Fixation of tibia fracture
The best treatment for your tibia fracture is determined by a variety of factors including your age, past and present health, the location and severity of the fracture and your history with various medications and treatments. Tibia fracture, which is a partial or complete break in the shinbone, can be caused by trauma or stress from overuse.
A tibia fracture can be extremely painful, and depending on the severity, it may immobilize you. If you have any reason to suspect that you may have a fracture of any size in your shinbone, it is important to seek medical attention so it does not worsen. To best diagnose your condition, the doctor will talk to you about your activity and recent trauma (if any) and perform a physical exam. To further determine the severity of the fracture, the following techniques may be used:
- X-ray (radiograph) – This is typically the first test done because it gives the best overview of the skeletal system. It is conducted by using electromagnetic radiation that passes through your body and produces images of your shinbone, knee and ankle area to determine the extent of the injury. When bone absorbs the radiation it stands out on an X-ray, making it easier to see where there are breaks in the bone.
- Computed tomography scan (CT or CAT scan) – A CAT scan uses X-ray technology combined with computer technology to enhance the image provided. This may be used in more complicated fractures.
- Magnetic resonance imaging (MRI) – In some cases, when the fracture is severe or when it is thought to have spread to other areas of the bone or surrounding joints, an MRI may be used for better imaging. This is done by placing you inside a vessel. Magnetic waves create vibrations inside the vessel which are then transposed into a high-definition computer-generated image.
If the tibia fracture is minor with partial breakage that does not spread into any surrounding joints, it often can be treated without the need for surgery. In many cases, this breakage can be repaired using the traditional casting method to immobilize the bone and allow it to heal naturally. A person will generally be asked to use crutches to limit the amount of weight put on the bone as it heals.
In some cases, a tibia fracture requires surgery. The aim of tibia fracture surgeries is to reconnect the bone and keep it in place as it heals. Most tibia fractures are treated using one of three techniques:
- Intramedullary rodding – This surgery involves placing a large rod down the center of the tibia to hold it in alignment as it heals. The rod or rods used in this surgery are secured using screws to keep the bone stable. Incisions are made by the knee and ankle bones and in some occasions at the site of the fracture as well.
- Plates and screws – These generally are not used as often as the rod approach is, but for fractures near the surrounding joints they are used to help stabilize the fracture and help it to heal correctly. This type of surgery is used mostly in tibia plateau and tibia plafond fractures, or fractures near the joint.
- External fixator – In fractures that involve any soft tissue damage or extensive injury, an external fixator is usually the best option. This surgery includes stabilizing the joint and allowing the surgeon to keep an eye on the soft tissues as the injury heals.
The multidisciplinary team of trauma and fracture experts at North Shore-LIJ Orthopaedic Institute performs tibia fracture surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones.
Many tibia fractures occur because of overuse by an athlete. Because of this, there has been significant research in the sports medicine world on how to help stop these stress fractures in the shinbone.
In a study conducted by the University of Minnesota, female runners and competitive athletes were analyzed over a period of time. The study’s authors initially wanted to see if stress fractures were more common in women who had previously experienced these same injuries, as many researchers suggested. They also measured the size of the calf and shinbone to better understand if this had any relevance on whether the participants sustained stress fractures due to exercise. As a result, they found that those who had suffered from previous fractures actually had stronger bones and that people with stronger calf muscles experienced fewer injuries. In other studies conducted on men, these findings appeared to be true as well.
Another factor was stride length. In one study done by Iowa State University, researchers found that even a slight reduction of only 10 percent in stride distance while maintaining the same pace put significantly less pressure on the shinbone and caused fewer fractures in the long run.
As research on sports medicine is ongoing, it is a good idea for your conversation about it with your doctor to be ongoing as well.