Key Anatomy
List the two bones immediately inferior to the femur
tibia and fibula
What type of velocity and impact would you expect to cause a fracture?
High velocity, high impact
What is the main purpose of using a cast for a fractured tibia?
To immobilize the area and promote the natural healing process.
Simple fractures often have good outcomes whereas complex fractures can often result in
Residual pain, prolonged wound healing, and difficulty with gait.
True or False: in indirect bone healing, there is soft callus formation and hard callus formation.
True
Acute fracture
Type of fracture that doesn't cause a true break in the cortex or the matrix of the bone
During the recovery process, it is important to maintain active range of motion in the ____ and _____.
Knee and ankle
How long does it typically take for a tibia fracture to heal?
4-6 months.
What are the two types of direct fracture healing
Contact healing and gap healing
One of the primary functions of the tibia
Weight bearing
Compared to a high-energy collision, a sports related injury likely sees more ______ force.
Comminuted fracture means broken into ___ or more pieces
3
Continuous overuse can lead to recurring
Stress fractures
The initial inflammatory response usually peaks around____ hours and is completed after ____ days.
24 hours; 7 days.
What bones does the tibia articulate with?
Talus, femur, and fibula
What is one of the main causes of stress fractures
Overuse/ repetitive loading over long periods of time
Does every tibia fracture require surgical intervention?
No. i.e.: less than 5 degrees of varus-valgus angulation, less than 10 degrees in anterior-posterior angulation, greater than 50% cortical apposition, less than 1-cm shortening and less than 10 to 20 degrees of flexion and less than 10 degrees of rotational malalignment after reduction.
What are two secondary injuries that may develop following a tibia fracture?
Deep vein thrombosis (DVT) and compartment syndrome
List four types fractures that may occur in the tibia
Spiral, oblique, comminuted, and transverse
Which artery passes between the two heads of the tibialis anterior and extensor hallucis longus (EHL)
Anterior tibial artery
List some predisposing factors that impact the integrity of the tissue that might contribute to a fracture
Poor health: smoking, alcoholism, steroids, diabetes (type one = low bone density)
Previous fractures, family history, arthritis
Why might someone with stress fractures make changes to their exercise routine?
To mitigate overuse by reducing the amount/frequency of stress being applied to the tissue. The goal is to allow enough rest for osteoblasts to keep up with osteoclasts.
Why do fracture of the proximal third of the shaft has a higher rate of nonunion compared to midshaft fractures?
Deforming forces in the proximal aspect of the tibia as well as limited soft tissue coverage.
In order for bone to regenerate, specific mesenchymal stem cells (MSCs) have to be recruited, proliferate and differentiate into _____.
Osteogenic cells