Often during road traffic injuries of the tibia, as well as minor. Often the lower leg is injured. These damages occur with the same statistics. A fracture of the tibia is considered a rather serious injury, which is accompanied by many complications.
Injury description
It should be noted that the tibia takes a huge load when moving. That is why her fracture is a frequent occurrence. Most of the patients with a similar trauma are found in the winter, as well as in older people who have a broken bone structure. Fracture can be small or tibia, however, their simultaneous injury is sometimes found.
Where the tibia is located, everyone understands. However, its anatomical structure remains a mystery to many. The large bone is located inwards (towards the middle of the body). It consists of a long tubular bone. The tibia is located on the side (lateral). Its shape is the same as that of a large one, but it is smaller in size.
Causes
In order for a fracture of the tibia to occur, an impact force is needed, which will be much greater than the strength of the bone. The reasons should be hit in an accident, a jump from a height or fall, skiing, skating, skateboard, a strong blow to the kneecap, car wreck, twisting of the legs, as well as a blow to the ankle.
A provoking factor should be called diseases that affect the strength of bone tissue.
Types of Fractures
With a fracture of the tibia, it will be rather difficult to predict any outcome, especially when it comes to simultaneous trauma of a small and a large part. With this option, complications will most likely arise. It also requires long-term treatment and further long-term rehabilitation.
A closed fracture of the tibia is characterized by an invisible at first glance injury, an open one - by the exit of tissues and debris out. The first injuries are divided into full or incomplete (the occurrence of cracks). Fractures with and without displacement are also distinguished.
Minor bone fracture
As a rule, a fracture of a small part of the bone occurs due to impact or fall. This is due to the fact that the structure has lost its integrity and was deformed. Injury can be caused by inaccurate falling or getting into an accident. Also, safety at work should not be neglected, since a fracture of the tibia can be obtained completely by accident. She can still be injured due to bad weather.
This type of fracture is divided into several types, depending on the nuances of the injury. There is a fracture of a spiral view, as well as a fragmentary one. Allocate a transverse injury, with oblique damage. There is also a fracture of the tibia with and without displacement.
If we talk about the symptoms of the problem, then we should highlight the special nuances. The limb may become numb, one will become longer than the other, swelling and pain will appear. In addition, the leg will deviate slightly from the axis.
How to treat this type of fracture will depend on the degree of injury and its nature.
Fracture of a large bone
A fracture of the tibia can occur when the load exceeds its strength. In this case, the tissue will begin to break down. The cause of injury should be called a direct blow, which is the result of a collision with a vehicle or a fall.
The types of this injury should be noted. There are open and closed fractures. There is also a fracture of the tibia without displacement, fracture and comminuted injury.
Special features should also be highlighted. The leg will be slightly deformed, swelling and bruising will appear. Surely dull and aching pain appears. When trying to lean on a damaged leg, the patient will feel severe pain, which can also cause a cramp.
It should be understood that with a fracture of this bone, it is important to provide first aid. The patient should not try to move independently.
First aid
In order for rehabilitation to be as successful as possible after a tibia fracture, first aid should be provided correctly. Many people ask how and what to do, but if you get into a situation when someone is injured, you should take measures only if you have a certain skill or experience. Until the moment when the ambulance arrives or the patient is taken to the hospital, a number of manipulations are necessary.
With the help of analgesics, you need to remove the pain effect. If we are talking about small children, this item should be omitted. With a closed wound, you need to apply something cold. This will both relieve pain and prevent the development of a hematoma with edema.
Next, the leg must be fixed in one position so that the internal fragments do not damage the surrounding tissue. This is especially important when a person has helical injuries. That it is the most dangerous, since the bone, in fact, is broken into fragments. For fixing, you can take boards or sticks. One of them should be fixed to the outside, the second to the inside of the leg. To make such a tire as effective as possible, you need to impose it from the heel to the very thigh. Strong fixation should be done around the knee and ankle.
With an open fracture of the tibia, you need to rinse the wound from dirt as much as possible. However, you need to try not to hurt the fragments. After this, the wound is washed with an antiseptic and a bandage is applied. It should be dry, sterile and tightly tied. Ointment is prohibited.
In case of injury with blood loss, it is necessary to apply a tourniquet and detect for two hours. After the expiration of the period, the bandage should be changed. If the leg began to change color and cool, then the tourniquet should be removed.
The victim should only be transported in a supine position. This is the only way to protect the body from further complications.
