An elite Kenyan runner presented with a tibial fracture sustained during an international cross-country race. There was no clear history of symptoms suggestive of preceding overload and no radiological features of stress fracture. He was found to have sustained an osteoporotic, insufficiency fracture. There are no previous case reports of an osteoporotic fracture in a male athlete. Possible aetiologies and directions for future investigation are presented.
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Competing interests: None.
Patient consent: Obtained.