TIBIA-FIBULA FRACTURE

 The Injury

Often confused, the tibia is the shin bone that bears most of the weight and the fibula is the splint bone located on the outside of the lower leg.

• Motorcycle accidents are the most common cause of this type of injury although, because of the nature of the sport, fractures to the tibia and fibula are not uncommon in football.
• In the case of football-related injuries, the fractures are caused either by a twisting force when the foot is fixed or by a direct blow from an opponent. Depending on the mechanism of injury, the fracture pattern may be different.
• Tibial fractures are also classified into closed fractures (where the skin is not broken by the fracture fragments) and open fractures (where the fracture fragments break through the skin).

 Signs and Symptoms

• Obviously there will be a great deal of pain and the person will be unable to move their leg.
• There may be deformity at the site of the fracture, and an open fracture is obvious.
• In the case of a closed fracture there may be swelling and discolouration due to the large amounts of blood that emanate from a fractured bone.

 Treatment & Prevention

• If the fracture is closed, and the evidence from x-ray films show the two fragments to be in close proximity, then the orthopedic consultant will bring fragments as close together as is possible (usually under anesthetic) and fit a plaster cast to immobilize the injury site. The patient may be admitted to hospital in order that the medical team can observe the tightness of the cast and the pressure on the leg. The usual healing time for a mid-shaft tibia and fibula fracture treated in a plaster cast is 12 to 16 weeks. This is followed by rehabilitation with a physiotherapist to restore the range of ankle and knee movement, and to restore the muscle strength that is lost during the immobilization period.
• Where the injury is caused by a greater force there is more chance of the fragments being splintered and displaced, and of the fracture being open. In these circumstances the orthopedic consultant may choose to fix the fracture surgically. This can be done using a plate and screw method, a large nail down the center of the bone, or what is known as an external fixator - a frame around the leg that is screwed into the bone. These methods allow earlier and more active rehabilitation, and there is less of a problem with joint stiffness and muscle wastage.