetitive direct horizontal loading from a trapeze bar. In addition, the bony injury resulted in a secondary injury to the common peroneal nerve with corresponding weakness. Both injuries responded well to nonoperative treatment and the athlete had an excellent recovery with no residual symptoms. He was able to resume his training with the use of protective padding applied to the proximal legs. Fracture of the proximal fibula caused by direct repetitive stress to the bone with a secondary compression injury to the common peroneal nerve is a previously undescribed injury. We report a patient who presented with this injury, the possible mechanisms of such injury, its management, and outcome.