The tibia, also known as the shin bone, is a major bone in the leg that runs from the knee down to the ankle. A tibial fracture refers to a break or crack in the tibia, which disrupts the bone's normal structure and continuity.
Types
Fractures of the proximal tibia refer to a break in the upper part of the shin bone, which is called the tibia. These types of fractures may or may not involve the knee joint. If the break reaches into the knee joint, it can cause unevenness in the joint surface, improper alignment of the leg, and joint instability. This can lead to long-term problems such as arthritis or limited movement. These fractures can happen from a sudden injury, repeated stress, or from weak bones due to conditions like cancer or infection. In addition to the bone, these fractures can also harm nearby tissues, such as skin, muscles, nerves, blood vessels, and ligaments.
Tibial shaft fractures are breaks that happen along the length of the tibia, which is the larger bone in the lower leg, located between the knee and ankle. These types of fractures can occur during activities like playing soccer or skiing.
The symptoms of a tibia fracture may involve pain when putting weight on the leg, tightness around the knee area, difficulty moving the leg, and noticeable changes in the shape of the knee. In certain cases, the fracture can affect blood flow to the foot, leading to a pale or cold foot. Additionally, some patients may feel numbness or tingling in the foot due to injury to nearby nerves.
The diagnosis of a tibial fracture is made by considering the patient's medical history, including any previous injuries, conducting a thorough physical examination, and using imaging tests. The doctor will check the soft tissues around the joint to look for any damage to nerves or blood vessels. Several X-rays and other imaging methods like CT and MRI scans might be used to determine where the fracture is located and how serious it is.
The management of the fracture is based on the severity of the fracture, medical condition of the patient and the patient’s lifestyle.
Non-surgical treatment involves keeping the broken area still using casts or braces to avoid putting weight on it and to support the healing process. X-rays are regularly taken to check how well the healing is progressing. The patient can start putting weight on the area and moving it slowly, based on the type of injury and how the patient is recovering.
Surgical treatment is used to ensure the fractured bone remains properly aligned. Either external or internal devices can be used to align the broken parts of the bone. If the break does not involve the knee joint, rods and plates can be used to hold the bone in place. However, if the fracture affects the knee joint, a bone graft might be necessary to stop the joint from collapsing. An external fixator is typically chosen when the soft tissues around the injury are badly damaged, as using plates and screws could cause further harm.
As the tibial fracture usually involves the weight bearing joint it may cause long term problems such as loss of knee motion or instability and long term arthritis. Hence a rehabilitation program is initiated along with the treatment comprising of instructions on weight bearing, knee movements, and the use of external devices such as braces.
