fbpx
 

Tibia Fractures – Symptoms, Causes, Treatments, Surgery and Recovery

Kevin_Martin_DO_250xd250_C

Kevin D. Martin, DO, FAAOS,

Orthopedic Foot and Ankle Surgeon
Associate Professor of Surgery

About the author – Dr. Martin specializes in orthopaedic surgery of the foot and ankle. In addition to his practice Dr. Martin serves as committee member of the American Orthopaedic Foot and Ankle Society and is a regular contributor to multiple medical journals including Foot and Ankle International.

The tibia (shinbone) is one of two long bones in your lower leg that runs between your knee and your foot. Tibia fractures are common and are usually caused by a sudden forceful injury, like a fall or motor vehicle accident. If the fracture is severe, you may need surgery to correct the deformity. Although the treatment for each fracture will vary, most people can be treated with a cast immobilization and strict non-weight bearing by keeping the weight off their injured leg for several weeks.

Our guide explains the main causes and symptoms of a fractured tibia, treatment options, and recovery time, and answers the most frequently asked questions about this injury.

Your Guide To Recovery
What is a Tibia Fracture?
Causes and Types of Tibial Fractures
Symptoms of a Fractured Tibia
Diagnosing a Fractured Tibia
Treatment Options for a Broken Tibia
What will my Recovery Entail?
Frequently Asked Questions

What is a Tibia Fracture?

A tibia fracture is a break in the tibia bone, which is one of the two long bones that make up your lower leg (the other is the fibula). The tibia is the larger and stronger of the two bones and has an important role to play because it supports most of your weight. Of all the long bones in the body – which include the femur, humerus, tibia and fibula – the tibia is the most commonly fractured. Around 4% of the senior population(1) experience a fractured tibia.


Causes and Types of Tibial Fractures

Tibial fractures are usually caused by a sudden injury such as a fall, collision while playing sports, automobile and cycling accidents. If the upper part of the bone is affected, it’s known as a proximal or plateau fracture and if the lower part breaks, it’s called a distal or pilon fracture. Due to the shape of the tibia, there are several different ways that you can fracture your tibia that include:

Stable (non-displaced) fracture: most of the bone is left intact and in its normal position. The bones stay in place during healing.

Displaced fracture: the bone no longer lines up properly. Surgery is usually needed to realign the bone and ensure that it heals correctly.

Transverse fracture: the fracture is horizontal. It may still be stable depending on the location of the fracture and the stability of the fibula.

 

Oblique fracture: the fracture is diagonal or at an angle. While these fractures can be initially stable, over time they can shift, resulting in the bones becoming displaced.

Spiral fracture: the fracture line resembles a spiral staircase, which is usually caused by a twisting movement.

Comminuted fracture: the bone breaks into several small pieces. It is inherently very unstable and is usually the result of a high-impact trauma, like a car accident.

Open fracture: Also known as a compound fracture, the break to the tibia or the soft tissue injury is so severe that the bone has torn through the soft tissues and punctured the skin.

Stress fracture: a stress fracture, , is a small crack in the bone caused by overuse. Symptoms usually occur slowly over time associated with a sudden increase in running or jumping activities. Stress fractures are more common in females and military recruits.

.

Common Symptoms of a Fractured Tibia

The main symptoms of a fractured tibia are:

  • Immediate and severe pain
  • Being unable to walk or put any weight on your injured leg
  • Bruising and swelling
  • Your leg may be an odd shape
  • Bone may be protruding through the skin
  • Some people feel faint, dizzy, or sick

It you suspect that you might have a broken tibia, it’s important to seek medical help as soon as possible. In the meantime, put a cushion or pile of clothes underneath your leg for support and try not to move it. Don’t try to walk on your injured leg because this could make the break worse and cause further problems, such as soft tissue damage.

.

Diagnosing a Fractured Tibia

Your doctor will examine your leg and ask you some questions about how the injury happened. If they suspect a broken tibia, they’ll order an X-ray so that they can see the bone in more detail.

They may also order a CT scan, which is a more sensitive imaging test and can give them a better idea of the type and size of the break.

.

