Louie KW. Management of open fractures of the lower limb. BMJ. 2009 Dec 17. 339:b5092. [QxMD MEDLINE Link].
Krieg JC. Proximal tibial fractures: current treatment, results, and problems. Injury. 2003 Aug. 34 Suppl 1:A2-10. [QxMD MEDLINE Link].
Louie KW. Management of open fractures of the lower limb. BMJ. 2009 Dec 17. 339:b5092. [QxMD MEDLINE Link].
Miller NC, Askew AE. Tibia fractures. An overview of evaluation and treatment. Orthop Nurs. 2007 Jul-Aug. 26(4):216-23; quiz 224-5. [QxMD MEDLINE Link].
Newton EJ, Love J. Emergency department management of selected orthopedic injuries. Emerg Med Clin North Am. 2007 Aug. 25(3):763-93, ix-x. [QxMD MEDLINE Link].
Allmon C, Greenwell P, Paryavi E, Dubina A, OʼToole RV. Radiographic Predictors of Compartment Syndrome Occurring After Tibial Fracture. J Orthop Trauma. 2016 Jul. 30 (7):387-91. [QxMD MEDLINE Link].
Wuarin L, Gonzalez AI, Zingg M, et al. Clinical and radiographic predictors of acute compartment syndrome in the treatment of tibial shaft fractures: a retrospective cohort study. BMC Musculoskelet Disord. 2020 Jan 13. 21 (1):25. [QxMD MEDLINE Link].
Beebe MJ, Auston DA, Quade JH, Serrano-Riera R, Shah AR, Watson DT, et al. OTA/AO Classification Is Highly Predictive of Acute Compartment Syndrome After Tibia Fracture: A Cohort of 2885 Fractures. J Orthop Trauma. 2017 Nov. 31 (11):600-605. [QxMD MEDLINE Link].
Busel GA, Watson JT, Israel H. Evaluation of Fibular Fracture Type vs Location of Tibial Fixation of Pilon Fractures. Foot Ankle Int. 2017 Jun. 38 (6):650-655. [QxMD MEDLINE Link].
AO/OTA Fracture and Dislocation Classification. AO Foundation. Available at https://www.aofoundation.org/Structure/resource/AO-OTA-Fracture-Dislocation-Classification/Pages/AO-OTA-Fracture-Dislocation-Classification-Long-Bones.aspx. 2014; Accessed: November 30, 2017.
Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968--1975. Clin Orthop Relat Res. 1979 Jan-Feb. 94-104. [QxMD MEDLINE Link].
Court-Brown CM, Rimmer S, Prakash U, McQueen MM. The epidemiology of open long bone fractures. Injury. 1998 Sep. 29(7):529-34. [QxMD MEDLINE Link].
Howard M, Court-Brown CM. Epidemiology and management of open fractures of the lower limb. Br J Hosp Med. 1997 Jun 4-17. 57(11):582-7. [QxMD MEDLINE Link].
Grottkau BE, Epps HR, Di Scala C. Compartment syndrome in children and adolescents. J Pediatr Surg. 2005 Apr. 40(4):678-82. [QxMD MEDLINE Link].
Yang JP, Letts RM. Isolated fractures of the tibia with intact fibula in children: a review of 95 patients. J Pediatr Orthop. 1997 May-Jun. 17(3):347-51. [QxMD MEDLINE Link].
Adamich JS, Camp MW. Do toddler's fractures of the tibia require evaluation and management by an orthopaedic surgeon routinely?. Eur J Emerg Med. 2017 Jun 16. [QxMD MEDLINE Link].
Rozell JC, Vemulapalli KC, Gary JL, Donegan DJ. Tibial Plateau Fractures in Elderly Patients. Geriatr Orthop Surg Rehabil. 2016 Sep. 7 (3):126-34. [QxMD MEDLINE Link].
Tibia and Fibula Fractures in Children. https://www.hopkinsmedicine.org. Available at https://www.hopkinsmedicine.org/healthlibrary/conditions/orthopaedic_disorders/tibia_and_fibula_fractures_22,TibiaandFibulaFractures.
Haber DB, Tepolt FA, McClincy MP, et al. Tibial tubercle fractures in children and adolescents: a large retrospective case series. J Pediatr Orthop B. 2021 Jan. 30 (1):13-18. [QxMD MEDLINE Link].
Meyers AL, Nelson R. Tibial Eminence Fractures. 2022 Jan. [QxMD MEDLINE Link]. [Full Text].
Thabet AM, Craft M, Pisquiy J, Jeon S, Abdelgawad A, Azzam W. Tibial shaft fractures in the adolescents: treatment outcomes and the risk factors for complications. Injury. 2022 Feb. 53 (2):706-712. [QxMD MEDLINE Link].
