The tibia is the shin bone, and bears most of the body’s weight; the fibula is the splint bone on the outside of the lower leg. When the tibia breaks, the fibula often does as well. Tibial fractures are classified as closed fractures, in which fractured bone fragments do not break through the skin, or open fractures, in which the fragments break through the skin. Open fractures are common because the skin in the lower leg is thin. Fractures of the tibia require immediate treatment in a hospital.
What is the Treatment for a Broken Leg?
Treatment depends on the type of fracture. If it is a closed fracture and the x-rays show that the two fragments are close together, the orthopedic surgeon will bring the fragments as close together as is possible, usually under anesthesia, and will fit a plaster cast to immobilize the lower leg. This is called a closed reduction. The patient is sometimes admitted to hospital so the doctor can check the tightness of the cast and the amount of pressure it places on the leg. Sometimes the doctor will opt for a removable plastic cast walker, instead of a plaster cast.
It usually takes between 12 and 16 weeks for a mid-shaft tibia and fibula fracture to heal. This is followed by physical therapy to restore the range of motion in the ankle and knee, and to restore the muscle strength that has been lost while the leg was immobilized.
In a more serious break, fragments may be splintered and displaced, and the fracture may be open, where bone pierces the skin. In this case, surgery is often required. Open reduction surgery uses a rod to secure the bone and a plate and screws to hold it in place. An external fixation uses a frame around the leg, which is screwed into the bone.
Once the fracture is healed, the patient begins physical therapy, including non-weight- bearing exercises or hydrotherapy exercises. Manual therapy can help restore normal movement if there is ankle stiffness.
Complications of a Broken Leg
Sometimes the two broken ends of a fractured tibia don’t come together normally, causing a longer hospital stay. Serious complications include a missed torn artery, compartment syndrome (increased pressure in the tightly-restrictive compartments of the lower leg), and peroneal nerve injury causing foot drop, creating an abnormal gait. Pressure syndrome can restrict oxygen to muscles and nerves, causing gangrene, amputation, or death. Infections from open wounds can be resistant to treatment. Fat particles from the tissues of the leg may enter the blood stream and clog vessels. Casts sometimes interfere with circulation, compounding compartment syndrome if it occurs.
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