Tibia Fractures

The tibia (or shin bone) is the major lower leg bone and thus open to several serious injuries. Fractures to the tibia can arise from multiple kinds of injury and in many different positions on the bone, with each requiring attention and treatment dependent on a number of factors.

Types of Tibia Fracture

Broadly speaking there are 3 distinct kinds of tibia fracture. The most widespread form of tibia fracture is a tibial shaft fracture, occurring at a point between the ankle joint and the knee. A tibial plafond fracture is found near the bottom of the tibia where the bone meets the ankle, and is of greater concern due to the likelihood of soft tissue damage and the propensity for injuring the ankle cartilage. The third type of fracture – tibial plateau fracture – is generally the most injurious to the knee, occurring immediately below the knee joint and possibly affecting both the bone and cartilage surface. In some cases these fractures can lead to knee arthritis.

Fracture Severity

Fractures are often only noticeable due to pain and an inability for the affected bone to function properly. However, if the fractured tibia is visible through or protrudes from the skin, this is an open (or compound) fracture. This type of fracture is severe, partly due to the risk of infection, and is nearly always treated with a surgical procedure. Other fractures can also be severe.

Causes

Tibia fractures can be provoked by any number of sports injuries. Pre-existing leg conditions may raise the risk of injuring that leg again. The most prominent accidents to look out for are those involving falls, such as in cycling or a fast paced contact sport, and severe strikes to the leg from a fellow athlete or projectile (e.g. in rugby or ice hockey). Inadequate muscle conditioning (and other overuse factors) may also increase the likelihood of injury or worsen the impact.

Varieties of Treatment

See a doctor when you experience ongoing or recurring pain in the lower leg, especially if it is worsened during activity. After examining you and taking appropriate tests they will treat the fracture based on type, location, bone alignment, the amount of soft tissue damage, any simultaneous injuries, and other concerns they might have.

Relatively minor tibial shaft fractures are usually treated with a long leg cast to ensure successful healing. This will immobilise the area from above the knee to below the ankle, and the treatment is a useful safeguard against infection. Fitting a metal rod along the middle of the tibia is an effective surgical treatment for more serious shaft fractures.

Tibial plafond and plateau fractures may be treated conservatively or with surgery depending on severity. A screw or plate might be utilised for fractures very close to joints. Open and other major fractures often need an ‘external fixator’ due to tissue damage ruling out the placement of plates and rods. This immobilises the leg from the outside in cases requiring more precise fixation than a cast. It facilitates close examination during treatment. Most tibial plateau fractures result in a period of non-walking for at least 3 months.

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