Tibial shaft fracture
This page is for adult patients; for pediatric patients see tibia fracture (peds)
Background
- Open fracture is common due to minimal amount of subcutaneous tissue
- Fibula is often fractured as well
Clinical Features
- Localized pain/swelling
- Inability to bear weight
Differential Diagnosis
Distal Leg Fracture Types
- Tibial plateau fracture
- Tibial shaft fracture
- Pilon fracture
- Maisonneuve fracture
- Tibia fracture (peds)
- Ankle fracture
- Foot and toe fractures
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Immobilization
- Long leg posterior splint
- Knee at 5 degrees flexion, foot in slight plantarflexion
Disposition
- Consider discharge if low-energy injury and patient not at risk of compartment syndrome