A fracture of the tibia, which is the shin bone, are common in high-impact sports.
The tibia or shinbone, along with the fibula are the two bones of the leg. The tibia is the stronger of the two and a major weight-bearing bone.
Classification of tibia bone fracture:
The tibia can be fractured in three places
- Plateau fracture or condylar fracture of the tibia involves the upper part of the tibia, which is a part of the knee-joint. If this fracture is neglected it may lead to arthritis of the knee later on.
- Fracture of the shaft of the tibia is a fracture in the middle of the tibia. If there is a break in the overlying skin it is called an open fracture. If not, it is called closed fracture.
- Plafond fracture or pilon fracture of tibia is the fracture of the lower end of the tibia where it is a part of the ankle joint. This area is surrounded by tendons and ligaments, which support the ankle joint and hence a fracture in this region is complicated to treat.
Causes of tibia fracture:
- Tibia fractures are common in high-impact sports like football, rugby, ice hockey and car racing.
- Motor vehicle injuries, generally involve the shaft when one’s leg is run over by a car.
- They can also happen as a result of falls while trekking for example. They are common in young adults.
- In elderly women, fractures of the tibia may occur as a result of osteoporosis.
Symptoms and signs of tibia fracture
Tibia fractures are characterised by swelling of the knee, severe pain, bruising, weakness and numbness. In plateau fractures the stability of the knee-joint can be harmed and the surrounding cartilages may be damaged.
Diagnosing a tibia fracture:
A history of injury or trauma to the area along with signs of inflammation can point to the diagnosis. X –rays of the tibia will confirm the diagnosis.
Treatment for tibia fracture:
Conservative methods and surgery are used to treat different fractures according to the individual case. In tibial plateau fractures, surgery is required followed by traction.
In fractures of the shaft, a undisplaced fracture can heal in a plaster cast while a displaced fracture requires surgical intervention with a long nail put in the centres of the bones to help it unite properly. This is called intramedullary nailing.
In fractures of the lower tibia or plafond fracture, swelling may delay surgery. Each case should be treated according to its merit.
Complications seen in a tibia fracture
- Delayed union where the fragments do not unite in a reasonable amount of time is a possibility. Or the fracture may fail to unite which is called mal-union. This is due to the precarious blood supply to this bone, which may be hampered at the time of the fracture. These cases require an operation.
- Osteoarthritis – This happens in plateau fractures, which occurs close to the knee joint. It occurs many months after the fracture has occurred and is a late complication.
- Infection is a strong possibility in open fractures.
- Injury to nerves and blood vessels: If the fracture occurs in the upper third of the shaft, damage to important nerves or blood vessels may occur. Thus a thorough examination must be conducted by the attending doctor.
Written by Dr Nisreen Nakhoda, General Physician