What Causes Tibial Fractures?

The tibia is a strong, resilient bone that supports most of your body weight, but it is not immune to fractures. Typically, tibial fractures are caused by a great amount of force or pressure being exerted on the tibia, although long-term exposure to stress or microtraumas can also cause the condition. People who play high-impact sports or suffer from diseases that weaken the bones are also more likely to suffer a tibia fracture.

Some examples of activities, conditions, or injuries that can lead to a tibial fracture include:

• Traumatic injuries sustained in an accident, such as a fall or a car accident
• Participating in contact sports like football or hockey or other sporting activities that carry some risk of high-impact injury, like skiing
• Osteoporosis, a disease that weakens bones, can increase your chance of suffering a tibial fracture
• Long-distance running can subject your shinbone to repeated stress over time and cause a tibial stress fracture

Tibial Fracture Symptoms

Generally, the symptoms of a tibia fracture will be hard to ignore. You will likely feel localized pain around the site of the fracture, and it may be difficult or even impossible to put weight on the injured leg.

However, in the case of a stress fracture, the onset of pain may be slower and more insidious. At first, you may only feel pain while doing an activity that stresses the injury, such as running, but over time it will grow more noticeable.

Other general symptoms of a tibial fracture might include:

• Swelling in the lower leg
• Discoloration or bruising around the shinbone
• Bone protruding through the skin or pushing on the skin and creating a tent-like appearance
• Numbness, tingling, or burning sensations in the lower leg, which may indicate damage to neurovascular structures
• In the case of a tibial plateau (top of the tibia) or a tibial plafond (bottom of the tibia) fracture, there may be associated instability or inability to flex the knee or ankle, respectively

How is a Tibial Fracture Diagnosed?

Diagnosis for a tibial fracture will generally start with a physical examination of the injury, and your doctor will also ask you questions about your medical history and how the injury occured. During the physical exam, your doctor may need to press on the injured area to determine if there is a fracture (and what type of fracture it may be).

Your doctor may also want to order a variety of diagnostic tests to better understand the nature of your injury. Those test may include:

• An X-ray of the tibia
• A computed tomography scan, also known as a CT scan or CAT scan. This can provide a more comprehensive picture of the tibia than an X-ray.
• A magnetic resonance imaging scan, also known as a MRI, which provides a more detailed image of the soft tissues around the tibia, like bones, muscles, and ligaments

Tibial Fracture Treatment

Your treatment options for a broken tibia will depend on the specific cause and nature of your injury, your overall health at the time, and whether or not surrounding muscles, tendons, or ligaments were damaged.

Some tibial fractures may heal with just a cast, while others may require surgery. Your Resurgens Orthopaedics physician will carefully evaluate your non-surgical and surgical options, and help develop a treatment plan that works best for you.

Non-Surgical Treatment

While everyone's treatment plan will depend on the specific circumstances of their injury, some tibial fractures may not require surgery, or it may not be possible due to health issues.

Generally, tibial fractures that are more stable, have minimal bone displacement, and are extra-articular (meaning the fracture does extend into the joint surfaces) will require surgery less frequently than more severe or unstable fractures. Most stress fractures can also be treated without surgery.

The most common non-surgical treatments include:

• Closed reduction and immobilization of the leg in a cast
• The use of a hinged knee brace, which partially limits the amount of weight your leg must bear
• Physical therapy, especially range of motion (ROM) therapy
• The use of a functional brace - also called a traction brace - which can be used after transitioning out of a cast (or immediately, in the case of less severe fractures)

Surgical Treatment

When a tibial fracture is open, has significantly displaced the bone, or is intra-articular, then your doctor is much more likely to recommend surgery. That's also true if previous non-surgical measurements are unsuccessful in treating your fracture.

The surgical procedure your doctor recommends will depend on the specific type of fracture and the extent of your injury. For example, severe compound fractures will require more immediate intervention to clean the area as well as antibiotic treatment to help reduce the chance of serious infection. And while the specific application and location of surgical intervention can vary, most operations involve one of the following:

• The placement of metal screws, pins, or plates on the outside or inside of your leg, which can help stabilize the injury and keep your bones aligned while they heal
• The use of intramedullary nailing (IMN), a procedure where a rod is placed down the length of your tibia to keep the bone aligned

At Resurgens Orthopaedics, we understand that every patient has unique needs and customize our treatment plans to meet those needs. If you are experiencing leg pain, schedule an appointment with a Resurgens Orthopaedics physician today.