Fractures of the Tibia and Fibula

Fractures of the Tibia and Fibula

In our years of experience as orthopedic implants manufacturers, we have seen that fractures of the tibia with related fractures of the fibula are more rickety than isolated fractures of the tibia. Yet, most of these fractures can be stabilized using orthopedic implants like a functional cast or brace as the presence of any kind of support for the fibula when it is fractured allows for the more uniform motion of the limb segment. Thus, the shortening that occurs may be somewhat greater than the remote fractures of the tibia, but the angular misalignment is less.

Proximal Fractures:

Spine Implants Suppliers research and development team state that fractures of the proximal tibia with linked fibular fracture do not show a propensity to develop angular deformities. If any reduction and realignment of the fragments are obtained, it is usually maintained using orthopedic instruments like a below-the-knee functional brace.

A high range of fractures in the case of obese patients is stabilized in another kind of orthopedic surgical instrument like a below-the-knee functional brace with a thigh extension that permits free bending movement around a joint in a limb and extension of the knee and provides medial-lateral stability. This orthopedic implant company brace does not prevent the development of angular deformities in similar fractures where there is an intact fibula. Because of the nearness of the fracture to the knee, there is usually an associated intraarticular accumulation of fluid that calls for a wait in the introduction of function for longer periods of time than with similar fractures present at a more distal level.

Minimal counterbalance between the fragments is acceptable predicting the maintenance of length and cosmetic appearance.

Mid Diaphyseal fractures:

Most diaphyseal tibial fractures in orthopedic implants patients have associated fibular fractures. In such cases, the cause of injury possibly determines the level of the fibular fracture. Our reports on orthopedic surgical instruments claim that transverse fractures usually have cases of fibular fractures opposite the tibial fractures or slightly above or below it. Further analysis also suggested that these fractures typically occur from a bending type of injury, often from a direct blow.

Orthopedic products manufacturers in India case study stated that fractures resulting from injuries with momentous torque commonly have proximal fibular fractures and occasionally an additional fracture at or below the level of the distal or middle of the oblique fracture of the tibia. Although these fracture conditions involve very different means of injury, our statistical studies on orthopedic instruments failed to reveal any significant difference in the behavior of fractures of the tibia and fibula according to the stage of fracture in either bone. On further analysis of various test cases, we have observed that a relatively stable transverse and a non-displaced fracture of the fibula can heal very rapidly and provide a stabilizing result very similar to that of the intact fibula. In these instances, the tibia may angulate toward the fibula, as in the case of the isolated tibia fracture, hence, Varus angulation possibility should be carefully monitored.

Distal Fractures:

Distal third fractures of the tibial diaphysis (the midsection of the tibia, also known as the shaft or body) with a connected fibular fracture are generally of an oblique or curved nature and are thought to be linked with a high incidence of nonunion or angular or rotary malformation. Statistical analysis by the orthopedic implant company of these fractures has not shown any difference in healing time for healing rate compared to fractures at other locations or of other types.

However, the orthopedic implant company study stated that because of the short distal fragments, there is a higher tendency for angular deformities in the distal third of the tibia than in the midshaft area. Therefore, close attention to detail in the distal fracture is an important part of the management protocol of an ortho surgical implants physician.

“Distal metaphyseal fractures of the tibia are some of the most difficult and challenging fractures to treat by any method” claims a top orthopedic implants physician. The nearness to the ankle joint results in a significant amount of swelling of the area, which prevents the early removal of the initial immobilizing cast and application of the orthopedic instrument’s functional brace. If these fractures receive the brace ahead of time, there are high chances of painful and disabling distal swelling. Our trauma implants and spine implants doctor state that the condition of the fibula must be significantly and carefully assessed and the possibility of the development of recurvatum deformity (knee joint deformity in which the knee bends backward) should be carefully monitored.

Recurvatum can be prohibited in most instances by careful consideration of the application of the initial above-the-knee cast. Its positions at the ankle should be at 90° and not in plantar flexion (a movement in which the peak of your foot points away from your leg). In this manner, the succeeding introduction of ankle motion and weight-bearing does not place excessive recurvatum moments on the distal fragment.

Segmental Fractures:

The next important type of fracture in the manufacturers of the Orthopedic products in India category is the Segmental fractures. These fractures of the tibia are managed just like other fractures of the tibia, anticipating that their behavior will not significantly differ from that of other fractures. In closed fractures, the initial shortening remains essentially unchanged in spite of the introduction of early function and weight-bearing movement. Although Segmental fractures healing may be slightly slower than observed in other fractures, our ortho surgical implants and Spine Implants analysis has not yet found a higher incidence of nonunion.

Angular deformities in such cases seem to be based on the same factors as seen in fractures of other types. The presence of an intact fibula is inclined to varus angulation of the tibia. Further, the report stated that because there are two fracture sites, the entire shortening of the limb will tend to be slightly greater than in a single fracture of the tibial diaphysis.

The reason stated for such kind of behavior is a greater level of trauma in such fractures that results in the pain and swelling in the extremity. This leads to the delayed application of the orthopedic implants like a brace by an additional few days or weeks. There are very fewer chances that any manipulative attempts can restore anatomical alignment between the three fragments in relation to the proximal and distal fragments,

However, if by any means the central fragment is mildly angulated this need not be of great concern until the knee and the ankle joint are parallel to one another. The top company in the orthopedic implant company list in India states that open segmental fractures require a longer period of waiting before the braces can be applied. The same case holds valid for open fracture in which the initial shortening is usually greater.

External fixators like interlocking nails and locking plates can be applied to restore length and should be held in place until early stability is obtained which usually takes around 4-6 weeks. If removed prematurely, the initial shortening can recur. Internal fixation may be necessary if the displacement of the middle fragment is beyond an acceptable amount. Closed interlocking intramedullary nailing has been the most effectual method of treatment.

Bilateral Fractures:

Bilateral tibial fractures constitute a significant clinical challenge to both orthopedic implant company and orthopedic implants doctor. In such cases, the analysis states that the internal fixation in the form of intramedullary nailing is often the treatment of choice.

When bracing is chosen the overall management does not vary considerably from that of unilateral fractures (fracture in which injury occurs when a large amount of force is applied to a specific area), but the inception of ambulation and the succession of weight-bearing must be adapted since the laterality of the condition prevent adequate control of weight-bearing even with maximum external support.

Once the severe and sudden symptoms have subsided and the extremities appear to be in the proper condition to receive the functional braces, these can be applied. In sternly traumatized extremities with a momentous amount of soft tissue pathology, it is necessary to wait more than a few weeks before bracing can be done and ambulation initiated. Fractures with negligible soft tissue injury have received braces as early as 2 to 5 weeks after the initial injury. Patients usually begin to walk in fixed parallel bars, which better allow them to control the range of weight-bearing. As the symptoms decrease, patients can be taught to crutch-assisted walking, after which increased weight-bearing is determined by the degree of symptoms, as in the case of unilateral fractures states top Ortho surgical implants researchers.