Knee

The knee is one of the largest and most complex joints in the body. The knee is made up of bones, cartilage, ligaments, and tendons. The knee joins the thigh bone (femur), the shin bone (tibia), the smaller bone that runs alongside the tibia (fibula) and the kneecap (patella) altogether to make up the knee joint. The knee is a synovial joint, meaning it contains a fluid-filled capsule.

Tendons connect the knee bones to the leg muscles that move the knee joint, and ligaments join the knee bones and provide stability to the knee.

Tibia Fracture

WHAT IS A TIBIA FRACTURE?

The tibia (also known as the shin) is the most common long bone in the body that gets fractured. A tibia fracture refers to any crack or breaks in the tibia bone.

The lower leg is made up of two bones: tibia and fibula. The tibia is the larger of the two bones, is an important part of both the knee joint and ankle joint and is responsible for supporting most of your weight.

The severity and type of fracture is dependent on the cause of the fracture. A transverse fracture indicates that the crack is horizontal across the bone, while an oblique fracture indicates that the crack is at an angle. A tibia can have the following types of fractures:

  • Stable fracture (aka non-displaced fracture)

Most of the bone remains intact and in its normal position. Broken parts of the tibia line up and maintain their correct position during the healing process.

  • Displaced fracture

Part of the bone gets moved due to a crack in the bone and is no longer aligned. Surgery is required to correct this type of fracture and realign the bones back together.

  • Stress fracture (aka hairline fracture)

This is a common overuse injury. These fractures create small, thin cracks in the bone.

  • Spiral fracture

When a twisting movement causes a break, there may be a spiral-shaped fracture of the bone.

  • Comminuted fracture

Occurs when the bone fractures into three or more pieces.

 

WHAT ARE THE SYMPTOMS OF A TIBIA FRACTURE?

A tibia fracture causes immediate and severe pain. Other symptoms include:

  • Bruising
  • Loss of feeling and sensation in the foot
  • Inability to stand, walk, or bear weight on the affected leg
  • Bone protruding through the skin, resulting in a tent-like appearance
  • Deformity of the leg or uneven leg length

WHAT ARE THE CAUSES OF A TIBIA FRACTURE?

A tibia fracture is often due to high impact to the shin bone. Common causes include:

  • Motor vehicle accidents
  • Sports that involve repeated impact to the shin bone, such as long-distance running and soccer
  • Falls that have direct impact to the shin bone
  • Osteoporosis (bones are weaker than usual)

WHAT IS THE DIAGNOSIS OF A TIBIA FRACTURE?

A history of the injury and a physical examination of the knee will be conducted by the Doctor. Imaging tests will be taken, such as an x-ray for the doctor to examine the tibia in detail, a CT scan which gives a 3D image of the bone and a MRI scan for examination of the muscles, ligaments and bones around the tibia.

WHAT ARE THE TREATMENT OPTIONS FOR A TIBIA FRACTURE?

When deciding on what treatment is suitable for your tibia fracture, the doctor will take into account your overall health, the cause and severity of the fracture, and the extent of damage to the soft tissue surrounding the tibia.

Nonsurgical treatment is recommended for patients who have poor health, are less active and have closed fractures. This includes:

  • Wearing a splint to hold the bone in place. Unlike a full cast, a splint is adjustable which allows for swelling to occur safely and allows for more flexibility
  • Bracing, used in less severe cases to immobilize the bone to allow for healing
  • Physiotherapy
  • Use of crutches

 

Surgical treatment involves metal screws and plates being placed on the bones to hold the bone in place. This allows for healing to be done with minimal long-term damage.

Alternatively, a specially designed metal rod is inserted into the tibia and passed across the fracture to keep it in position.

A titanium nail (known as Intramedullary nail) is screwed to the bone at both ends. This keeps the nail and the bone in proper position during healing. This method is not recommended for children and teens as they are still experiencing bone growth, and this procedure may cross into the bone’s growth plates.

 

WHAT IS THE RECOVERY PROCESS AFTER A TIBIA FRACTURE?

The recovery process depends on the severity of the fracture. On average, recovery period is 4 to 6 months. Should the patient experience a complete fracture of the bone, or if they have health issues, recovery period will be longer.

Medications will be prescribed to help with managing the pain. This includes NSAIDs, acetaminophen and local anaesthetics.

Physiotherapy is also recommended to help you restore muscle strength, decrease stiffness and restore mobility in your leg. As your slowly recover from your injury and regain muscle strength, you will be able to put on more weight on your leg.

WHAT ARE THE RISKS AND COMPLICATIONS OF A TIBIA FRACTURE?

A tibia fracture is usually successfully managed without complications. However, some complications of a tibia fracture include:

  • Complications from surgery or the need for further surgeries
  • Nerve, muscle, or blood vessel damage due to the sharp ends of broken bones
  • Acute compartment syndrome, a painful condition that occurs when pressure within the muscles builds to dangerous levels. This results in a reduction in blood flow and may lead to permanent disability
  • A bone infection called osteomyelitis
  • A non-union, where the bone does not heal
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