Our lower legs are made up of two bones, the tibia and the fibula. The tibia or shinbone is the larger of the two and supports the majority of our weight.
Whether it be from the edge of a chair or the infamous scooter, we are all too aware of the pain caused by a direct hit to the shinbone. Fortunately, these impacts rarely carry enough force to cause an even more painful injury: a fracture of the tibia.
“The tibia is the most commonly fractured long bone in the human body,” explains Kwadwo Owusu-Akyaw, MD, a sports medicine specialist. “Occurring along the length of the bone below the knee and above the ankle, the fracture of the tibia typically requires major force. In the event of a tibia fracture, the fibula is often broken as well.”
Types of tibia fractures
The type of tibia fracture you can endure greatly depends on the initial force that causes the break. They are classified depending on their location and the pattern of the break.
- Transverse fracture: the break of a transverse fracture is a horizontal line going straight across the tibial shaft.
- Oblique fracture: this type of break involves an angled line across the tibial shaft.
- Spiral fracture: the fracture line of the spiral break encircles the tibial shaft like the stripes of a barber pole.
- Comminuted fracture: this fracture type is extremely unstable and involves the bone splintering into three or more pieces.
All types of tibia fractures are defined as one of the following.
- Stable fracture: the broken ends of the tibia correctly line up and are aligned.
- Displaced fracture: unlike the stable fracture, the broken ends of the tibia are out of place and do not correctly line up.
- Closed fracture: the skin surrounding the fracture is intact.
- Open or compound fracture: the broken end of the tibia punctures through the skin, or there is a wound that shows the bone. This type of fracture can cause much more significant damage to the surrounding muscles, tendons, and ligaments.
What causes a tibia fracture?
The fracture of the shinbone is usually caused by some type of high-energy collision such as a motor-vehicle or motorcycle accident.
Sports injuries, such as the sliding tackle in soccer or the awkward fall in football, are lower-energy collisions that can also result in a tibia fracture if they are accompanied by a twisting force.
What are the symptoms of a tibia fracture?
- Immediate, severe pain is usually felt at the injury site.
- Swelling and bruising.
- Inability to walk or place weight onto the affected leg.
- Numbness or tingling sensation in the foot.
- Bone tenting or protruding through the skin.
- Deformity or instability of the leg.
Diagnosis and tests
Your physician will start with a physical exam of your leg to determine if the bone is fractured. A physical exam alone can diagnosis some breaks, but your physician most likely will run a series of imaging tests.
- CT or CAT scan
How do you treat a tibia fracture?
Non-surgical treatment may be recommended for patients who have a closed fracture with minimal movement of the fracture ends. Initially, a splint may be provided to offer some support and comfort for your leg. Most tibia fractures involve significant swelling, and the adjustable straps allow you to loosen or tighten the splint so swelling can occur safely.
Once the swelling has decreased, casting and bracing may be needed. Aaron Ferro, DO, CAQSM, another sports medicine specialist states, ”The fracture site often needs to be immobilized in cast for 6-8 weeks. After 6-8 weeks, the cast may be replaced with a removable brace. The brace keeps the fracture protected, but it can be removed for hygienic purposes such as showers or for physical therapy sessions.”
Surgical treatment may be recommended for patients who have an open fracture, a comminuted fracture, or a fracture that has not healed properly with non-surgical treatment. There are several different methods that may be used depending upon the location of the break, how severe the break is, and if other parts of the leg (muscles, tendons) have been damaged.
- Internal fixation: metal pins, plates, or screws are placed into the bone to keep the fractured ends aligned.
- External fixation: metal pins or screws are placed into the bone above and below the site of the fracture. The pins and screws are then connected to a bar outside of the skin for added stability.
- Intramedullary nailing: starting at the knee, a long, straight metal rod is inserted into the center of the bone to keep the bone straight and stable.
What is the recovery process for a tibia fracture?
Recovery time for a tibia fracture typically takes 4-6 months to heal completely. If the fracture is open or comminuted, healing time may take longer.
Your doctor will often prescribe medications for pain-relief for a short period of time after the injury or surgery. As soon as pain begins to improve, these medications can be stopped.
At the beginning of the healing process, you will probably need the assistance of crutches or a walker. Some cases may allow the patient to put as much weight as possible onto the leg after the injury or surgery, but you may not able to put your full weight onto the leg until the fracture is healed. Be sure to follow your physician’s instructions to avoid healing problems.
Since you will not be using your leg for an extended period of time, the muscles within your leg will most likely be weakened. Exercising during the recovery process is essential, and physical therapy will help restore muscle strength, joint motion, and flexibility to the affected leg. A physical therapist can also teach you how to properly use crutches and a walker.
How can I prevent a tibia fracture?
Unfortunately, some forces that cause a tibia fracture are simply out of our control. However, the following tips can help lower your risk of a tibia fracture.
- Don’t smoke or use tobacco products.
- Keep home clean and floor clutter free to avoid falling or tripping.
- Eat a diet rich in calcium to lower risk of osteoporosis.
- Exercise regularly to keep bones and muscles in shape.
- Practice safe driving habits to avoid motor-vehicle accidents and crashes.