What Is the Most Common Fibula Fracture Treatment?

Tibia and fibula shaft fractures are most common in systemic fractures. Children under 10 are particularly common. Among them, the tibial shaft fracture was the most, the tibiofibular shaft was the most bifurcated, and the fibula shaft was the least fractured. The tibia is the main bone that supports the weight under the femur, and the fibula is an important bone that attaches to the calf muscles and bears 1/6 of the weight. The middle and lower tibias are prone to fracture. The fracture of the upper 1/3 of the tibia is displaced, which easily compresses the iliac artery, causing severe ischemic necrosis of the lower leg. The contusion of 1/3 of the tibia fracture remains in the fascial compartment of the calf, increasing the pressure in the room and causing ischemic muscle contracture. Fracture of the middle and lower 1/3 of the tibia ruptures the nourishing arteries and easily causes delayed healing of the fracture.

Basic Information

English name: fracture of tibia and fibula
Visiting department: orthopedics
Multiple groups: Children under 10
Common locations: Tibial shaft

Common causes: Caused by direct violence, which is often caused by crushing, collision, or injury.
Common symptoms: Local pain, swelling, and significant deformity, showing angular and overlapping displacement

Causes of tibiofibular fractures

The disease is mostly caused by direct violence, which is usually caused by crushing, collision, or blow. The fracture line is transverse or comminuted. Sometimes the two lower legs are broken in the same plane, and the soft tissue damage is often more serious, which may cause open fractures. Indirect violence is more commonly caused by a fall, a sprain or a slip caused by a running jump; the fracture line is often oblique or spiral, and the tibia and fibula are often not in the same plane.

Clinical manifestations of tibia and fibula fractures

Local pain, swelling, and deformity are more prominent, showing angular and overlapping displacement. Attention should be paid to whether it is accompanied by common peroneal nerve injury, anterior tibial and posterior tibial artery injury, and whether the tension in the anterior tibial and gastrocnemius regions is increased. Often the complications of a fracture are more serious than the consequences of the fracture itself.

Tibia and fibula fracture examination

X-ray examination showed fractures in the tibia and fibula, discontinuities in the cortex and notches. Increased bone density and periosteal thickening and sclerosis can occur in almost all cases. The trabecular bones are rough and irregularly arranged. And blurry incomplete fracture line can be seen, severe cases of bone deformation and surrounding soft tissue damage.

In cases where arterial injury is suspected, vascular color ultrasonography should be performed in time. Because Doppler ultrasound vascular examination is a non-invasive examination method, it can be performed at the bedside, it is convenient and fast to operate, and it can clarify the blood flow velocity and direction in the blood vessels in various parts, and it often affects the blood supply range of the limbs and vascular injury. Having a general understanding is of great significance for the timely formulation of emergency surgery plans. An angiogram may be performed if necessary for patients whose diagnosis is still unclear. However, the clinical application of angiography still has many limitations, which is an invasive examination method; the patient needs to be moved repeatedly, which is more inconvenient and dangerous for patients with multiple body injuries; it is time-consuming and may delay treatment opportunities.

Diagnosis of tibiofibular fracture

Due to the superficial position of the tibia and fibula, the diagnosis is generally not difficult, and the displaced bone ends can often be protruded in the localized pain and swelling. It is important to detect the anterior and posterior tibial arteriovenous and common peroneal nerve injuries with fractures in time. During the examination, the dorsal foot artery pulsation, foot sensation, ankle joint and toe dorsiflexion activity should be recorded as routine records.

Differential diagnosis of tibiofibular fractures

Combined clinical and X-ray findings can be diagnosed, but fatigue tibiofibular fractures sometimes need to be distinguished from osteoid osteoma and green branch fractures, local bone infections, and early bone tumors.

Osteoid osteoma

Although there is thickening of the cortical bone and periosteal reaction, there are more typical tumor nests.

2. Local bone infection

The periosteal response is mainly based on thickening of the cortex, without trabecular rupture and cortical notch signs, but clinically the skin temperature is higher.

3. Early bone tumors

Lace-like or onion-like periosteal reactions are the main causes, and bone destruction, tumor bones, and soft tissue masses gradually appear.

Fatigue fractures have the same local periosteal response and thickening and sclerosis of the bone cortex, but they still have their own characteristics. As long as you have the characteristics of X-rays and clinical history, you can make fatigue fractures correctly. diagnosis.

Complications of tibia and fibula fractures

Tibia and fibula fractures are prone to delayed or non-union. Especially unstable fractures are easily displaced. Local external fixation often fails.

In traumatic tibia and fibula fractures, they are mostly injuries caused by major violence, and are often combined with other parts of the injury and internal organ damage; after tibia and fibula fractures with vascular injury, the muscle-rich calf muscle group tissue is extremely vulnerable, because Skeletal muscle is more sensitive to ischemia. It is generally believed that limb muscle tissue can degenerate and necrotize after 6 to 8 hours of ischemia. Severe soft tissue injury and postoperative wound infections also significantly increase the number of amputations. Dangerous.

Tibia and fibula fracture treatment

The treatment of this disease has the following aspects:

1. Manual reset and external fixation

After anesthesia, the two assistants performed anti-traction on the knees and ankles respectively. The surgeon squeezed and squeezed the broken ends of the fractured bones according to the direction of displacement under the perspective. After reduction, a small splint or long-legged plaster was used for restoration. fixed.

2. Bone traction

Tibiofibular fractures, such as oblique, spiral, and comminuted, are very unstable due to bone fractures. It is not easy to maintain good alignment after a reduction, and there are wounds in the fractures. Skin abrasions and severe swelling of the limbs must be closely observed. Fix with a small splint or plaster splint, preferably with continuous traction.

3. External bone fixation.

4. Incision and internal fixation.