Lower leg fractures, or, Tibia fractures are common injuries and are often complicated with open fracture sites (the fracture site is exposed through the traumatic wound), due to the thin skin covering of this bone. Open fractures require specific emergency management with wound debridement and intravenous antibiotics. Open fractures carry an increased risk of delayed development of bone infection (osteomyelitis / osteitis). Initial fracture stabilisation in these cases is often carried out with a external fixation apparatus, which may be exchanged for an intra-medullary nail or a plate within 10 days or once the soft tissue injury allows.
Lower leg fractures, or Tibia fractures in children are less often managed with internal fixation and may often be treated with manipulation under anaesthetic and above-knee plaster cast immobilisation. This may then be converted to a below-knee cast at four weeks.
Patients are often concerned that an associated fibula fracture remains displaced – the fibula fractures only become important when they are situated at the proximal or distal end of the fibula and therefore either represent knee ligament avulsion injuries or unstable ankle fractures.
