Tibia Fracture

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Tibia Fracture

Introduction

Tibia is the larger bone of the two bones in the lower leg. It is commonly known as shin bone. It is accompanied with fibula bone in the lower leg. The fracture in the tibia bone is known as tibia fracture. Tibia fractures can cause due to direct and immense stress on the shin bone because of varied reasons like falling from a vehicle or high places or from the weakening of the bones due to diseases like osteoporosis. It can be treated by several methods which basically depend upon the type of fracture and alignment of the injured bone. As a large pressure can only break the tibia bone therefore this fracture is generally accompanied with injuries like sprained ankle, foot fracture etc.

Types

Tibial shaft fracture: It is the most common type of tibia fracture. It occurs at the region between the ankle joint and the knee joint.
Tibial plafond fracture: It occurs near the center of the tibia around the ankle joint. It requires consideration because of the presence of soft tissues and ankle cartilage in these areas and this kind of fracture can easily make damage to them.
Tibial plateau fracture: It occur just below the knee joint and is the most injurious type of tibia fractures as it may affect the cartilage surface of the bone (i.e. below the knee). It may further lead to the possibility of developing knee arthritis.
In addition to above types of tibia fracture, tibia stress fracture is also a common type of fracture, in which one can notice a hairline crack on the bone due to excessive stress. It is very common in athletes.

Causes
Any trauma may leads to tibia fracture such as road accident or motor vehicle accidents.
Falling directly on front or inner direction of lower leg may also result in breaking of tibia bones. Tibia fracture by falling is very common in children as they usually fall down while playing in playgrounds or while using stairs.
Many sports injury also results in tibia fracture.
Excessive stress on fine tissues or overuse during trainings and exercises also leads to tibia stress fracture.
It may accompany with a rolled ankle particularly with some weight bearing forces.
Poor landing techniques in activities like high or broad jumps or landing on uneven surfaces may result in tibia fracture.

Contributing factors
Some other factors are also discussed below which are also responsible to cause frequent tibia fracture. One needs to evaluate and assess these factors constantly to avoid any such reoccurrences. It includes:
Weak bones due to lack of calcium.
Excessive training or activity causing stress.
Incorrect posture of lying down the foot.
People suffering from osteoporosis (decreased density of bones) or diabetes are more prone to such fractures.
People with flat feet or more arched feet are also more prone to leg fractures.

Sings and Symptoms

Sudden onset of pain in the lower leg is the initial symptoms in cases of tibia fracture. The firmly touch on the affected area can also result in great pain. Pain becomes worse with any kind of movement.
Redness and swelling are also there in tibia fracture.
Leg bruise or discoloration of skin of lower leg can also be noticed in such cases.
Tenderness or unusual kind of sensitivity in any touch or pressure over the bone of lower leg is also noticed in tibia fracture.
One can feel difficulty in walking and inability in standing or in any kind of movement of the injured leg.
Deformation in bone or leg can also be noticed in severe cases.
Numbness (lack of sensation) in leg is also one of the symptoms of tibia fracture.
Pain in the injured bone is accompanied with knee and ankle pain in some cases.
Weakness in foot is also one of the important symptoms in tibia fracture.

Diagnosis

The proper clinical examination is essential to check out the status of tibia in case of tibia fracture. Usually an X-ray is required to assure diagnosis and to assess the severity of the fracture. In initial physical examination, the doctor will examine the status of the tissues around the knee joint and other symptoms such as redness, swelling and open wounds. The doctor will also assess the supply of blood by the fractured leg to the foot region. In some cases if the injury is severe, further investigations such as an MRI, bone scan or CT scan are advised to assess the exact location and for displacement of the fracture.

Complications
Some risk factors are always available in injuries leads to tibia fracture. Complications of a tibia fracture may include:
A severe kind of open and infected fractures because the tibia lies just behind the skin and damage to skin in case of fracture may result in bone infection caused by exposure of bone to germs.
Limitation in movement of the knee joint, ankle and foot generally caused by injury in related joints and tissues.
A tendency to develop swelling and pain due to bad neuromuscular condition near the injured bone can be noticed in high impact injuries.
Tibia fracture can injure the adjacent nerves and blood vessels which immediately require medical treatment if one find any numbness in the affected area or any kind of blood circulation problems.
Severe fractures may leads to osteoarthritis after some years. If the injured leg starts to hurt after a long break, one should see the doctor for instant evaluation.