Mousa AEM, Mousa M, Singisetti K. Peroneal artery safe zone in the posterolateral approach to the distal tibia: a CT angiogram based anatomical study. Injury. 2022 Mar. 53 (3):1268-75. [QxMD MEDLINE Link].
Horwitz DS, Kubiak EN. Surgical treatment of osteoporotic fractures about the knee. Instr Course Lect. 2010. 59:511-23. [QxMD MEDLINE Link].
Hannon M, Hadji*zacharia P, Chan L, Plurad D, Demetriades D. Prognostic significance of lower extremity long bone fractures after automobile versus pedestrian injuries. J Trauma. 2009 Dec. 67(6):1384-8. [QxMD MEDLINE Link].
Mustonen AO, Koskinen SK, Kiuru MJ. Acute knee trauma: analysis of multidetector computed tomography findings and comparison with conventional radiography. Acta Radiol. 2005 Dec. 46(8):866-74. [QxMD MEDLINE Link].
Dodd A, Oddone Paolucci E, Korley R. The effect of three-dimensional computed tomography reconstructions on preoperative planning of tibial plateau fractures: a case-control series. BMC Musculoskelet Disord. 2015 Jun 13. 16:144. [QxMD MEDLINE Link].
Bartoníček J, Rammelt S, Kašper Š, Malík J, Tuček M. Pathoanatomy of Maisonneuve fracture based on radiologic and CT examination. Arch Orthop Trauma Surg. 2019 Apr. 139 (4):497-506. [QxMD MEDLINE Link].
Mellema JJ, Doornberg JN, Molenaars RJ, Ring D, Kloen P, Traumaplatform Study Collaborative & Science of Variation Group. Tibial Plateau Fracture Characteristics: Reliability and Diagnostic Accuracy. J Orthop Trauma. 2016 May. 30 (5):e144-51. [QxMD MEDLINE Link].
Chartier LB, Bosco L, Lapointe-Shaw L, Chenkin J. Use of point-of-care ultrasound in long bone fractures: a systematic review and meta-analysis. CJEM. 2017 Mar. 19 (2):131-142. [QxMD MEDLINE Link].
Kozaci N, Ay MO, Avci M, Turhan S, Donertas E, Celik A, et al. The comparison of point-of-care ultrasonography and radiography in the diagnosis of tibia and fibula fractures. Injury. 2017 Jul. 48 (7):1628-1635. [QxMD MEDLINE Link].
Kozaci N, Avci M, Yuksel S, et al. Comparison of diagnostic accuracy of point-of-care ultrasonography and X-ray of bony injuries of the knee. Eur J Trauma Emerg Surg. 2022 Aug. 48 (4):3221-7. [QxMD MEDLINE Link].
Accousti WK, Willis RB. Tibial eminence fractures. Orthop Clin North Am. 2003 Jul. 34(3):365-75. [QxMD MEDLINE Link].
Roddy E, Patterson JT, Kandemir U. Delay of Antibiotic Administration Greater than 2 Hours Predicts Surgical Site Infection in Open Fractures. Injury. 2020 May 12. [QxMD MEDLINE Link].
Campbell S, Dhyani J, Greenberg P, Ahmed N. Outcomes in patients with late debridement of open long bone fractures of the lower extremities in penetrating trauma: a retrospective review of the National Trauma Data Bank. Eur J Orthop Surg Traumatol. 2020 Apr 23. [QxMD MEDLINE Link].
Zhao J, Yang J, He X, et al. Etiological spectrum and treatment outcome of wound infection in patients with open tibia and fibula fractures. Am J Transl Res. 2022. 14 (10):7208-16. [QxMD MEDLINE Link].
Sears ED, Davis MM, Chung KC. Relationship between timing of emergency procedures and limb amputation in patients with open tibia fracture in the United States, 2003 to 2009. Plast Reconstr Surg. 2012 Aug. 130(2):369-78. [QxMD MEDLINE Link]. [Full Text].
Lee A, Geoghegan L, Nolan G, et al. Open tibia/fibula in the elderly: a retrospective cohort study. JPRAS Open. 2022 Mar. 31:1-9. [QxMD MEDLINE Link].
Konstantakos EK, Dalstrom DJ, Nelles ME, Laughlin RT, Prayson MJ. Diagnosis and management of extremity compartment syndromes: an orthopaedic perspective. Am Surg. 2007 Dec. 73(12):1199-209. [QxMD MEDLINE Link].
McQueen MM, Gaston P, Court-Brown CM. Acute compartment syndrome. Who is at risk?. J Bone Joint Surg Br. 2000 Mar. 82(2):200-3. [QxMD MEDLINE Link].
Taylor RM, Sullivan MP, Mehta S. Acute compartment syndrome: obtaining diagnosis, providing treatment, and minimizing medicolegal risk. Curr Rev Musculoskelet Med. 2012 Sep. 5 (3):206-13. [QxMD MEDLINE Link].
