Tibia (Shinbone) Shaft Fracture
The tibia (shinbone) shaft fracture, is the most common fractured long bone in your body. The long bones include the femur, humerus, tibia, and fibula. A tibial shaft fracture occurs along the length of the bone, below the knee and above the ankle.
Because it typically takes a major force to break a long bone, other injuries often occur with these types of fractures.
The lower leg is made up of two bones: the tibia and fibula. The tibia is the larger of the two bones. It supports most of your weight and is an important part of both the knee joint and ankle joint.
Types of Tibia Shaft Fractures
The tibia can break in several ways. The severity of the fracture usually depends on the amount of force that caused the break. The fibula is often broken as well.
Common types of tibial fractures include:
Stable fracture: This type of fracture is barely out of place. The broken ends of the bones basically line up correctly and are aligned. In a stable fracture, the bones usually stay in place during healing.
Displaced fracture: When a bone breaks and is displaced, the broken ends are separated and do not line up. These types of fractures often require surgery to put the pieces back together.
Transverse fracture: This type of fracture has a horizontal fracture line. This fracture can be unstable, especially if the fibula is also broken.
Oblique fracture: This type of fracture has an angled pattern and is typically unstable. If an oblique fracture is initially stable or minimally displaced, over time it can become more out of place. This is especially true if the fibula is not broken.
Spiral fracture: This type of fracture is caused by a twisting force. The result is a spiral-shaped fracture line about the bone, like a staircase. Spiral fractures can be displaced or stable, depending on how much force causes the fracture.
Comminuted fracture: This type of fracture is very unstable. The bone shatters into three or more pieces.
Open fracture: When broken bones break through the skin, they are called open or compound fractures. For example, when a pedestrian is struck by the bumper of a moving car, the broken tibia may protrude through a tear in the skin and other soft tissues.
Open fractures often involve much more damage to the surrounding muscles, tendons, and ligaments. They have a higher risk for complications and take a longer time to heal.
Closed fracture: With this injury, the broken bones do not break the skin. Although the skin is not broken, internal soft tissues can still be badly damaged. In extreme cases, excessive swelling may cut off blood supply and lead to muscle death, and in rare cases, amputation.
Cause & Symptoms
High-energy collisions, such as an automobile or motorcycle crash, are common causes of tibial shaft fractures. In cases like these, the bone can be broken into several pieces (comminuted fracture).
Sports injuries, such as a fall while skiing or running into another player during soccer, are lower-energy injuries that can cause tibial shaft fractures. These fractures are typically caused by a twisting force and result in an oblique or spiral type of fracture.
The most common symptoms of a tibial shaft fracture are:
Inability to walk or bear weight on the leg
Deformity or instability of the leg
Bone “tenting” the skin or protruding through a break in the skin
Occasional loss of feeling in the foot
It is important that your doctor knows the circumstances of your injury. For example, if you fell from a tree, how far did you fall? It is just as important for your doctor to know if you sustained any other injuries and if you have any other medical problems, such as diabetes. Your doctor also needs to know if you take any medications.
After discussing your symptoms and medical history, your doctor will do a careful examination. He or she will assess your overall condition, and then focus on your leg. Your doctor will look for:
Obvious deformity such as angulation or shortening (the legs are not the same length)
Breaks in the skin
Bony prominences under the skin
Instability (some patients may retain a degree of stability if the fibula remains intact or the fracture is incomplete)
After the visual inspection, your doctor will feel along your leg to see if there are abnormalities of the tibia. If you are awake and alert, your doctor will test your sensation and muscle strength by asking you to move your toes and see if you can feel different areas over your foot and ankle.
Other tests that may help your doctor confirm your fracture include:
X-rays can show if the bone is broken and whether there is displacement (the gap between broken bones). They can also show how many pieces of bone there are. X-rays are also useful for identifying the involvement of the knee or ankle joint, and the presence of a fibula fracture.
Computed Tomography (CT) Scan
After reviewing your x-rays, your doctor may recommend a CT scan of your leg. This is often done if there is a question of the fracture extending into either the knee or ankle joint. A CT scan shows a cross-sectional image of your limb. It can provide your doctor with valuable information about the severity of the fracture.
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