Usually referred to as the shin bone, the tibia is the major bone of the lower leg. Fractures of the tibia can happen from a variety of injuries and can come in different shapes and sizes. Treatment varies depending on the location of the fracture, the displacement of the fracture, the alignment of the fracture, and any injuries associated with it. An individual can experience a cracked tibia through a low-energy incident, such as a fall, or through a high-energy incident, such as a sporting injury, a car accident, or any other type of rigorous activity.
I am no stranger to this type of fracture. I sustained a fracture of my right tibia a few years ago when I was actively engaged in the sport of kick boxing. I also had a ripped meniscus associated with this injury. Due to my commitment to and love of the sport, I refused to stop practicing; enduring through the pain (and misery) until one day I could not take it anymore. Needless to say, upon examination by a surgeon, my kick boxing days came to an abrupt halt and I endured some surgery to correct the situation.
Tibia fractures can be separated into three categories, depending upon the location of the fracture:
1.) Tibial Shaft Fracture – The most common type of tibial fracture, these occur in the area between the knee and the ankle joints. These can usually be treated with a long leg cast. Those fractures that have significant displacement may require surgery to secure and realign the bones.
2.) Tibial Plateau Fracture – These happen just below the knee joint. Fractures of this nature require that the knee joint and its cartilage surface be taken into consideration. With this type of tibial fracture, there is the added risk of developing arthritis in the knee.
3.) Tibial Plafond Fracture – These occur a the bottom of the shin bone near the ankle joint. Because of the ankle cartilage surface, this type of fracture also requires special consideration. This type of fracture can also contribute to damage in the surrounding soft tissue areas.
Symptoms of a cracked tibia include pain upon bearing weight on the affected extremity. You may also notice tenseness near the knee which can limit mobility. My knee was so swollen that it resembled a deformed grapefruit. The embarrassment of that alone led me to see a physician! Your foot may become pale or feel cool, indicative of a potential impairment of blood supply. Your foot may feel numb or like pins and needles. My foot always felt numb, as we did our kick boxing routines barefoot. I foolishly ignored my symptoms while heeding the call of my instructor who told me to work through the pain. I do not necessarily recommend that approach to people.
With the most common type of tibia fracture, the shaft fracture, typical treatment includes a cast that goes above the knee and below the ankle, also known as a long leg cast. When these types of fractures are placed in a cast, they generally heal well, and casting avoids the added risk that surgery might allow for, such as infection. With a cast, it is important to make sure the bones maintain their proper alignment.
Another treatment method is the use of intrameduallary rodding, which is a metal rod that is placed down the center of the tibia so that the alignment of the bone can be held. This is an invasive procedure. These rods are secured with screws both above and below the fracture and can be left in place for life. However, if the screws and the rod cause problems, they can be removed. These rods do provide for excellent alignment of the bones. Risks of this type of surgery include knee pain and infection.
Although less commonly used, plates and screws are helpful with some fracture types, mainly with those that are located closer to the knee or ankle joints.
Also helpful with some fracture types is an external fixator, which is used for more severe cases, such as those with open fractures, lacerations, and soft tissue damage. With severe soft tissue damage, the external fixator allows for superior immobilization so that the soft tissues can be treated effectively.
Recovery from a cracked tibia takes time, depending on its severity and treatment plan. Fortunately for me, I was back to my running routine within two weeks. I did discover a love for swimming and cycling during my recuperation phase. I miss the stimulation of kick boxing, however. I practiced regularly and was well on my way to becoming a force with which to be reckoned…grapefruit knee and all!
(Information for this article was found at http://orthoinfo.aaos.org/topic.cfm?topic+A00393 and http://orthopedics.about.com/od/brokenbones/a/tibia.htm)