Tibia and Fibula Fracture

What are tibia and fibula fractures?

Tibia (shin bone) and fibula (calf bone) fractures are two broken bones in your lower leg caused by major trauma that puts more pressure on your bones than they can handle.

Because they occur due to trauma like car accidents or falls, people often break both their tibias and fibulas during the same injury. It’s rare, but you can fracture either your tibia or your fibula without breaking the other.

Lower leg bone fractures are major injuries that need medical attention right away. You might need surgery to repair your bones and physical therapy to regain your ability to move your leg. But with time, your tibia and fibula should heal completely.

Types of tibia and fibula fractures

Your healthcare provider will assign the fracture a type or classification depending on how your tibia or fibula is broken. They classify some fractures by the shape or pattern of the break line:

• Transverse fracture.
• Oblique fracture.
• Spiral fracture.
• Segmental fracture.
• Comminuted fracture.

They classify some types of fractures by how they happen:

• Compound fracture (open fracture).
• Stress fracture.
• Avulsion fracture.

Other types of tibia and fibula fractures include:

• Tibia plateau fractures: When you break your tibia close to your knee and it damages your knee joint.
• Displaced tibia and fibula fractures: A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke.
• Non-displaced tibia and fibula fractures: Non-displaced fractures are still broken bones, but the pieces didn’t move far enough to be out of alignment during the break.
• Distal fractures: Distal is the end of a bone that’s further away from the middle of your body (trunk). If you have a distal tibia fracture, it means your shin bone is broken closer to your ankle.
• Proximal fractures: Proximal is the end of a bone that’s closer to your trunk. If you have a proximal fibula fracture, your calf bone is broken near the end that connects to your knee.

What are the symptoms of a tibia or fibula fracture?

Symptoms of tibia and fibula fractures include:

• Pain.
• Swelling (edema).
• Tenderness.
• An inability to move your leg like you usually can.
• Bruising or skin discoloration.
• A deformity or bump that’s not usually on your body.

What causes tibia and fibula fractures?

Trauma almost always causes tibia and fibula fractures. Some of the most common causes include:

• Car accidents.
• Falls.
• Sports injuries.

You’re more likely to experience a fracture if osteoporosis weakens your bones. Osteoporosis makes your bones more susceptible to sudden and unexpected fractures. Many people don’t know they have osteoporosis until after it causes them to break a bone.

How are tibia and fibula fractures diagnosed?

A healthcare provider will diagnose a tibia or fibula fracture with a physical exam and imaging tests. In some cases, this may be done in the emergency room (ER) if you’re admitted after trauma.

If you’re taken to the ER, a team of providers stabilize you and treat your injuries in the order of severity, especially if some are life-threatening. After you’re stabilized, you’ll need imaging tests to confirm the fracture.

What tests are done to diagnose tibia and fibula fractures?

You’ll need at least one of a few imaging tests to take pictures of your fracture:

• X-rays: X-rays confirm which of your lower leg bones are fractured. They also show how displaced the bones are.
• MRI scan: It’s rare, but your provider might use an MRI (magnetic resonance imaging) to get a complete picture of the damage to your bones and the area around them
• CT scan: A CT (computed tomography) scan will give your provider or surgeon a more detailed picture of your bones and the surrounding tissue than an X-ray.

How are tibia and fibula fractures treated?

Treatment for a tibia/fibula fracture depends on which type it is, what caused it and how damaged your bones are. Treatment options include:

• Immobilization: If the break is mild and your bones didn’t move far out of place (if it’s non-displaced), you might only need a splint or cast. In both cases, you’ll likely need follow-up X-rays.
• Closed reduction: More severe breaks require a closed reduction to set (realign) your bones. It’s not surgery. Your provider lines up your broken bones by pushing and pulling them into place.
• Internal fixation: Fixation is surgery to repair a fracture. Your surgeon realigns your bones to their correct positions and secures them in place so they can heal and grow back together.
• External fixation: Your surgeon puts screws in your bone on either side of the fracture inside your body. Then, they connect the screws to a brace or bracket outside your body.
• Physical therapy: After surgery, you’ll need to work with a physical therapist to help increase your strength, flexibility and mobility.

Complications of tibia and fibula fracture treatment

Fracture surgery complications include:

• Acute compartment syndrome (ACS): A buildup of pressure in your muscles may stop blood from getting to your tissue, which can cause permanent muscle and nerve damage.
• Malunion: This happens when your broken bones don’t line up correctly while they heal.
• Nonunion: Your bones may not grow back together fully or at all.
• Bone infection (osteomyelitis): If you have an open fracture (the bone breaks through your skin), you have an increased risk of bacterial infection.
• Other internal damage: Fractures can damage the area around the injury, including your muscles, nerves, blood vessels, tendons and ligaments.

How can I reduce my risk for tibia and fibula fractures?

Follow these general safety tips to reduce your risk of an injury:

• Always wear your seatbelt.
• Wear the right protective equipment for all activities and sports.
• Make sure your home and workspace are free of clutter that could trip you or others.
• Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
• Talk to your provider about a bone density test if you’re 50 or older, or if you have a family history of osteoporosis.
• Use a cane or walker if you have difficulty walking or have an increased risk of falls.

What can I expect if I experience a tibia or fibula fracture?

It might take a few weeks for your symptoms to start to improve after treatment. Depending on which type of surgery you had to repair your fracture — and which of your two lower leg bones were broken — you should be able to start moving again in a few weeks. Contact your healthcare provider right away if you experience intense pain that doesn’t get better. Most people make a full recovery.

How long does it take tibia and fibula fractures to heal?

How long it takes you to heal depends on the severity of your fracture and which treatments you needed. Most tibia or fibula fractures will heal completely in four to six months.

There are lots of factors that can affect how long it takes your body to heal. Talk to your provider or surgeon about a timeline that fits your specific situation.

When should I go to the emergency room?

If you think you have a tibia or fibula fracture — or any other broken bone — you need to see a healthcare provider as soon as possible. Go to the emergency room if you experience any of the following:

• Intense pain.
• You can’t move your leg like usual.
• Your leg looks noticeably different or is out of its usual place.
• You can see your bone through your skin.
• Swelling.
• New bruising that appears at the same time as any of these other symptoms.

Go to the emergency room right away if you’ve experienced trauma.

Which questions should I ask my healthcare provider?

Questions you may want to ask your provider include:

• Which bones are fractured?
• What type of fracture do I have?
• Will I need surgery?
• How long will it take to recover?
• When can I resume physical activities or play sports?

Can you walk on a fractured tibia or fibula?

Your ability to walk and move with a fracture in your lower leg depends on which bone is broken, what type of fracture it is and what kind of trauma caused the break.

Your fibula isn’t weight-bearing (it doesn’t support your body when you stand or move), so some people can walk with a fracture. However, you shouldn’t ignore pain or other symptoms in your leg. Even if you can move or walk, you should get your injury examined by your provider or in the ER right away.

It’s unlikely that you’ll be able to stand, walk or put weight on your leg if you have a fractured tibia. Because it’s weight-bearing, it’s especially important that you don’t try to “play through the pain” or ignore any symptoms.

If you were in a trauma and you experience symptoms, go to the ER right away.