Immediate Treatment for Tibia / Fibula Fractures

If you have fracture to the tibia or fibula or both, see a doctor immediately as the two bones are weight bearing bones. It will be good not to delay treatment. Immobilise the leg.

Brief Outline of Fractures (Tibia, Fibula)

Most human bones have outer shells of cortical bone, which means that the porosity is low, with cancellous bone underneath (high porosity). The cortical bone means that the structure is stiffer and capable of withstanding great stress. When the outer shell is cracked it is called a fracture. The bone may be either partially fractured or completely broken.

Anatomy and Physiology of Fractures (Tibia, Fibula)

The tibia (shin bone) is the larger and more medial of the bones in the lower leg. At the proximal end the medial and lateral condyles articulate with the distal end of the femur to form the knee joint. The tibial tuberosity is a roughened area on the anterior surface of the tibia. The fibula lies lateral and parallel to the tibia and is thin and sticklike. The fibula is not a weight bearing bone and plays no part in the knee joint, the tibia i the only weight bearing bone of the lower leg. Both bones meet at the ankle. Although either bone can be fractured alone, they are most commonly fractured together. Most fractures involve the proximal (near the knee), or distal (near the ankle) ends of the bone. Due to the thin covering of skin and other tissue over the tibia, these fractures are often open fractures, meaning the broken bone ends break the skin.


Cause of Fractures (Tibia, Fibula)

Direct force (impact) to the bones along the shaft or extreme loading of the bone, such as with a landing from a high fall. Rotational or indirect forces on the bones, e.g. tackle in football. Twisting, especially when the bone is under a load or when the foot is fixed.

Signs and Symptoms (Tibia, Fibula)

Pain, inability to walk or bear weight, and often inability to move the leg. Deformity may be present at the fracture site, or the fracture may be open. Swelling and tenderness.

Complications If Left Tibia / Fibula Fractures Unattended

Instability in the lower leg is one long-term complication of an untreated fracture. Blood vessel damage from a fracture can lead to internal bleeding and swelling as well as circulation problems for the foot. Nerve involvement can lead to serious problems such as drop foot or a loss of sensation in the lower leg and foot.

Rehabilitation and Prevention for Tibia / Fibula Fractures

After the fracture has healed, it will be necessary to rebuild the strength and flexibility of the muscles in the lower leg. Range of motion activities may be needed for the knee and ankle depending on the location of the fracture and the extent of immobilisation required. When the fracture has healed a gradual re-entry into activity must be observed to prevent re-injury. Strong calf and anterior tibialis muscles will help protect the tibia and fibula.

Long-term Prognosis for Tibia / Fibula Fractures

If set properly and allowed to heal fully, a fracture should not present any future problems. In some cases a rod or pins may be needed to hold the bones in place during healing. Surgery may be required in a few cases where blood vessel or nerve damage is severe.

Call (+65) 6471 2674 (24 Hour) to fix an appointment to treat your Tibia / Fibula Fracture today.

Anterior compartment syndrome is more often a chronic rather than an acute injury. Runners and other athletes involved in activities that require a lot of repetitive flexion and extension of the foot are most susceptible. Swelling or enlargement of the muscle in the front of the lower leg, causes this condition. Pain, especially when toeing up, and decreased sensation and weakness in the foot may be experienced with this condition. Virtually any injury involving bleeding or oedema formation may lead to compartment syndrome.

Anatomy and Physiology of Anterior Compartment Syndrome

Muscles are covered by fascia, a fairly inflexible fibrous sleeve that encases the muscle and bone. This creates a compartment for the muscle, with the bone forming one side, and the fascia is covering the other sides. In the lower leg, the two bones, the tibia and the fibula, create a more rigid compartment. The tbialis anterior muscle runs over the tibia and fibula and is covered by the fascia. This leaves little room for expansion or swelling of the muscle. When there is increased intramuscular swelling, as a result of trauma or overuse, it creates pressure inside the compartment, which can impede blood flow and function of tissues within the compartment of the muscle.

Cause of Anterior Compartment Syndrome

Acute: Trauma to, or tearing of, the tibialis anterior muscle causing bleeding and/or swelling.

Chronic: Overuse of the muscle causing inflammation and swelling of the muscle pressure in the compartment. Rapid growth of the muscle before the fascia can expand (as seen with anabolic steroid use).

