What are the other Names for this Condition? (Also known as/Synonyms)

• Broken Leg - Shinbone
• Fracture of the Shinbone
• Lower Limb Fracture

What is Fracture of the Tibia? (Definition/Background Information)

• There are 2 bones in the lower part of the leg (below the knee), called the tibia and fibula. The larger, stronger of the two bones (tibia or shinbone) is located just below the kneecap. The smaller bone (fibula) is located on the lateral outer side of the lower leg
• The shinbone, also known as the shankbone, is the most commonly fractured bone within the human body
• A Fracture of the Tibial Shaft is a break or crack that occurs anywhere in the center region (along the length) of the tibia
• Fractures of the Tibial Shaft are usually caused by direct injuries/trauma to the leg, associated with falls, participation in contact sports, or automobile accidents

There are several different types of fractures, some of which are categorized based on the injury impact force. In many cases, the smaller fibular bone also fractures. The fracture types include:

• Stable fracture: In this type of fracture, the bone pieces are only slightly displaced. The broken bone ends remain in place and stay aligned, as the injury heals
• Displaced fracture: In this type of fracture, the bone may fragment around the point of breakage and get misaligned; hence, surgery is usually required
• Transverse fracture: Transverse fracture occurs when the bone fractures horizontally, along the bone length
• Oblique fracture: An oblique fracture occurs when the bone is fractured at a slanted angle. The fracture is usually unstable, or may become unstable over time
• Spiral Fracture: A spiral fracture usually involves a violent twist of the bone. The severity of the injury is based on bone displacement
• Comminuted fracture: In a comminuted fracture, the bone is broken into three or more pieces. It is considered one of the most unstable type of fracture
• Open fracture: In this type of fracture, the bone breaks and pierces the skin, requiring immediate medical treatment. Apart from this, ligament, muscle, and tendon damage, may also occur
• Close fracture: In this type, the bones do not pierce the skin. However, injury to the soft tissues under the skin, may occur

Who gets Fracture of the Tibia? (Age and Sex Distribution)

• Tibial Shaft Fractures are non-specific and can occur in individuals of all age, race, ethnic group, and gender
• Adolescent males between the ages of 15-19 have the highest incidence rate and represent approximately one-half of all lower extremity fractures
• The fracture is also seen in middle-aged and elderly adults, who develop osteoarthritis of the leg

What are the Risk Factors for Fracture of the Tibia? (Predisposing Factors)

Risk factors associated with Tibial Shaft Fractures include:

• Participation in rough, high-impact contact sports, such as football, basketball
• Advanced age (elderly adults are higher prone)
• Reduced bone mass (osteoporosis)
• Reduced muscle mass
• Excess body weight associated with obesity, which can cause increased pressure on the joints

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Fracture of the Tibia? (Etiology)

Some of the causes of a Fracture of the Tibia include:

• Direct trauma to the leg associated with an automobile accident
• Taking part in any rough or high-impact sport
• Falling from a significant height (or the fracture occurring since the individual is overweight)
• Fracture of the shinbone resulting from street fights, gunshot wounds, domestic violence

What are the Signs and Symptoms of Fracture of the Tibia?

Signs and symptoms of a Tibial Fracture include:

• Sharp and sudden pain in the leg, immediately after the injury occurs
• Swelling, tenderness, and possible bruising around the injury site
• Noticeable deformity of the leg
• Reduced range of motion of the knee or ankle
• Inability to put weight or pressure on the injured leg
• Difficulty walking
• Excessive pain
• In some cases, there may be a protrusion of bone through the skin

How is Fracture of the Tibia Diagnosed?

