Fractures of the Tibia and Fibula

Question 1

what is a fracture?

Answer 1

this is a break in the continuity of a bone.

Question 2

what are the common causes of fractures?

Answer 2

Trauma
overuse
osteomyelitis

Question 3

what fracture is the most common in children?

Answer 3

Tibial which account for 10 to 15%

Question 4

what bone is the largest between the tibial and fibula?

Answer 4

Tibial is the largest and is medial while fibula is smaller and is more lateral.

Question 5

why can their fractures be characterized as being low energy or high energy?

Answer 5

low energy are nondisplaced ones, commonly called toddlers fractures occur from minor falls.

high energy are those caused by serious car accidents or extremely high falls.

Question 6

what is the second longest bone in the body?

Answer 6

Tibial

Question 7

which bone is your calf bone?

Answer 7

Fibula which gives your calf its structure and forms the top of your ankle.

Question 8

what are proximal tibial epiphyseal fractures?

Answer 8

these occur in the knee end of the tibial and are also called plateau fractures

Question 9

what are proximal tibial epiphyseal fractures?

Answer 9

these occur in the knee end of the tibial and are also called plateau fractures

Question 10

what are the fractures that fall under the proximal tibial fractures?

Answer 10

Proximal Tibial Epiphyseal Fracture: This type of fracture affects the top portion of the bone (epiphysis) and the growth plate. Separation of the growth plate from the bone is usually caused by direct force to the knee. It’s important to have this type of fracture corrected properly. It may affect future growth and cause deformities

Proximal Tibial Metaphyseal Fracture (Cozen’s Fracture): This fracture affects the “neck” of the bone (metaphysis), where the tibia starts to narrow down. It is most common in children between the ages of two and eight. This injury can happen when force is applied to the side of the knee while the leg is extended.

Question 11

how would you treat an epiphysis and metaphysis fracture?

Answer 11

with an epiphysis, . Treatment usually consists of setting the bone without surgery, which in some cases may be accompanied by surgical insertion of special pins or screws to secure the tibia while it heals.

Metaphysis, It is typically treated by setting the bone without surgery and using a cast to reduce movement. The cast is usually worn for about six weeks. Valgus deformity (knock knee) is one of the main potential complications after this fracture

Question 12

which part if the tibia shaft is affected?

Answer 12

middle, or shaft (diaphysis), of the tibia

Question 13

what are the two tibial shaft fractures?

Answer 13

Nondisplaced: A fracture where the broken bones remain aligned. This type of fracture is usually seen in children under four. It can be caused by a mildly traumatic event or a twisting injury. Often, the first symptom is a limp

Displaced, noncomminuted: A fracture where the bones are broken in no more than two pieces (noncomminuted) but are not aligned. This is an isolated fracture of the tibia with an intact fibula.

Question 14

what is the most common tibial shaft fracture?

Answer 14

Displaced or noncomminuted

Question 15

on examination what does nondisplaced reveal?

Answer 15

Examination usually reveals tenderness or swelling at the lower part of the tibia.

Question 16

what treatment would be best for nondisplaced fracture?

Answer 16

the treatment typically involves immobilization in a short- or long-leg cast. The duration is three to four weeks for toddlers and six to 10 weeks for older children

Question 17

what treatment would be best for displaced/noncomminuted fractures?

Answer 17

Treatment includes setting the bone without surgery and a long-leg cast with the knee bent. Unstable displaced fractures may require surgery.

Question 18

what other shaft fracture is there?

Answer 18

Displaced, comminuted: A fracture where the bones are broken in several fragments and are not aligned. This fracture can be caused by high-energy trauma, such as a car accident or being struck by a vehicle

Question 19

what is the treatment for a comminuted one?

Answer 19

The treatment includes setting the bone without surgery and a long-leg cast worn for four to eight weeks. A short-leg weight-bearing cast maybe also be needed in some patients. Unstable fractures may need surgery to maintain alignment

Question 20

what are distal tibial fractures?

Answer 20

These fractures occur at the ankle end of the tibia. They are also called tibial plafond fractures

Question 21

how do distal tibial fractures run on the bone?

Answer 21

usually transverse (across) or oblique (slanted) breaks in the bone

Question 22

tibial and fibula fractures are more common in?

Answer 22

Athletes, runners or non athletes who suddenly increase their activity levels.

Question 23

what type of fractures happen to the fibula bone?

Answer 23

lat.malleolus fracture which is a break around the ankle.

fibular head fracture which is a break around the knee.

avulsion fracture, a small part of the bone gets pulled off.

stress fracture, a hairline fracture due to repetitive injury.

shaft fracture, a break that affects the midline of the leg due to direct impact.

Question 24

what are the signs and symptoms of a fracture?

Answer 24

pain
swelling entire leg or near fracture
deformity in affected part
tenderness
bruising
pain that gets worse when putting pressure on affected leg
tingling or numbness due to neurovascular injury

Question 25

how do you diagnose?

Answer 25

mainly done through physical examination and X-rays of lower extremities

for more detailed imaging the use of a CT scan and MRI is done.

Question 26

treatment?

Answer 26

setting the bone without surgery if possible.
use of special pins and screws to secure tibial while it heals.

Question 27

what are some of the complications that may occur in these fractures?

Answer 27

neurovascular compromise
compartment syndrome
peroneal nerve injury
infection
gangrene
osteomyelitis
delayed union, non union and malunion
amputation
skin loss