Ziran BH, Becher SJ. Radiographic predictors of compartment syndrome in tibial plateau fractures. J Orthop Trauma. 2013 Nov. 27 (11):612-5. [QxMD MEDLINE Link].
Schmidt AH. Acute compartment syndrome. Injury. 2017 Jun. 48 Suppl 1:S22-S25. [QxMD MEDLINE Link].
Malhotra K, Pai S, Radcliffe G. Do minimally displaced, closed tibial fractures in children need monitoring for compartment syndrome?. Injury. 2014 Jun 6. [QxMD MEDLINE Link].
Wong MT, Bourget-Murray J, Johnston K, Desy NM. Understanding the role of total knee arthroplasty for primary treatment of tibial plateau fracture: a systematic review of the literature. J Orthop Traumatol. 2020 May 25. 21 (1):7. [QxMD MEDLINE Link].
Pretell-Mazzini J, Kelly DM, Sawyer JR, Esteban EM, Spence DD, Warner WC Jr, et al. Outcomes and Complications of Tibial Tubercle Fractures in Pediatric Patients: A Systematic Review of the Literature. J Pediatr Orthop. 2015 Apr 10. [QxMD MEDLINE Link].
Vuurberg G, Dahmen J, Dobbe IGG, et al. Lower leg symmetry: a Q3D-CT analysis. Surg Radiol Anat. 2022 Jun. 44 (6):851-60. [QxMD MEDLINE Link].
Grottkau BE, Epps HR, Di Scala C. Compartment syndrome in children and adolescents. J Pediatr Surg. 2005 Apr. 40(4):678-82. [QxMD MEDLINE Link].
Casstevens C, Le T, Archdeacon MT, Wyrick JD. Management of extra-articular fractures of the distal tibia: intramedullary nailing versus plate fixation. J Am Acad Orthop Surg. 2012 Nov. 20(11):675-83. [QxMD MEDLINE Link].
Fredericson M, Jennings F, Beaulieu C, Matheson GO. Stress fractures in athletes. Top Magn Reson Imaging. 2006 Oct. 17(5):309-25. [QxMD MEDLINE Link].
Germann CA, Perron AD, Sweeney TW. Orthopedic pitfalls in the ED: tibial plafond fractures. Am J Emerg Med. 2005 May. 23(3):357-62. [QxMD MEDLINE Link].
Haller PR, Harris CR. The tibia and fibula. Emergent Management of Skeletal Injuries. St Louis: Mosby-Year Book; 1995. 499-517.
Harris IA, Kadir A, Donald G. Continuous compartment pressure monitoring for tibia fractures: does it influence outcome?. J Trauma. 2006 Jun. 60(6):1330-5; discussion 1335. [QxMD MEDLINE Link].
Harris IA, Kadir A, Donald G. Continuous compartment pressure monitoring for tibia fractures: does it influence outcome?. J Trauma. 2006 Jun. 60(6):1330-5; discussion 1335. [QxMD MEDLINE Link].
He B, Wang J. Plate fixation of paediatric fractures of the distal tibia and fibula. Acta Orthop Belg. 2012 Oct. 78(5):660-2. [QxMD MEDLINE Link].
Khalily C, Behnke S, Seligson D. Treatment of closed tibia shaft fractures: a survey from the 1997 Orthopaedic Trauma Association and Osteosynthesis International--Gerhard Kuntscher Kreis meeting. J Orthop Trauma. 2000 Nov. 14(8):577-81. [QxMD MEDLINE Link].
McKoy BE, Stanitski CL. Acute tibial tubercle avulsion fractures. Orthop Clin North Am. 2003 Jul. 34(3):397-403. [QxMD MEDLINE Link].
Ritsema TS, Kelen GD, Pronovost PJ, Pham JC. The national trend in quality of emergency department pain management for long bone fractures. Acad Emerg Med. 2007 Feb. 14(2):163-9. [QxMD MEDLINE Link].
Roberts DM, Stallard TC. Emergency department evaluation and treatment of knee and leg injuries. Emerg Med Clin North Am. 2000 Feb. 18(1):67-84, v-vi. [QxMD MEDLINE Link].
Russell TA. Fractures of the tibia and fibula. Fractures in Adults. 4th ed. Philadelphia, Pa: Lippincott-Raven; 1996. 2127-2201.
Sproule JA, Khalid M, O'Sullivan M. Outcome after surgery for Maisonneuve fracture of the fibula. Injury. 2004 Aug. 35(8):791-8. [QxMD MEDLINE Link].
Taketomo CK, Hodding JH, Kraus DM. Naproxen. Pediatric Dosage Handbook. 1999-2000. Vol 6.: 632-633.
