Tibial shaft fracture: Difference between revisions

Latest revision as of 04:59, 18 September 2019

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

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

References

Authors:

@@ Line 1: / Line 1: @@
-==Tibial Plateau==
+''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
-===Background===
+==Clinical Features==
-*Medial condyle + intercondylar eminence + lateral condule
+*Localized pain/swelling
-**Intercondylar eminence is where ACL attaches
+*Inability to bear weight
-*Ligamentous and meniscal injuries are common
-*Compartment syndrome may occur
-===Diagnosis===
-*TTP
-*Knee effusion
-===Work-Up===
-*AP, lateral, and intercondylar notch views
-**If suspicion high but xray negative consider MRI or CT
-===Management===
+==Differential Diagnosis==
-*Plateau Fracture
+{{Distal leg fractures DDX}}
-**RICE
-**Splint in full extension
-**NWB
-===Disposition===
+==Management==
-*Indications for referral within 48hr:
+{{General Fracture Management}}
-**Significant displacement or depression
-**Suspected or documented ligamentous injury
-==Tibial Shaft Fracture==
+===Immobilization===
-===Signs/Symptoms===
+*[[Long leg posterior splint]]
-*Localized pain/swelling
+**Knee at 5 degrees flexion, foot in slight plantarflexion
-*Inability to bear weight
-===Conservative versus operative management===
+==Disposition==
-*≥10 degrees of rotation in any plane
+*Consider discharge if low-energy injury and patient not at risk of [[compartment syndrome]]
-*Angulation ≥10 degrees
-*≥5 mm of displacement
-===Initial Management===
+==See Also==
-*RICE
+*[[Fractures (Main)]]
-*Long leg posterior splint
+*[[Tibia fracture (peds)]]
-*NWB
-==Source==
+==References==
-UpToDate
+<references/>
-[[Category:Ortho]]
+[[Category:Orthopedics]]