The tibia is the major bone of the lower leg, commonly referred to as the shin bone. The top of the tibia connects to the knee joint and the bottom of the tibia connects to the ankle joint. It is the most commonly fractured long bone in the human body. The tibia is one of the longest bones in the body. Other long bones include the femur, humerus and fibula. A tibial fracture is a condition characterized by a break in the tibia of the lower leg.
Causes of Tibial Fracture
Fractures happen when there’s more force applied to the bone than it can withstand. A tibial shaft fracture occurs along the length of the bone, below the knee and above the ankle. Typically, tibial fractures occur with high velocity injuries, such as motor vehicle accidents, and are fairly uncommon in sports. Contact and collision sports injuries, such as a fall while skiing, football, rugby or running into another player during soccer, are lower-energy injuries that can cause tibial shaft fractures. These fractures are typically caused by a twisting force, and result in an oblique or spiral type of fracture.
Symptoms of Tibial Fracture
The most common symptoms of a tibial fracture are:
- Pain and swelling in the lower leg area
- Uneven leg lengths
- Inability to walk or bear weight on the leg
- Deformity or instability of the leg
- Limited range of motion in the knee or ankle area
- Bone “tenting” the skin or protruding through a break in the skin
- Occasional loss of feeling in the foot
- Bruising or discoloration (may indicate damage to blood vessels)
- An abnormal alignment or positioning of the foot on the affected side
- Visible portions of the fractured bone, if the fracture causes a break in the skin
- Loss of sensation in foot of injured leg
Treatment of Tibial Fracture
Treatment of a tibial fracture can be either surgical or nonsurgical, and it depends on several factors including:
- The cause of the injury
- The location of the fracture
- The severity of the injury
- The extent of soft tissue damage
- The overall health of the patient
Nonsurgical Treatment
If the patient has an uncomplicated tibial fracture that has not occurred near the knee or ankle, nonsurgical treatment includes using immobilization of the leg in a cast. The advantage of casting is that these fractures tend to heal well, and casting avoids the potential risks of surgery such as infection. In addition, nonsurgical treatment may be recommended for patients who are poor surgical candidates due to their overall health problems or less active, so are better able to tolerate small degrees of angulation or differences in leg length. It is also recommended for patients who have closed fractures with only two major bone fragments and little displacement (gap).
Surgical Treatment
More severe fractures usually have to be repaired surgically with a metal rod, wires, or plates and screws. The orthopedic surgeon may recommend surgery for the tibial fracture if it is:
- An open fracture with wounds that need monitoring
- Extremely unstable because of many bone fragments and large degrees of displacement
- Not healed with nonsurgical methods