Treatment

Tibia Fracture can be treated by several methods which basically depend upon the type of fracture and alignment of the injured bone. It is also dictated by available facilities and circumstances.

Treatment for tibia fractures with no displacement involves the recuperation of the bone by use of crutches, protective boot, brace or plaster cast immobilization (any of them guided by an orthopedic specialist) for a number of weeks with physiotherapy, minimum for a month. Surgery is generally not required in these cases until there is a need of realign the injured bone.

Tibia fractures that are severe because of displacement of bone involves clinical treatment such as surgical re-alignment of the fractured bone known as anatomical reduction, by carefully manipulating the patient under anesthetics further following the internal fixation for stabilizing the fracture with use of plates, wires, rods and screws, if required. Patient needs to use things like plaster cast, protective boots, brace or crutches for a long time. Anti-inflammatory medications are mainly prescribed by doctor, specialists or physiotherapist to reduce pain and swelling of the affected area. The healing of the injury needs to be evaluated timely to ensure the complete and timely recovery. Once healing is ensured one can move further for rehabilitation suggested by the treating physiotherapist.

Sufficient rest from the activities which raises the pain is most important part of rehabilitation program after a tibia fracture. All such activities that places large amount of pain or stress on tibia should strictly be avoided to prevent any further damage and to ensure quick healing.

Aggravating activities like walking, running, jumping, skipping lead to soreness and further damage of the connective tissues of the injured leg. Therefore proper rest from such activities should be taken to ensure the beginning of healing process without any further increase in symptoms. Once there is no pain or not any kind of increase in the symptoms one can gradually return to the routine activities. Ignoring the symptoms for a long time may cause the problem to become severe. Immediate and appropriate treatment ensures an early recovery in cases of tibia fracture. Once the healing process get stared one can perform those activities which place less stress on the tibia bone in order to maintain fitness and to keep the tissues active but only under the guidance of the treating physiotherapist. Patients with a tibia fracture should perform exercises to increase flexibility and strength of the injured leg as part of the rehabilitation program under the guidance of doctor to ensure the best outcome after recovery. Knowing the exact status of the injury only the physiotherapist can advise the best suitable exercises for the patient.

Recovery
With proper rest, medication and treatment patient can make a full recovery from tibia fracture. The recovery time may vary from weeks to months depending upon the severity of the fracture. It basically depends upon the type of fracture and alignment of the injured bone. Proper follow-up appointments with treating doctor are essential to check the progress of the healing. Once there is no pain or any kind of increase in symptom patient can gradually return to routine activity in weeks or months as suggested by the doctor or treating physiotherapist.
Strictly following the prescription and avoiding any kind of mental and physical stress during the healing process leads to quick and easy recovery.
Physiotherapy
Physiotherapy plays a vital role in recovery from tibia fracture. It ensures the healing process and helps to bring the beneficial outcomes of entire treatment. It includes:
Massage of the soft tissues.
Joints mobilization exercises.
Exercise for improving the inner strength, flexibility and balance of the injured area.
Using crutches, protective boots or braces.
Using arch wrap if required.
Useful modification of the daily activity.
Advise regarding the healing process, anti-inflammatory medication and comfortable footwear.
Gradual return to the daily activities.

Exercises

Some of the main exercises suggested by the specialist are discussed below but one should always discuss the effectiveness and stability of the given exercises from the treating doctor or physiotherapist before starting them which leads to gain the maximum results out of them. Exercises discussed below should be performed twice or thrice a day only and only if they do not result in any kind of increase in symptoms.
Move the foot and ankle up and down with the possible and comfortable stretch without any pain. Repeat it for minimum 10-20 times but only if there is no increase in symptoms.
Move the foot and ankle in and out with the possible and comfortable stretch without causing any pain. Repeat it for minimum 10-20 times.
Move the foot and ankle in a circle as maximum as possible and comfortable without causing any pain. Repeat it for minimum 10 times in each direction.
Bending and straightening of knee to the maximum extent without any pain for 10 to 20 times.
Tightening and loosing the thigh muscle with fingers to feel contraction in thigh muscles, pushing the knee down into a towel for ten times.