Man golfing on an iWALK2.0

Treatment Options for a Broken Tibia

Your treatment will depend on the type and severity of your injury. If the broken bone is stable, then you probably won’t need surgery. You’ll need to wear a cast, splint or brace which holds the bone in place while it heals. As the bone heals the doctor may order a boot which provides support as your leg slowly heals and you start to bear weight.

A broken bone can cause a lot of swelling. If your leg is too swollen to put a cast on it immediately, you’ll be given a splint to wear instead. This will immobilize and support your leg and it can be adjusted as your swelling goes down. Once the swelling has reduced enough, which can takedays to weeks,your doctor will then decide if you need a cast, boot or surgery.

A broken tibia can be very painful. Over the counter medication can help to manage the pain but if your symptoms are severe, your doctor may prescribe painkillers.

Tibia Fracture Surgery

If your fracture is unstable, displaced or angulated –you’ll probably need surgery. Your surgeon has several different surgical options available to treat tibial fractures with different fixation techniques for each fracture pattern. These surgeries are usually performed under general anesthetic:

Intramedullary nailing (IMN): this involves inserting a specially designed metal rod from the front of your knee down the canal of the tibia. The rod passes across the fracture to keep it in position and is screwed to the bone at both ends. This procedure is popular because it keeps the bone in proper position and allows for strong, stable fixation.

Open reduction internal fixation (ORIF): otherwise known as “plates and screws” this method may be used if nailing isn’t possible – usually when the fracture extends into the knee or ankle joint. During this procedure, bone fragments are repositioned to their normal alignment and held together with special screws and metal plates that attach to the outer surface of the bone. These aren’t usually removed unless they cause a problem.

Surgeons will consider the location, type, and severity of the tibia fractures when deciding which method to use.

External fixation: this procedure involves placing metal pins into the bone above and below the fracture. A bar located on the outside of the skin is attached to the pins, stabilizing the frame and holding the bones in the proper position. Once the bone has healed, the frame is removed. External fixation is predominantly used in patients who have severe, open fractures.

.

What to Expect During my Recovery?

The recovery time for a fractured tibia varies depending on the fracture pattern and the type of treatment the surgeon used. Most fractures heal completely in around three to six months.

Wearing a Cast, Boot or Splint

Typically you will initially wear a splint (half cast) as the initial swelling improves. The splint then can be transitioned to a cast to hold your bones in place and allow your body to heal. It’s important to keep your splint or cast clean and dry.

Keep your leg elevated to about the level of your heart because this will help to reduce pain and swelling. You may find that the cast feels itchy at first but as tempting as it is, do not stick anything in the splint as even small scratches can cause irritation or infections.

It’s extremely important not to get your splint or cast wet so you’ll need to protect it with a specialized cast bag when you shower, which you can buy online or from drugstores. Some people use a plastic bag tied tightly around the cast. Whichever method you choose to keep your splint or cast dry, keep in mind that either one can leak.

Once your cast is removed, you may be given a special boot to wear which will support your leg as you start to slowly bear weight again. Your health professional will show you how to put this on and adjust it so that it fits correctly. The benefit of this boot is that you can take it off when you are resting and washing as per your physicians instructions.. Each physician will have specific instructions on how much to wear the boot and how much weight to place on the foot. Always follow the instructions your physician has provided. Like a splint or cast keep the boot clean and dry.

Physical Therapy for a Fractured Tibia

Physical therapy can play an important role in your recovery from a fractured tibia. During the initial non-weight bearing period you may be given some gentle exercises to do, which will help to reduce stiffness, strengthen the surrounding muscles, and prevent atrophy.

Once your physician allows you to start bearing weight again on your leg, your physical therapist will initiate exercises to build up strength and regain balance control. Muscle atrophies or shrinks occur shortly after an injury and even after a brief period of non-weight bearing. Thus, restoring and preventing muscle atrophy is paramount to returning to normal walking and daily activities.

Mobility Options During the Non-Weight Bearing Period

Unless you only have a minor stress fracture, your physician will in most cases ask you to be completely non-weight bearing for your initial recovery, which means that you can’t put any weight on your injured leg. In order to maintain non-weight bearing, you’ll need to use a mobility aid such as crutches, a wheelchair, knee scooter, or the iWALK2.0 hands-free crutch.

