Causes and sequelae of tibia and fibula fractures.

Many people suffer fractures during sports or other factors. Tibial and fibular fractures (lower leg fractures) are the most common fractures in the body, especially in children under 10 years old. So what are the symptoms of tibia and fibular fractures and how should they be treated?

Causes

This disease is mostly caused by direct violence, which is often caused by crushing, collision, and blow. The fracture line is transverse or comminuted. Sometimes both lower legs are fractured in the same plane, and the soft tissue damage is often serious, which can easily cause open fractures. Indirect violence is often caused by falling from a height, sprains from running or jumping, or fractures caused by slipping. The fracture line is often oblique or spiral, and the tibia and fibula are often not fractured in the same plane.

Clinical manifestations

Local pain, swelling, and significant deformity, showing angulation and overlapping displacement. Attention should be paid to whether there is damage to the common peroneal nerve, damage to the anterior and posterior tibial arteries, and increased tension in the anterior tibial region and gastrocnemius region. Complications caused by fractures are often more serious than the consequences of the fracture itself.

Complications

Tibial and fibula fractures are prone to delayed union or nonunion. Unstable fractures are particularly prone to displacement. Local external fixation often fails.

In traumatic tibia and fibula fractures, most of them are caused by severe violence, and are often combined with injuries to other parts of the body and internal organs. After tibia and fibula fractures are combined with vascular damage, the muscular calf muscle tissue is very susceptible to involvement 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 damage and postoperative wound infection caused by purulent blood syndrome also greatly increase the risk of amputation.

treatment

The treatment of this disease mainly includes the following aspects:

1. Manual reduction and external fixation

After anesthesia, two assistants perform countertraction at the knee and ankle respectively, and the surgeon uses both hands to push, squeeze and pinch the fracture ends according to the direction of displacement under fluoroscopy to restore the fracture. After reduction, a small splint or long leg plaster can be used for fixation.

2. Bone traction

For example, oblique, spiral, comminuted tibia and fibula fractures are very unstable, and it is difficult to maintain good alignment after reduction. There are also wounds at the fracture site, skin abrasions, and severe limb swelling. The limb condition must be closely observed and cannot be fixed immediately with a small splint or plaster splint. It is best to use continuous traction with the calcaneus.

3. Extraosseous pin fixation method.

4. Open reduction and internal fixation.