I suspect I have a tibia fracture. How did it happen?
Our skeleton is able to handle a lot of pressure, torsion and crushing forces. Your body constantly maintains the strong structure of your bones by producing new bone cells. A fracture is when there is a crack in a bone. This can be anything from a thin, hairline crack to a much more serious fracture where the bone shatters into two or more pieces. Keep in mind that the tibia is a very strong and sturdy bone. So, you need an immense force, like a fall or a car accident, to cause a tibia fracture. The location of the fracture determines how critical it is together with the degree of fragment separation. Your tibia is most vulnerable against twisting and rotational forces when combined with a crushing pressure your tibia bone doesn’t need much to break.
Classification of a fracture
- Stable or non-displaced fractures – also known as a clean break, the fragment pieces of the tibia line up.
- Displaced fracture – one part of the bone shifts, so the tibia isn’t aligned anymore. If the pieces don’t line up, the bone won’t heal properly. This type usually needs surgery.
- Stress fracture – small, hairline cracks form in the structure of the bone. This injury is caused by overuse i.e. constantly overloading the bone.
- Spiral fracture – caused by a forceful twisting movement, it causes a spiral-shaped fracture. The tibia usually doesn’t line up and this type of fracture requires surgery.
- Comminuted fracture – the bone shatters into three or more parts. This is a complex injury because the sharp ends of the broken bone can cause damage to nerves or blood vessels.
- Avulsion fracture – a ligament or tendon pulls a small piece of bone from the tibia. This usually happens where your patella tendon is anchored at the upper part of your tibia or on the inside of your ankle where important ankle ligaments attach onto the malleoli.
- Greenstick or incomplete fracture – when one side of the bone cracks and the opposite side bends without breaking. This injury is only found in children, because their bones are softer.
- Open vs closed fracture – when the skin and muscle over the tibia is torn, with a piece of the bone sticking out, it is called an open fracture.
It starts with an injury
Let’s say you were in an accident and now you have extreme pain in your lower leg. Your pain shoots through the roof the moment you try to walk. Now, you’re wondering if you have a tibia fracture.
The x-rays show that you have a tibia fracture
You are referred for x-rays and it shows a clear fracture of your tibia. The first thing your body does in response to a fracture is to cause an immediate and severe inflammatory reaction. This is an influx of repair cells to the injury site, all these cells accumulate causing a very powerful immune response leading to swelling and increased pressure and pain. Walking or stepping on your injured leg produce sudden, sharp, intense pain, because it compresses the fractured bone pieces together. The velocity of force needed to break your tibia bone is quite high, these fractured tibia segments tearing through blood vessels, and piercing muscle tissue, rupturing ligaments and cutting through nerves causing severe instant blue bruising and swelling.
It’s a serious injury
To have a broken tibia is a serious injury, the first priority is to get a clear X-ray of the broken tibia fragments and classify your fracture. Tibia fracture treatment is determined after you know the extent of the damage. Bone can grow back together again, but it will take time, discipline and effort. Often, surgery is necessary to fixate the different pieces of bone in the right position. If you continue walking with a tibia fracture, the movement between the bone fragments destroys the surrounding tissue which delays healing considerably.
It’s only a stress fracture
Let’s say your x-rays showed that you only have a hairline fracture or stress fracture. Often, an injury like this is caused by too much repetitive impact, combined with wringing forces that slowly breaks the tibia bone. This includes running and jumping. A stress fracture is not as serious and you certainly won’t need surgery, but you still need to fix how load is distributed through your leg. Chronic shin pain or shin splints eventually caves under the repetitive bone stress. A tibia stress fracture often leads to a full-blown fracture if repeated impact is continuous.
What if the x-rays showed it’s not a tibia fracture at all?
You can still have severe lower leg pain with soft tissue injuries. In fact, nerve and muscle damage is much more painful than a Tibia fracture because the bone has less ‘feeling’ due to less nerve innervation. Trauma to blood vessels, inflammation, swelling and bruising of the layers of soft tissue and muscles around your tibia can produce severe, intense lower leg pain.
Get your leg checked out if you suspect you have a fractured tibia, because it determines the type of treatment you need to recover. Our Physiotherapists can refer you for the necessary X-rays.