The tibia is a large bone located in the lower front portion of the leg. The tibia is also known as the shinbone, and is the second largest bone in the body. There are two bones in the shin area: the tibia and fibula, or calf bone. The fibula is smaller and thinner than the tibia. These two bones connect the ankle to the knee and work together to stabilize the ankle and provide support to the muscles of the lower leg; however, the tibia carries a significant portion of the body weight.
High-energy collisions, such as an automobile or motorcycle crash, are common causes of tibial shaft fractures. In cases like these, the bone can be broken into several pieces. Sports injuries, such as a fall while skiing or running into another player during soccer, are lower-energy injuries that can cause tibial shaft fractures. These fractures are typically caused by a twisting force and result in an oblique or spiral type of fracture.
The most common symptoms of a tibial shaft fracture are:
- Inability to walk or bear weight on the leg
- Deformity or instability of the leg
- Bone "tenting" the skin or protruding through a break in the skin
Types of Tibial Shaft Fractures
The tibia can break in several ways. The severity of the fracture usually depends on the amount of force that caused the break. Common types of tibial fractures include:
- Stable fracture: This type of fracture is barely out of place. The broken ends of the bones basically line up correctly and are aligned. In a stable fracture, the bones usually stay in place during healing.
- Displaced fracture: When a bone breaks and is displaced, the broken ends are separated and do not line up. These types of fractures often require surgery to put the pieces back together.
- Transverse fracture: This type of fracture has a horizontal fracture line. This fracture can be unstable, especially if the fibula is also broken.
- Oblique fracture: This type of fracture has an angled pattern and is typically unstable. If an oblique fracture is initially stable or minimally displaced, over time it can become more out of place. This is especially true if the fibula is not broken.
- Spiral fracture: This type of fracture is caused by a twisting force. The result is a spiral-shaped fracture line about the bone, like a staircase. Spiral fractures can be displaced or stable, depending on how much force causes the fracture.
- Comminuted fracture: This type of fracture is very unstable. The bone shatters into three or more pieces.
- Open fracture: When broken bones break through the skin, they are called open or compound fractures. For example, when a pedestrian is struck by the bumper of a moving car, the broken tibia may protrude through a tear in the skin and other soft tissues.
- Closed fracture: With this injury, the broken bones do not break the skin. Although the skin is not broken, internal soft tissues can still be badly damaged. In extreme cases, excessive swelling may cut off blood supply and lead to muscle death, and in rare cases, amputation.
How long it takes to return to daily activities varies with different types of fractures. Some tibial shaft fractures heal within 4 months, yet many may take 6 months or longer to heal. This is particularly true with open fractures and fractures in patients who are less healthy. Pain after an injury or surgery is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover faster.