The shinbone or tibia is the long bone located in the lower leg between the knee and foot. Tibial fractures are common and usually caused by an injury or repetitive strain on the bone.
A fracture is another word for a break. In some cases, the only symptom of a small fracture is a pain in the shin while walking. In more severe cases, the tibia bone may protrude through the skin.
The recovery and healing time for tibial fractures differs and depends on the type and severity of the fracture. Fractures can be treated by a medical professional, and at-home exercises can speed up a person's recovery.
This article looks in detail at types of tibial fractures, along with the symptoms, treatment, and recovery times for a fractured tibia.
According to the American Academy of Orthopedic Surgeons, the tibia is the most common long bone in the body to fracture. A tibia fracture refers to any crack or breaks in the tibia bone.
The tibia is one of two bones that make up the lower leg, the other being the fibula. The tibia is the larger of these two bones.
The tibia plays a key role in body mechanics, as it is:
- the larger of the two lower leg bones
- responsible for supporting most of the body weight
- vital for proper knee and ankle joint mechanics
A fractured tibia often occurs with other kinds of tissue damage to the nearby muscles or ligaments. It should always be checked out by a medical professional.
Depending on the cause of the broken bone, the severity and type of fracture may vary. It may be a transverse fracture, meaning the crack is horizontal across the bone, or oblique, meaning the crack is at an angle.
Proximal fractures are those that affect the upper part of the tibia. Tibia shaft fractures occur below this area.
The tibia can have the following types of fracture:
- Stable fracture. A stable fracture involves a crack in the bone that leaves most of the bone intact and in its normal position. The broken parts of the tibia line up and maintain their correct position during the healing process. This is called a non-displaced fracture.
- Displaced fracture. With a displaced fracture, a crack in the bone moves part of the bone so that it is no longer aligned. Surgery is often needed to correct this type of fracture and realign the bones back together.
- Stress fracture. Stress fractures, also called hairline fractures, are common overuse injuries. These fractures are small, thin cracks in the bone.
- Spiral fracture. When a twisting movement causes a break, there may be a spiral-shaped fracture of the bone.
- Comminuted fracture. When the bone fractures into three or more pieces, this is called a comminuted fracture.
Below is a 3-D model of a stable fracture of the tibia.
This model is fully interactive and can be explored with your mouse pad or touchscreen.
When bones are broken, they can either stay under the skin or break through its surface. Open fractures are fractures where a broken bone breaks through the skin. With closed fractures, the bone does not break the skin, though there may still be internal tissue damage.
Long bones in the body are resilient, but there are many ways that a person can sustain a tibia fracture. These include:
- traumatic injuries, such as motor vehicle accidents or falls
- sports that involve repeated impact to the shinbones, such as long-distance running
- injuries from contact sports such as American football
- osteoporosis, which makes the bones weaker than usual
Symptoms of a fractured tibia may include:
- localized pain in one area of the tibia or several areas if there are multiple fractures
- lower leg swelling
- difficulty or inability to stand, walk, or bear weight
- leg deformity or uneven leg length
- bruising or discoloration around the shinbone
- sensation changes in the foot
- bone protruding through the skin
- a tent-like appearance where the skin is being pushed up by the bone
To diagnose a fractured tibia, a doctor will ask about a person's medical history and how the injury happened. They will do an examination and order diagnostic tests to assess the extent of the injury and whether the bone is fractured. This is important for determining the best course of treatment.
Diagnostic tests may include:
- an X-ray to have an image of the tibia
- a computed tomography (CT) scan, also called a CAT scan, which is more powerful than an X-ray and gives a 3-D image of the bone
- a magnetic resonance imaging (MRI) scan for a detailed image of the muscles, ligaments, and bones around the tibia
An MRI scan is often used if the other scans have not been able to diagnose the problem.
Treatment of a tibia fracture depends on several factors, including a person's overall health at the time of the injury, the cause and severity of the injury, and the presence or extent of damage to the soft tissues that surround the tibia.
In severe cases, surgery may be necessary to make sure the bone heals properly. A surgeon may place metal screws and plates on the bone to hold it in the right place, allowing it to heal with minimal long-term damage.
The surgeon may also use rods placed inside the tibia or pins placed through the bones above and below the fracture. They will attach these to a rigid frame called an external fixator to hold the bone in place.
Where surgery is not necessary or is not possible, for instance, due to a person's health, a doctor may use the following treatments for a fractured tibia:
- A splint or cast to hold the bone in place, stop it from moving and allow it to heal. A splint can be removed easily and so it is a more flexible treatment option than surgical ones.
- A traction or functional brace, which is used in cases of less severe breaks to hold the bone in place while it heals.
In many cases, a person with a tibial fracture will require physical therapy and crutches or a walker to help them get back on their feet.
Recovery from a tibial fracture varies based on the severity of the fracture.
A person will often recover within 4 to 6 months. Recovery time may be longer for a complete break compared to a partial one and may take longer if a person has poor health for other reasons.
It may take longer than this time frame for a person to be able to return to their normal activities. People should always follow their doctor's recommendations about returning to walking, exercising, and other physical activity after a leg fracture.
Certain exercises can help to take the pressure off the tibia bone, such as exercises that strengthen the hips, calves, and thighs. This protection may also prevent future injuries from happening.
Complications of a tibia fracture may include:
- complications from surgery or the need for further surgeries
- nerve, muscle, or blood vessel damage
- compartment syndrome, a serious condition which there is a reduction in blood supply to the leg due to swelling
- a bone infection called osteomyelitis
- development of a non-union where the bone does not heal
In many cases, a tibial fracture will be successfully managed without complication.
Fractures of the tibia or shinbone are common and can be caused by many types of situations. They can occur anywhere along the bone and include many variations in fracture type.
Fractures can be minor and take a short time to heal or more serious and require extensive surgery and healing times.
The long-term outlook for a tibia fracture is usually good but depends on the severity of the injury and other health-related factors. Doctors will be able to provide a person with a long-term outlook during the evaluation and healing process as their leg recovers.