Signs and Symptoms of Anterior Compartment Syndrome

Pain and tightness in the shin (especially the lateral side). Worsens with exercise. Decreased sensation on top of the foot over the second toe. Weakness and tingling may be noticed in the foot.

Complications if Left Anterior Compartment Syndrome Unattended

The pressure int he compartment may lead to permanent nerve and blood vessel damage if left unattended. The underlying cause of the condition will most likely continue to cause irritation and swelling if not treated.

Immediate Treatment for Anterior Compartment Syndrome

Rest, ice and elevation (no compression). Anti-inflammatory medication. Sports massage may be used to stretch the fascia.

Rehabilitation and Prevention for Anterior Compartment Syndrome

Stretching the muscles in the front of the shin will help to alleviate some of the pressure and elongate the muscle. Massage to stretch the fascia may also help to speed recovery. Gradual strengthening and a good flexibility program will help prevent this condition. Avoiding direct trauma to the shin area will prevent acute compartment syndrome.

Long-term Prognosis for Anterior Compartment Syndrome

If treated before damage to the nerves and blood vessels becomes serious, the recovery rate is very good. Acute or severe chronic anterior compartment syndrome may require surgical intervention to relieve the pressure in the compartment.

Call (+65) 6471 2674 (24 Hour) to fix an appointment to see our specialist regarding Anterior Compartment Syndrome.

Posterior Tibial Tendon

Brief Outline of Posterior Tibial Tendinitis

Pain along the medial (inner) side of the lower leg, ankle, and foot may be the result of posterior tibial tendinitis. The posterior tibial tendon helps hold the longitudinal arch of the foot, which means there is a level of tension and friction in the tendon. If the arch falls, the stress on the tendon increase. This can occur with poor running mechanics, improper footwear, or untreated injuries.

Anatomy and Physiology for Posterior Tibial Tendinitis

The posterior tibial tendon runs from the calf muscle behind the medial malleolus (the bony prominence) of the ankle, to the navicular bone in the arch of the foot. This tendon supports the arch and aids in inversion of the foot. If the navicular moves out of place, it causes stress and irritation to the tendon. This irritation over time becomes tendinitis, inflammation of the tendon.

Posterior Tibial TendonPosterior Tibial Tendon Pain

Cause of Posterior Tibial Tendinitis

Improper running mechanics. Improper footwear. Prior  injury to the medial side of the ankle.

Signs and Symptoms of Posterior Tibial Tendinitis

Pain and tenderness over the inner side of the shin, ankle, and foot. Pain when walking or running. Some swelling may be noted over the tendon.

Complications if Left Posterior Tibial Tendinitis Unattended

If left unattended, this condition can lead to a fallen arch or a complete rupture of the tendon. The pain may cause a change in footfall during running leading to injuries in other structures of the foot and ankle.

Immediate Treatment for Posterior Tibial Tendinitis

R.I.C.E. Anti-inflammatory medication.

Rehabilitation and Prevention for Posterior Tibial Tendinitis

After pain subsides, it is important to stretch and strengthen the calf muscles to support the tendon and speed recovery. Arch supports may be required until the tendon heals and the muscles are strengthened. Gradual reintroduction into activity is important and proper warm-ups will help prevent a recurrence of the injury. Proper footwear and corrections of any mechanical inefficiency will also help prevent this injury.

Long-term Prognosis for Posterior Tibial Tendinitis

Proper treatment should lead to a complete recovery. The longer the condition exists before treatment the longer recovery will take.

Call (+65) 6471 2674 (24 Hour) to check your posterior tibial tendon today.

Shin Splints

What is Shin Splint (Medial Tibial Stress Syndrome)?

Shin Splints
Shin Splints may develop in the muscles in the front and outer parts of the shin

Shin splint is the symptom of pain over the front of the tibial bone.

What are the Causes?

Shin splints are normally due to overuse. When the overuse causes irritation to the tendons and the attachment of these tendons to the bone, the condition is called medial tibial stress syndrome. It is commonly seen in athletes who suddenly increase their duration or intensity of training.

What are the Treatments?

The treatments are applying ice packs or perform ice massage for up to 20 minutes three times a day, take anti-inflammatory medication prescribed by a doctor, or perform rehabilitation exercises regularly e.g. swimming and cycling.