Fracture of Tibia and Fibula:

 

 

                                 Definition of Tibia and Fibula:

 

 

          When fracture occur in Tibia and Fibula is known as fracture Tibia and Fibula.

 

 

Site:

1. Condyle of the tibia.

2. Neck of the fibula.

3. Shaft of the tibia and fibula.

4. Medial lateral malleolus or both.

5. Medial or anterior margin of the lower end of the tibia.

6. Posterior margin of the lower end of the tibia.

 

 

 

Causes of Tibia and Fibula:

 

 

1.    Direct trauma- by direct hit

2.    Indirect trauma-

i) Road Traffic Accident.

ii) Fall from height.

iii) During play.

iv) Twisting force.

 

 

 

Clinical Features of Tibia and Fibula:

 

 

1.    History of trauma.

2.    Pain in the affected tibia and fibula.

3.    Swelling of the affected site.

4.    Abnormal shape.

5.    Shortening.

6.    In-ability to move.

7.    Tenderness.

8.    Cripitation.

9.    Displacement may be palpable.

10.X-ray to confirm diagnosis.

11.Skin examination-Skin injury or skin contact.

 

 

 

Complications of Tibia and Fibula:

 

 

1.    Mal union.

2.    Non-union.

3.    Delayed- union.

4.    Stiffness of the knee and ankle joint.

5.    Osteo arthritis.

6.    Infection.

7.    Shortening.

8.    Fat-embolism.

9.    Compartmental syndromes.

10.Refracture.

 

 

 

 

Treatment of Tibia and Fibula:

 

 

 

A.   General-

1.    History of trauma is to be taken.

2.    Examine the patient thoroughly- Check and record TPR and BP.

3.    Skin examination If any external injury.

4.    X-ray to confirm diagnosis.

5.    I/V fluid is to be given if haemorrhage is present.

6.    Blood transfusion is to be given if excessive bleeding.

7.    Steroid is to be given if necessary.

8.    Surgical toileting is to be done in case of open fracture.

9.    Immobilize the affected limb by plaster cast.

10.Analgesic is to be given to relieve pain.

11.Sedative is to be given if necessary.

12.Antibiotic is to be given to prevent infection like- Coxacillin, ceftraxon etc.

13.Immunization- is to be done in case of external injury-

a). If the patient is not immunized then-

i). Inj-TIG 250 IU i/m is to be given if not available then Inj-ATS 1500IUi/m is to be given after skin test.

ii). Inj- TT 1 ample i/m is to be given and another after one month.

b). If the patient is immunized- Only Inj. TT1 ample i/m is to be given (Buster dose).

 

 

B. Specific-

1. If undisplaced fracture then immobilize the affected part by plaster cast.

2. If the fracture is displaced then close reduction is done under G/A and immobilize by plaster casr.

3. When close reduction is failed then open reduction and internal fixation under G/A by plate and screw.