Shinbone Fracture
En Español (Spanish Version)

Definition
A shinbone fracture is a break in the tibia. The lower leg has two bones that connect the knee to the ankle: the tibia and the fibula. The tibia is the larger of the two bones and runs on the inside of the lower leg. The fibula is much smaller and runs along the outside of the lower leg.

Fractured Leg

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Causes
A shinbone fracture is caused by trauma to the shinbone. Trauma includes:

  • Falls
  • Twists
  • Blows
  • Collisions
  • Gunshot wounds
Risk Factors
Factors that may increase your chance of getting a shinbone fracture include:

  • Advancing age
  • Osteoporosis
  • Certain diseases or conditions that result in bone or mineral loss, such as abnormal or absent menstrual cycles, or post- menopause
  • Certain diseases and conditions that weaken bones, such as tumors or cysts
  • Decreased muscle mass
  • Playing certain sports that may result in:
    • Spiral fractures—associated with collisions or falls from sports such as soccer or skiing
    • Stress fractures—associated with overuse or repetitive motion from sports such as gymnastics or dance
  • Violence, such as car or car-pedestrian accidents
Symptoms
Shinbone fracture may cause:

  • Pain that ranges from mild to severe, but worsens with activity
  • Swelling, inflammation, and tenderness
  • Bruising in the injured area
  • Decreased range of motion of the knee or ankle
  • Limping
  • Inability to bear weight on the fractured leg
Diagnosis
The doctor will ask about your symptoms, physical activity, and how the injury occurred. The doctor will examine the injured area.

Imaging tests may include:

  • X-rays to look for a break in the bone
  • CT scan may be needed for more detailed views
Treatment
Proper treatment can prevent long-term complications or problems with your shinbone. Treatment will depend on how serious the fracture is, but may include:

Intial Care
Extra support may be needed to protect, support, and keep your shinbone in line while it heals. Supportive steps may include a splint, brace, walking boot, or cast. A walker or crutches will help you move around while keeping weight off your leg.

Some fractures cause pieces of bone to separate. Your doctor will need to put these pieces back into their proper place. This may be done:

  • Without surgery—you will have anesthesia to decrease pain while the doctor moves the pieces back into place
  • With surgery—pins, screws, plates, or a rod may be needed to reconnect the pieces and hold them in place
Children’s bones are still growing at an area of the bone called the growth plate. If the fracture affected the growth plate, your child may need to see a specialist. Injuries to the growth plate will need to be monitored to make sure the bone can continue to grow as expected.

Medication
Prescription or over-the-counter medications may be given to help reduce inflammation and pain.

Medications may include acetaminophen or ibuprofen.

Check with your doctor before taking nonsteroidal anti-inflammatory medications, such as ibuprofen or aspirin.

Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

Rest and Recovery
Healing time varies by age and your overall health. Children and people in better overall health heal faster. In general, it takes up to 4-6 months for a fractured shinbone to heal.

You will need to adjust your activities while your shinbone heals, but complete rest is rarely required. Ice and elevating your leg at rest may also be recommended to help with discomfort and swelling.

As you recover, you may be referred to physical therapy or rehabilitation to start range-of-motion and strengthening exercises. Do not return to activities or sports until your doctor gives you permission to do so.

Prevention
To help reduce your chance of shinbone fractures, take these steps:

  • Do weight-bearing and strengthening exercises regularly to build strong bones.
  • Wear proper padding and safety equipment when participating in sports or activities.
  • Do not put yourself at risk for trauma to the bone.
To help reduce falling hazards at work and home, take these steps:

  • Clean spills and slippery areas right away
  • Remove tripping hazards such as loose cords, rugs, and clutter
  • Use non-slip mats in the bathtub and shower
  • Install grab bars next to the toilet and in the shower or tub
  • Put in handrails on both sides of stairways
  • Walk only in well-lit rooms, stairs, and halls
  • Keep flashlights on hand in case of a power outage



RESOURCES:
American Academy of Orthopaedic Surgeons

American Physical Therapy Association

CANADIAN RESOURCES:
Canadian Orthopaedic Association

Canadian Orthopaedic Foundation

References:
Fractures of the proximal tibia (shinbone). American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00393 . Updated July 2013. Accessed September 10, 2013.

Giannoudis PV, Papakostidis C, et al. A review of the management of open fractures of the tibia and femur. J Bone & Joint Surg (British Vol). 2006;88:281-289.

Tibia (shinbone) shaft fractures. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00522 . Updated March 2010. Accessed September 10, 2013.

Tibial plateau fracture. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated November 15, 2011. Accessed September 10, 2013.

Tibial stress fracture. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated November 11, 2012. Accessed September 10, 2013.

What are ways to prevent falls and related fractures? National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Fracture/prevent_falls_ff.asp . Updated January 2011. Accessed September 10, 2013.

Last Reviewed September 2013



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