Introduction: Osteonecrosis (ON) is a serious pathological condition that can affect weight-bearing areas of the lower limbs, including the distal tibia. Although trauma is a common cause of ON, the condition has multiple possible etiologies. ON has been associated with a range of factors, including trauma, medication use, alcoholism, and vascular disease. Interruption of blood flow to a particular bone region is the first step in the pathophysiology of ON. Conservative management is typically indicated in the early stages of ON, but joint-preserving procedures may be necessary in cases where conservative treatment fails.
Case report: This article presents a case of bilateral ON of the distal tibia in a 38-year-old female patient without a history of trauma or identifiable risk factors. The patient was initially managed conservatively but ultimately underwent joint-preserving surgery due to treatment failure.
Conclusion: Joint-preserving procedures should be considered in cases of early-stage distal tibia ON that do not respond to conservative management to prevent joint collapse. This case highlights the importance of considering ON as a possible diagnosis even in the absence of identifiable risk factors or trauma.
Keywords: Distal tibia; atraumatic; avascular necrosis; bilateral; osteonecrosis.
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