Tibial and Fibular Fractures

What are Tibial and Fibular Fractures

Tibial and fibular fractures are breaks in both of the lower leg bones (tibia and fibula). The tibia is the larger of these two bones, and is also called the shin bone. The fibula is the smaller of the two bones and is on the outer side of the leg.

When tibiofibular fractures happen, the bones may:

  • Break, but stay close to their normal position (stable or non displaced fracture).
  • Break and move out of their normal position (unstable or displaced fracture).
  • Break into several small pieces (comminuted fracture).
  • Break through the skin (compound or open fracture).

What are the causes?

This condition is caused by injuries, such as:

  • Falls from a height or falls while cycling.
  • Sports contact injuries, like collisions in football or soccer.
  • Severe, forceful twisting of your leg, such as falls while skiing.
  • Car or motorcycle accidents.

What increases the risk?

You are more likely to develop this condition if:

  • You participate in sports, especially contact sports or sports that may involve impact or twisting, like football or skiing.
  • You smoke.

What are the signs or symptoms?

Symptoms of this condition include:

  • Pain, swelling, and bruising in the lower leg, ankle, or knee.
  • Difficulty walking or putting weight on your injured leg.
  • Change in the shape of your leg at the site of the injury.
  • Pain that gets worse with moving or standing and gets better with rest.

How is this diagnosed?

This condition is diagnosed with a physical exam and X-rays. In some cases, a CT scan may be done to help diagnose certain types of fractures.

How is this treated?

Treatment for this condition depends on the type and severity of your fractures.

  • If your bones did not move out of place and your leg is still stable, or if you are unable to have surgery, you may be treated with a cast, brace or walking boot. This keeps the bones in place while they heal (immobilization).
  • If your bones are out of place or if your leg is unstable, you may need surgery. Surgery is common for tibial and fibular fractures. During surgery, bones are moved back to their normal place, and a rod, plate, or screws are used to hold the bones in place. After surgery, the leg is put in a splint or cast.

Treatment may also include:

  • Medicine, ice, and elevation of the leg to help relieve pain and inflammation.
  • Using crutches or a walker while you heal.
  • Exercises to strengthen leg and ankle muscles and restore motion (physical therapy).

Follow these instructions at home:

If you have a splint, brace, or walking boot:

  • Wear the splint, brace, or boot as told by your health care provider. Remove it only as told by your health care provider. Some types of splints can only be removed by your health care provider.
  • Loosen the splint, brace, or boot if your toes tingle, become numb, or turn cold and blue.
  • Keep the splint, brace, or boot clean and dry.

If you have a cast:

  • Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
  • Check the skin around the cast every day. Tell your health care provider about any concerns.
  • You may put lotion on dry skin around the edges of the cast. Do not put lotion on the skin underneath the cast.
  • Keep the cast clean and dry.

Bathing

  • Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths.
  • If you have a cast, splint, brace, or boot that is not waterproof:
    • Do not let it get wet.
    • Cover it with a watertight covering when you take a bath or a shower.

Managing pain, stiffness, and swelling

  • If directed, put ice on the injured area.
    • If you have a removable splint, brace, or boot, remove it as told by your health care provider.
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag or between your splint or cast and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Move your toes often to avoid stiffness and to lessen swelling.
  • Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Driving

  • Do not drive or use heavy machinery while taking prescription pain medicine.
  • Ask your health care provider when it is safe to drive if you have a cast, splint, brace, or boot.

Activity

  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • If physical therapy was prescribed, do exercises as told by your health care provider.

Safety

  • Do not use the injured limb to support your body weight until your health care provider says that you can. Use crutches or a walker as told by your health care provider.

General instructions

  • Do not put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have pain that gets worse or does not get better with rest or medicine.
  • You have more swelling or redness in your foot.

Get help right away if:

  • Your skin or nails below your injury:
    • Turn blue or gray.
    • Feel cold.
    • Become numb.
    • Become less sensitive to touch.
  • You develop new or severe pain in your leg or foot.
  • You have tingling, burning, and tightness in your lower leg.

Summary

  • Tibial and fibular fractures are breaks in both of the lower leg bones (tibia and fibula).
  • If your bones are out of place or if your leg is unstable, you may need surgery. Surgery is common for tibial and fibular fractures.
  • If directed, put ice on the injured area for 20 minutes, 2–3 times a day.
  • Pain medicine and elevating your injured leg will help control pain and reduce swelling. Follow directions as told by your health care provider.
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