Costa ML, Achten J, Bruce J, Tutton E, Petrou S, Lamb SE, et al. Effect of Negative Pressure Wound Therapy vs Standard Wound Management on 12-Month Disability Among Adults With Severe Open Fracture of the Lower Limb: The WOLLF Randomized Clinical Trial. JAMA. 2018 Jun 12. 319 (22):2280-2288. [QxMD MEDLINE Link].
Avci M, Kozaci N, Tulubas G, Caliskan G, Yuksel A, Karaca A, et al. Comparison of Point-of-Care Ultrasonography and Radiography in the Diagnosis of Long-Bone Fractures. Medicina (Kaunas). 2019 Jul 9. 55 (7):[QxMD MEDLINE Link].
FAQs
What is the proper management of a tibia fibula fracture? ›
Treatment Options for Tibia and Fibula Fractures
Closed reduction and immobilization: Setting the bone in place without surgery, and immobilization in a long-leg or a short-leg cast.
Tibia and Fibula Fracture Management in the ED Medication: Nonsteroidal anti-inflammatory agents (NSAIDs), Analgesics, Immunoglobulins, Vaccines, Inactivated, Bacterial.
What is the best pain relief for a fractured fibula? ›For the initial management of pain in adults (16 or over) with suspected long bone fractures of the legs (tibia, fibula) or arms (humerus, radius, ulna), offer: oral paracetamol for mild pain. oral paracetamol and codeine for moderate pain.
What is the best pain reliever for a bone fracture? ›Post-operatively, rest, ice, and elevation is recommended. Medications begin with acetaminophen 500mg every 4-6 hours and a long-acting NSAID such as naproxen every 12 hours. For patients with a higher pain experience, gabapentin 100mg every 8 hours can also be added to the multi-modal standing pain regimen.
Can you walk on a fractured fibula and tibia? ›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.
How long does it take to walk after a broken tibia and fibula? ›Aim for full weight bearing 10-12 weeks. Encourage active rehab from 8 weeks +.
How long does it take for a tibia fibula fracture to heal? ›Recovery from a tibia-fibula fracture typically takes about three to six months. Your child may be able to heal faster by resting and not putting too much weight on their leg until the bone has healed.
Can you walk on a fractured tibia? ›A tibial shaft fracture usually causes immediate, severe pain. Other symptoms may include: Inability to walk or bear weight on the leg. Deformity or instability of the leg.
Can you walk on a fractured fibula? ›Can you walk on a fractured fibula? It is not recommended to walk on a fractured fibula without proper medical attention and evaluation. A fractured fibula can cause pain, swelling, and instability in the ankle and leg, and walking on it can worsen the injury and delay healing.
How bad does a broken tibia and fibula hurt? ›Intense pain will be the initial symptoms that you will experience as a result of a fractured tibia and fibula. If the fracture is open (the skin is broken) there may also be bleeding. Closed fractures (the skin remains intact) often have bruising associated with them as key symptoms.
What not to do with a broken fibula? ›
Complete rest is not advisable but it is important that you prevent putting the ankle under strain in the early stages of healing. If necessary, you will be given crutches to help you take some weight off the injured ankle.
How can I speed up the healing of a broken fibula? ›Early weight bearing (putting weight through your injured leg) helps increase the speed of healing. Try to walk as normally as possible as this will help with your recovery. Medical evidence suggests that smoking prolongs fracture healing time. In extreme cases it can stop healing altogether.
Can gabapentin help with fracture pain? ›Either as an ongoing medical treatment of accompanying neurological disorders or as an effective agent administered to control pain, many patients treated for a fracture during daily clinical practice of traumatology have been using gabapentin.
What drugs accelerate bone healing? ›| Adjuvant Drugs | Effect on Bone Metabolism |
|---|---|
| Alendronate | act during several fracture healing stages; prevent bone resorption and increase bone mineralization |
| Ibandronate | |
| Pamidronate | |
| Zoledronate |
A pain reliever such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others), or a combination of the two, can reduce pain and inflammation.
What is the appropriate care for stress fractures of the tibia and fibula? ›Rest your leg as much as you can for as long as your doctor advises. Follow your doctor's instructions for using crutches, a brace, or a splint. Ask your doctor before you change your activity level or go back to your usual exercise. Too much activity or weight on the leg with the fracture can cause it to get worse.
What is the medical management of bone fracture? ›The most common sites for bone fractures are the wrist, ankle and hip. Treatment includes immobilising the bone with a plaster cast, or surgically inserting metal rods or plates to hold the bone pieces together. Some complicated fractures may need surgery and surgical traction.
How do you treat a fractured fibula bone? ›Distal fibular fractures will predominantly require open reduction surgical fixation, however in stable minimally displaced fractures conservative treatment may be followed with excellent results. If the fracture is open, additional management is warranted to reduce the risk of contamination and infection.