The non-weight bearing period is an extremely frustrating but necessary part of the recovery process. You may be tempted to cheat a little but it’s essential to listen to your doctor’s orders. Any attempt to put weight on your injured leg before it’s ready could prevent the bone from healing and may make your injury worse. Fortunately, there are now some great alternatives to crutches to help you stay active during the recovery period.

Here are your main mobility options:

Crutches

Traditional crutches are easy to find and inexpensive making them the first thing people often try after surgery. However, crutches can be exhausting to use and cause additional pain in other parts of your body, mainly the underarms and wrists. They can also be restrictive because you can’t carry anything, which prevents many activities of daily living such as showering, grooming and eating. Crutches are so uncomfortable for most patients that they tend to become non-compliant in their non-weight bearing and start walking on the injured leg before it is healed, which can cause additional injury or slow the recovery.

Knee Scooters

Knee scooters or “knee walkers” are more efficient than crutches and require less upper body strength. They are great on flat surfaces as you can scoot easily from point A to point B without getting exhausted. Their use is fairly limited because they don’t work on stairs, slopes or uneven terrain. You also need to use your hands to operate the scooter so you still can’t carry things around, and they are bulky which makes them difficult to transport. It’s also difficult to navigate tight environments when on a knee scooter.

iWALK2.0 Hands-Free Crutch

The iWALK2.0 is a hands-free crutch that enables you to walk around unaided with full use of your hands and arms. It functions like a temporary lower leg so that you can go about your daily life as usual, while your injured leg remains safely and securely elevated. It can be used on stairs, slopes, uneven terrain, and in the shower. A 2019 medical study(2) found that nine out of 10 patients prefer the iWALK2.0 to traditional crutches and reported less pain, less exhaustion, and less shortness of breath while using the iWALK2.0.

Which mobility device is best for you? Find out here.

FAQs

Here are the most commonly asked questions about tibia fractures:

Can you still walk with a fractured tibia?

In most cases, the answer is no. Walking after a tibia fracture can make your injury worse and may cause further damage to the surrounding muscles, ligaments and skin. It’s also likely to be extremely painful. If you suspect that you might have broken your leg, don’t walk on it until you’ve been checked out by a doctor. If you do have a broken tibia, you’ll probably need to be non-weight bearing which means you’ll need crutches, a wheelchair, mobility scooter, or hands-free crutch to get around. However, if you only have a minor stress fracture you may still be able to walk. Always consult with or ask your treating surgeon prior to walking on a tibia fracture, as this will depend on your fracture pattern and if you had a surgery.

How long does it take for a tibia fracture to heal?

In most cases, the recovery time for a fractured tibia is six to ten weeks, but this will vary considerably depending on the patient and fracture. You may experience some swelling for up to a year afterwards. Minor stress fractures may take less time than this and severe breaks may take more.

Can a tibia fracture heal on its own?

A fractured tibia doesn’t always require surgery, but it won’t heal properly on its own as well. Leaving it to heal on its own is risky and can leave the leg angulated and painful. A tibia fracture needs to be treated under the supervision of a physician, which generally means being immobilized with a cast, splint, or special boot and not putting any weight on it to ensure proper healing.

How long do you wear a cast for a broken tibia?

It depends on how severe your injury is but it’s likely to be at least six weeks. Once your cast has been removed, you’ll probably be given a special boot to wear for a few weeks, which will support your leg as you slowly start to bear weight again.

How do you help someone with a broken leg?

If you suspect someone has broken their leg, it’s important to seek medical help as soon as possible. If they’re unable to get to the Emergency Room, you may need to call an ambulance.

How do you help someone with a broken leg?

If you suspect someone has broken their leg, it’s important to seek medical help as soon as possible. If they’re unable to get to the Emergency Room, you may need to call an ambulance.

The information above is intended for informational purposes only and is not intended to prevent, treat, or diagnose any illness or disease. We aim to provide the highest quality information, so if you have any questions on the information above, we welcome your feedback!
CITATIONS

www.orthoinfo.org. Ortho Info “Tibia (Shinbone) Shaft Fractures”

“A Stress Fracture Primer,” by Brian Fuller, D.P.M. www.runnersworld.com. “Runner’s World Magazine”

“Tibial Plateau Fracture.” Arlington Orthopedics Associates, P.A. www.arlingtonortho.com

“Tibia Fracture,” by Jason Howard. www.SportsInjuryClinic.net.