Diagnostic measures
Before you begin treatment for a fracture of the tibia, you should conduct a detailed examination by a doctor. The faster treatment is started, the faster the function will recover. The first stage of diagnosis is to collect indications and analyzes, as well as to examine the deformation for wounds, bleeding, edema, hematoma and so on. Sometimes various protrusions may appear.
After this stage, the patient is sent for x-ray. Thanks to him, it is clearly visible where the tibia is located, the nature of the fracture, its course and complexity. An x-ray will also make it possible to understand whether the damage is displaced or not.
If the doctor suspects a more serious pathology or the picture did not give clear and complete information about the injury, CT is prescribed. This method allows you to consider tissue in cross section. Thanks to this diagnostic method, you can get the whole picture about injury.
After the diagnosis is confirmed or refuted, treatment can begin. The patient is referred to a surgeon or orthopedist.
Displacement injury treatment
How much to walk in gypsum with a fracture of the tibia depends entirely on the severity and type of injury received. Complications, if any, should also be taken into account.
To heal the fracture without displacement, the doctor anesthetizes and applies a special cast bandage. After applying this dressing, a special x-ray is done to understand how correctly the bones lie. It is important that the debris remains in place.
A week after fixation, the patient's legs are again sent for x-ray. Plaster is allowed to be removed after a minimum of 2.5 months. Rehabilitation at the same time lasts another month. If there are no complications, and the bones grow together well, then after just four months you can achieve maximum functioning of all muscles.
Offset injury treatment
If we are talking about a clear displacement of fragments during a fracture of the tibia leg, then the therapy will be lengthy, and it also differs slightly from the above.
After the patient is taken to the hospital, the doctor must anesthetize the injury, then the patient is sent for traction. During the therapy, the muscles will come to their senses, but the displacement will not occur. In this condition, the patient will remain the entire course of therapy. The period depends on how quickly the callus will grow, as well as how badly the bones are damaged.
Throughout the treatment, the doctor will periodically send for x-rays so that the specialist can monitor the formation of corns. The extension will be canceled after 1.5-2 months, but only if the fracture of the tibia (large or small) heals satisfactorily. After removal, the limb is fixed with a gypsum splint. The last x-ray, which will be indicative, is carried out already after two to four months, depending on the speed of recovery. If the picture shows a bone in normal condition, then the use of a gypsum tire will not be necessary, the doctor will remove it.
Surgical treatment
Treatment is carried out by the surgical method in only a few cases. These include abnormal bone fusion during drug therapy, open damage, where you need to constantly monitor the condition of the wound, as well as an unstable fracture. The latter has a health risk or may consist of three fragments. Next, we consider those devices that are used by surgeons.
Ilizarov apparatus
This method is considered the most reliable and effective. Spokes are installed in the wreckage, which together with the main structure form a frame. As a result, the bones are fixed so tightly that the fragments are not able to move even one millimeter. During treatment, the doctor can change the location of each segment.
Wood screws
Doctors rarely resort to the use of screws, but they are also effective. They are installed during the operation. Screws are inserted into the bone, bringing them out. They are mounted on a metal structure. Thanks to this fixation, the debris will remain in place. For children, this method of treatment is practically not used.
Rod and plate
There are two more surgical methods that will allow the leg to bounce back.
The core is installed in the bone. A skin incision is made, then a special device is placed in the bone canal. It is made of steel. The rod is removed only after recovery.
The plate is attached using self-tapping screws. Holes are made on the skin. It is through them that specialists fix the plate. This operation is not done for children. A similar solution is due to the fact that during installation and wearing of the plate, the periosteum can be damaged. This will affect further bone formation.
Rehabilitation process
After a fracture of the tibia (small or large), a rehabilitation period must be passed. It starts from the moment the cast was applied, if the person has no complications of the disease. Be sure to follow the requirements and advice of a doctor. Most likely, he will offer to carefully rotate the foot and move his toes.
The limb should begin to be developed immediately, as soon as the specialist says that this can be done. Such a solution will restore all functions in the shortest possible time. The doctor should refer the patient to a specific rehabilitation scheme, which includes massage, gymnastics and physiotherapy. When developing, pay attention to the load. If overvoltage occurs, complications may occur.
Full recovery occurs with a successful scenario and timely treatment after six months.
Summary
In conclusion, it should be noted that tibia injuries are quite complex and their treatment is also not easy. You should take care of yourself and try to protect your limb from destructive blows as much as possible. Prevention is easier than cure.