Diagnostic methods that a physician may use to help diagnose a Tibial Shaft Fracture include:

• Physical examination: A thorough physical examination is important in identifying any noticeable deformities, swelling, contusions, and shortening or angulation of the leg. Individuals are also expected to provide an explanation of the circumstances that caused the injury. In addition to this, a complete medical history can aid in arriving at a definitive diagnosis
• X-ray: X-rays are the most common imaging methods used in assessing a fracture. This diagnostic test can help provide a clear image of the bone, identify the exact location of the injury, and determine the extent of the fracture
• Computerized tomography (CT): A CT scan takes a series of X-ray images from several different angles. These images are then merged to create cross-sectional images of bones and soft tissues of the leg, which aids in evaluating the severity of the injury

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Fracture of the Tibia?

Complications related to Fractures of the Tibial Shaft include:

• Infection of the bone (osteomyelitis)
• Damage to the nerves or blood vessels of the leg
• Prolonged or delayed healing process, due to other medical conditions
• Abnormal pressure build-up in the leg muscles, which can reduce blood flow and prevent nourishment and oxygen from reaching nerve and muscle cells (called compartment syndrome)
• Arthritis may develop, if the fracture impact affects the ankle/knee joint, or if the bone is improperly aligned
• Uneven leg length

How is Fracture of the Tibia Treated?

Fractures of the Tibial Shaft may be treated non-surgically or surgically, and both methods of treatment include certain risks and benefits.

Nonsurgical methods of treatment may include:

• Complete immobilization of the leg with a splint or cast is required. Specialized assistive devices, such as a cane, walker, or a walking boot, are also recommended, in order to decrease any weight/pressure on the bone, until it has healed. This can also help the individual perform some of their regular/daily activities
• Oral medications, such as acetaminophen or ibuprofen, can help decrease pain
• Stronger prescription medications, such as codeine, or a combination of hydrocodone-acetaminophen, may be prescribed, when over-the-counter medications are unsuccessful in relieving pain
• Individuals are likely to need physical therapy exercises after the cast is removed. The goals of these exercises are to strengthen the leg muscles, improve flexibility, and decrease stiffness. It may take several months for an individual to complete the physical therapy program and regain full strength and functionality

Surgical treatment methods include:

• Closed reduction: Closed reduction is a non-invasive operation that attempts to manipulate the bone back into its original position, without making an incision. This procedure is usually performed under a local anesthesia
• Intramedullary nailing: During an intramedullary nailing procedure, once the bone is realigned, a specialized metal rod is placed within the bone marrow canal (intramedullary) of the tibia. This medal rod is designed to hold the tibia bone in its original position
• Open reduction and internal fixation (ORIF): Open reduction is a surgical procedure to realign the fractured bone, to its original position. Surgical hardware (such as plates, screws, or rods) is then used to stabilize the fractured bone under the skin

How can Fracture of the Tibia be Prevented?

To prevent a Fracture of the Tibia, individuals should be careful and consciously aware, while performing any physical activities, such as sports, or even some normal daily activities that could lead to situations involving accidents. Children must be provided a safe environment to work, study, or play. Any possible dangers should also be anticipated and appropriate safety measures adopted.

A few ways to further help prevent unwanted injuries or Fractures of the Tibial Shaft include:

• Individuals who participate in any high-risk sports, should wear appropriate safety equipment to help prevent the possibility of such fractures
• Wearing appropriate footwear (such as the proper shoe size), may help prevent accidents
• Consuming foods rich in calcium, such as milk, yogurt, and cheese, help build bone strength. Regular diet with appropriate calcium-intake is recommended, even after a Tibial Shaft Fracture. For women, the recommended amount of calcium, increases with age and menopause
• Perform weight-bearing exercises to strengthen bones

What is the Prognosis of Fracture of the Tibia? (Outcomes/Resolutions)

• A majority of the Tibial Shaft Fractures heal without any serious complications
• A full recovery and a return to sports or normal daily activities usually requires 6-16 weeks, depending on the severity of the injury
• When properly treated and rehabilitated, a very high percentage of individuals regain their full strength and range of motion in the injured leg

Additional and Relevant Useful Information for Fracture of the Tibia:

A fracture that affects the upper leg (the thighbone, above the knee), is termed as femoral shaft fracture.