The tibia, also known as the shin bone, is a significant bone in the leg that links the knee to the ankle. A tibial fracture occurs when there is a break in the tibia, disrupting its continuous structure.
A crack in the upper part of the tibia, which is the shin bone, is called a proximal tibial fracture. This kind of break can happen near the knee or higher up, away from the joint. If the break affects the knee joint, it may cause problems like an uneven joint surface, a leg that is not aligned properly, and joint instability. These issues can lead to longer-term problems, such as arthritis and difficulty moving. Proximal tibial fractures can result from a sudden injury, repeated stress on the bone, or from a bone that has become weak due to conditions like cancer or infection. These fractures can also damage nearby soft tissues, including the skin, muscles, nerves, blood vessels, and ligaments.
The symptoms of a tibia fracture include pain when putting weight on the leg, tightness around the knee, limited movement, and noticeable changes in the shape of the knee area. In some cases, the fracture can affect blood flow to the foot, causing it to appear pale or feel cold. Patients might also feel numbness or tingling in the foot due to damage to nearby nerves.
The diagnosis of tibial fracture is based on the medical history including history of any previous injuries, complete physical examination and imaging studies. The physician will evaluate a soft tissue around the joint to identify any signs of nerve or blood vessel injury. Multiple X-rays and other imaging studies such as CT and MRI scans may be used to identify the location and severity of the fracture.
The way fractures are handled depends on how serious the break is, the patient's overall health, and their daily habits.
Non-surgical treatment involves keeping the broken area still using casts or braces to stop the patient from putting weight on it and to support the healing. X-rays are taken often to check how well the injury is healing. The patient can start to put weight on the area and move it slowly, based on the type of injury and how the patient is doing.
Surgical treatment is used to keep the broken bone properly aligned. Either external or internal devices can be used to position the broken bone pieces correctly. When the break does not involve the knee joint, metal rods and plates can be used to hold the broken parts in place. However, if the break affects the knee joint, a bone graft might be necessary to stop the joint from collapsing. An external fixator is typically used when the soft tissues around the injury are badly damaged, as using plates and screws could cause more harm.
Because the injury typically affects weight-bearing joints, it can lead to long-term issues like reduced knee movement, instability, and arthritis. Therefore, a rehabilitation program is started alongside the treatment, which includes guidance on weight-bearing activities, knee movement exercises, and the use of supportive devices like braces.
