The tibia, or shinbone, is the larger of the two bones in the lower leg. It’s one of the most commonly fractured bones in the body.
Symptoms of a fracture in your tibia can range from bruising to intense pain in your lower leg, based on the extent of your injury. To diagnose this type of injury, your doctor will do a physical exam and may run some tests to get an image of the tibia fracture.
Depending on the type of tibia fracture you have, your doctor may recommend surgery. Recovery time also depends on how bad the fracture is and can take from four to six months to heal.
Your symptoms will vary depending on how bad the fracture is. Symptoms may include:
- intense pain in your lower leg
- difficulty walking, running, or kicking
- numbness or tingling in your foot
- inability to bear weight on your injured leg
- deformity in your lower leg, knee, shin, or ankle area
- bone protruding through a skin break
- limited bending motion in and around your knee
- swelling around the site of your injury
- bruising and blueness on your injured leg
When the tibia is fractured, the other bone in the lower leg, called the fibula, is often affected as well.
The most common reasons for tibia fractures are:
- High-energy collisions: These typically involve motorcycle or automobile crashes and can result in the most severe fractures.
- Falls, especially from large heights and ones involving hard surfaces: This most commonly applies to the elderly, who may lack stability, and athletes.
- Twisting motions, such as pivoting: Sports such as snowboarding, skiing, and contact sports are a common cause of this type of injury.
If you suspect you have a tibia fracture, your doctor may refer you to an orthopedist. This is a specialist who diagnoses and treats abnormalities and injuries in the bones. If you also have foot and ankle problems, you may see a doctor called a podiatrist who specializes in those areas.
Your doctor will first ask you about your symptoms and a specific incident that may have caused the fracture, such as a fall or collision. They will also review your medical history to see if you have any risk factors for a tibia fracture or any prior injury. They will then perform a physical examination to look for:
- bruises, especially with lots of blueness and swelling
- instability when walking
- any obvious deformities, such as an abnormal bend or shortening of your leg
- any associated injury to your fibula
Your doctor will then perform a series of tests that check your muscle strength and whether you can feel sensation in the lower leg, foot, and ankle. They may also order the following tests to get a visual image of the fracture:
Depending on the extent of your injury, you may need emergency surgery. Conditions requiring surgery include the bone penetrating the skin, multiple broken bones, or injury to a major artery or nerve.
Doctors often classify tibia fractures into the following categories:
|Type of fracture||Description|
|stable fracture||The broken ends of the tibia line up correctly and stay in place during the healing process.|
|transverse fracture||The fracture is horizontal, and the bone can become unstable if the fibula is also broken.|
|displaced fracture||The tibia is moved out of place when it breaks. The broken ends of the bone are separated and don’t align. This type of fracture is fairly severe and may require surgery for full recovery.|
|oblique fracture||The bone fractures at an angle and is fairly stable. It may become more displaced over time, especially if the fibula is also broken.|
|comminuted fracture||The bone breaks into three or more separate pieces. This is the most unstable and severe type of tibia fracture.|
|spiral fracture||Often caused by a twisting force, this break causes a spiraling line to appear on the bone and may become unstable over time.|
Tibia fractures can also be closed or open. With closed fractures, the bone doesn’t break through the skin. Internal soft tissues such as tendons and blood vessels may be affected by this type of break.
In open fractures, the broken bone breaks through the skin. This usually only occurs during bad falls and vehicle accidents. Ligaments, muscles, tendons, and other soft tissue surrounding the fracture site are at risk of injury. Your body is more exposed to germs, increasing the risk of infection.
Your doctor will consider several factors when treating a tibia fracture, including:
- extent of the injury, taking into account the amount of damage to soft tissues
- the reasons for the injury
- overall health and medical history
- personal preferences
- any other fractures, such as a fibula fracture
Nonsurgical treatment of a fractured tibia includes:
- functional braces, which allow some movement of your leg
- pain medications, such as narcotics or anti-inflammatories
- physical therapy
- at-home exercises
According to a study published in the journal Injury, researchers are starting to investigate a potential nonsurgical treatment for fractures involving bone morphogenetic proteins. Research for this treatment is still in its early stages.
In certain cases, your doctor may recommend surgery. This is more likely if you have an open fracture, a comminuted fracture, or extreme instability in the bone or limb. Surgery may also be necessary if a combination of the nonsurgical treatments for fractured tibias don’t work. The following surgical procedures are most commonly used to treat tibia fractures:
- internal fixation, which involves using screws, rods, or plates to hold the tibia together
- external fixation, which connects screws or pins in the fracture to a metal bar outside your leg for added stability
Typically, these surgical methods are accompanied by physical therapy, at-home exercises, and pain medication. Small risks are associated with these surgeries. Ask your doctor to discuss these risks with you before your surgery.
Recovery time depends on the extent and type of fracture. Some shaft fractures of the tibia take as little as four months to heal, with more extreme cases taking a minimum of six months to heal. Your overall health and the extent of your fracture will influence your recovery time.
Tibia fractures are painful and common. Recovery rarely requires more than 12 months. If you suspect you have a tibia fracture, schedule an appointment with your doctor right away to get it evaluated, or go to an emergency room.