Tibial Fracture: Causes, Symptoms, Diagnosis and Treatment
Tibia, one of the longest bones of the body is also the one that is most commonly fractured. It can be fractured as a result of a trauma and can result in bruising accompanied with intense pain in the lower leg. A fracture to the tibia can take a variety of forms and can involve long periods of inactivity and immobility. It might also include a long recovery time, depending on the extent of damage caused to the bone. The doctor will advise a surgical or a non-surgical treatment based on the severity of the fracture.
Tibia – An Overview
Tibia, also commonly known as the shinbone, runs between the length of your shin between the ankle and the knee. It can be felt when you run your hand on the front of your leg. It is one of the most commonly injured bones in the body because of its excessive use in all the activities a person does. Fractures of the tibia can be really painful and can lead to months of recovery where you are not allowed to put any weight on your injured leg. In severe cases, you may also have to undergo a surgery to treat the fracture in case it is beyond repair through the non-surgical treatment methods.
The symptoms of a tibia fracture depend on how severe the fracture is. Here are some common signs and symptoms that indicate an injury to the tibia and a possible fracture:
- Difficulty in running, walking or kicking
- Intense and sharp pain in the lower leg
- Tingling or numbness in the foot
- Not being able to bear any weight on the injured leg
- Deformity in your ankle, knee, shin or lower leg area
- A limited bending or motion in the injured leg
- Bone protruding through the skin
- Blueness or bruising on the injured leg
- Swelling and tenderness around the injured area of the tibia
In cases of a tibia fracture, the fibula which is the second bone in the lower leg, is also affected.
Causes of a Fracture of the Tibia
The most common causes of a fracture of the tibia are:
- High-Energy Collisions: These collisions typically involve automobile or motorcycle crashes. This leads to severe fractures which can take a long time to recover
- Falls: Another leading cause of tibia fracture is falls, particularly from large heights and involving hard surfaces.
- Twisting Motions: Pivoting and other twisting motions also are a leading cause of fractures of the tibia. It is common in sports such as skiing and snowboarding and also in contact sports.
Having osteoarthritis or type 2 diabetes can also increase the risk of a fracture of the tibia.
If you have sustained an injury to your lower leg and are experiencing the symptoms mentioned above, you should consult a doctor at your earliest. You will be referred to an orthopedist who is a specialist in treating injuries and abnormalities of the bones. You will be asked about the symptoms and how the injury occurred. Your medical history will also be reviewed by the doctor. The doctor will perform a physical examination of the leg prior to other tests. The physical examination will be conducted to look for the following:
- Instability when walking
- Bruises with swelling and blueness
- Injury to the fibula
- Obvious deformities such as shortening of the leg or an abnormal bend
After the physical examination, your doctor will conduct a series of tests to get a visual image of the fracture and to check the muscle and bone strength of the injured leg. Here are the tests that may be conducted:
- Bone scan
- CT scan
- MRI scan
You may need an emergency surgery depending on the severity of the fracture. In not so severe cases, non-surgical treatment options work well.
Types of Fractures to the Tibia
Common types of the fractures of the tibia include:
- Transverse Fracture: In case of a transverse fracture, the fracture line is horizontal. The tibia may be stable in case of this fracture but can result in instability in case there is a damage to the fibula as well.
- Oblique Fracture: In the oblique fracture, the fracture line is at an angle or diagonal. These fractures are initially stable but tend to shift with time resulting in bone displacement.
- Spiral Fracture: This fracture, as the name suggests, resembles a spiral staircase. These fractures are caused by the twisting of the leg.
Comminuted Fracture: This involves shattering of the bone into multiple places. It is a very unstable form or fracture.
Open Fracture: This is the most severe form of fracture of the tibia where the bone punctures the skin. It is also known as compound fracture. There is also damage to the soft tissues, muscles, skin and ligaments in case of an open fracture.
Treatment of Tibia Fracture
Depending on the severity of the fracture, the doctor will guide you about whether you need a surgical treatment or a non-surgical one.
Non-Surgical Treatment Options
If the overall health of the patient does not allow them to undergo surgery, such as a weak heart, and if the fracture is not a serious one, the doctor will recommend a non-surgical treatment. It is also recommended in case there is a little displacement involved or there are only two major bone fragments. Non-surgical treatment options include:
- Splint: A splint is used immediately after the injury to keep the leg immobile. It provides support and stability to the injured leg. It can also be adjusted to allow room for swelling. It is done before casting to wait for the swelling to subside before the leg can be secured in the cast making it immobile.
- Cast, Brace or Boot: The most popular and highly effective method of treating a fracture of the tibia is immobilizing the limb with a brace, boot or cast. The initial treatment is a cast which keeps the bone in place and allows it to heal properly over a period of around 6 weeks. Later, a boot or brace made with plastic is used to provide support and protection to the leg until it completely recovers.
Surgical Treatment Options
If the non-surgical methods are not effective in healing the broken tibia, the doctor will conduct a surgical treatment to treat tibial fractures.
- Intramedullary Nailing: This is the most popular method of treating tibial fractures. It involves inserting a metal rod to the canal of the tibia from the knee down. It helps in keeping the bone in position as it is screwed to both ends.
- Plates and Screws: To align the bone fragments and to keep them in place, the doctors make use of screws and plates. Plates and screws help in keeping the leg aligned and allow for proper recovery of the bone.
- External Fixation: Screws and metal pins are placed into the bone from above and below the location of the fracture. With the help of a bar located outside the skin, screws and plates are inserted in. The frame helps in keeping the leg aligned at its place and help the bone heal.
It is important to seek medical helps as soon as the injury occurs. If left untreated, complications may arise in the bone leading to problems in healing.
Recovery from a fracture of the tibia depends on the severity of the fracture and the overall health of the individual. While minor and stress fractures require a few weeks to heal, most fractures take 4 months to completely heal. In more severe cases, it can also take up to 6 months to heal the bone. It is important to strictly follow the instructions of the doctor to let the bone heal properly.
The non-weight bearing part is one of the most important parts of the recovery phase from a tibial fracture. The period of immobilization may range from a few weeks to several months. During the non-weight bearing period, you will need help from mobility devices to carry on with some of the routine activities.
Traditional crutches are commonly used and inexpensive, however, they can cause pain in your wrists, arms, chest and underarms. Also, it is not very convenient and you will not be able to use your hands and arms while walking which makes doing simple everyday tasks difficult to perform. It also increases the risk of bearing weight on the broken leg, which can lead to a stress injury again and can also increase the time for recovery. The best crutch alternative is using a knee scooter or knee walker from KneeRover.
Knee scooters and knee walkers from KneeRover are becoming increasingly popular for all the right reasons. You can kneel yourself on a padded platform and can move yourself easily with the wheels on the bottom just as you do with a scooter. They are the most efficient solution for distances and for doing everyday tasks. When you are resting the leg on the knee scooter, there is minimal chance of bearing any weight on it and hence the recovery process goes smooth and as planned.
This is for informational purposes only, please remember to consult your doctor.
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