About Tibia Fractures
The obvious and most common symptom of a tibia shaft fracture is the inability to put weight on the affected leg. Often this is accompanied by a deformity of the leg at the site of the fracture. The tibia is often referred to as the “shinbone” and because it is right under the skin fractures can often be “open” or “compound”, meaning the bone can protrude through a wound in the skin.
Cause and Anatomy of a Tibia Fracture
Tibia shaft fractures are most commonly caused by some type of high-energy mechanism such as a motor vehicle collision or motorcycle crash. Often the tibia bone will be fractured into multiple pieces during these kinds of injuries. They can also occur during sporting activities such as skiing, playing soccer, football, or basketball. Some lower energy injuries can also cause tibial shaft fractures. This is most common in individuals with weaker bone quality and can be caused by a twisting injury to the leg.
The lower leg is made up of two bones: the tibia bone on the inside and the fibula bone on the outside. The tibia is much larger than the fibula and bears the majority of the weight through the knee and ankle joints.
Diagnosis of a Tibia Fracture
Tibia fractures can be diagnosed simply by looking at the lower leg for a significant deformity such as an unusual angle, twisting, or shortening of the leg. Sometimes this deformity can be associated with an open wound. X-rays are the most common form of imaging to confirm the diagnosis, specify the location of the fracture, identify the direction of the fracture, and determine the number of fractured pieces.
What Are My Options?
Non-surgical treatment may be recommended for fractures where there is little to no movement of the fracture ends and therefore no significant shortening or angle development (angulation) of the lower leg. Initial non-surgical treatment is likely to be a long leg splint to allow some degree of swelling. This is often exchanged in the first week or two for a long leg cast which is then transitioned to a short leg cast or brace once weight bearing is allowed.
It is much more common that a tibial shaft fracture results in a significant movement of the fracture end, therefore shortening the angulation of the leg. A significant percentage of tibial shaft fractures also involve an open wound, therefore are “open” or “compound” fractures. For these reasons, a majority of tibial shaft fractures require surgical treatment for the best possible outcome to allow appropriate alignment, fixation, and when necessary, also allow cleaning of the wound.
The most common surgical treatment for tibial shaft fractures is the placement of a metal rod on the inside hollow part of the bone to align the top and bottom pieces and allow the rod to be fixed to the top and bottom pieces of the fracture. This treatment is referred to as “intramedullary nailing”.
Frequently Asked Questions
Will the hardware used during surgical treatment of a tibia fracture stay in forever?
Some fracture locations and types of hardware used are in areas where it may be beneficial to remove the hardware after bone healing and can also cause some irritation, so may be removed due to patient symptoms after bone healing. Many forms of hardware can stay in permanently without any side effects, pain, or detriment to the patient.
How long will it take for my tibia fracture to heal?
Healing time depends on many variables including general overall health, whether a patient smokes or uses nicotine, and the severity of the fracture itself. Most tibial shaft fractures are fully healed in a 4 to 6-month time frame. Regardless of treatment, most patients are putting full weight on the fracture 2-3 months after injury.