LEG FRACTURE, TIBIA |
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DESCRIPTIONA leg fracture of the tibia is a complete or incomplete break in the large bone of the leg between the knee and ankle. See also Leg Fracture, Fibula.
Appropriate health care includes:
Hospitalization (sometimes) to set the fracture.
SIGNS & SYMPTOMS
Severe pain at the fracture site.
Swelling of soft tissue surrounding the fracture.
Visible deformity if the fracture is complete and bone fragments separate enough to distort the child's normal leg contours.
Numbness or coldness in the child's foot if the blood supply is impaired.
CAUSES
Direct blow to the child's leg.
Weakening of the bone from repeated stress, resulting in a stress fracture that progresses to a complete fracture. This is especially common in joggers, marathon runners, and walkers.
Indirect stress caused by twisting or violent muscle contraction.
RISK FACTORS
Contact sports; history of bone or joint disease; obesity; poor nutrition, especially calcium deficiency.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should build strength with a good conditioning program and should use appropriate protective equipment, including good shoes for running and shin guards for participation in contact sports.
BASIC INFORMATION
MEDICAL TESTSX-rays of the injured area, from the knee joint above to the ankle joint below.
POSSIBLE COMPLICATIONS
At the time of the child's injury: shock; pressure on or injury to nearby nerves, ligaments, tendons, muscles, blood vessels, or connective tissues.
After treatment or surgery: delayed union or non-union of the fracture; impaired blood supply to the fracture site; avascular necrosis (death of bone cells) due to interruption of the blood supply; shortening of the child's injured bones; arrest of normal bone growth in a child; infection in open fractures (skin broken over fracture site), or at the incision if surgical setting was necessary; an unstable or arthritic ankle or knee joint if the fracture is close to either; prolonged healing time if activity is resumed too soon; proneness to repeated leg injury; problems caused by casts. See Appendix 41 (Care of Casts).
PROBABLE OUTCOME
The average healing time for this fracture if 6 to 8 weeks.
TREATMENT
FIRST AID
Follow instructions for R.I.C.E., the first letters of rest, ice, compression, and elevation. See Appendix 39 for details.
The doctor will set (realign) the broken bones with surgery or, if possible, without.
HOME CARE
Immobilization will be necessary. A rigid cast is placed around the injured leg to immobilize the child's knee and ankle.
MEDICATION
Your doctor may prescribe:
General anesthesia, local anesthesia, or muscle relaxants to make bone manipulation and fixation of bone fragments possible.
Narcotic or synthetic narcotic pain relievers for severe pain.
Stool softeners to prevent constipation due to inactivity.
Acetaminophen for mild pain.
ACTIVITY
Your child will have to learn to walk with crutches. See Appendix 37. The child can resume normal activities gradually after treatment but should not drive until healing is complete.
DIET & FLUIDS
Give the child only water before manipulation or surgery to treat the fracture. Solid food in the stomach makes vomiting while under anesthesia more hazardous.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has signs or symptoms of a tibia fracture.
Any of the following occur after surgery or other treatment:
-- Increased pain, swelling, or drainage in the surgical area.
-- Signs of infection (headache, muscle aches, dizziness, or a general ill feeling and fever).
-- Swelling above or below the child's cast.
-- Blue or gray skin color beyond the cast, especially under the toenails.
-- Loss of feeling below the fracture site.
-- Nausea or vomiting.
-- Constipation.
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