Tibial shaft fracture

Clinical presentation

Tibial shaft fractures are the most common long bone fracture. It can occur from high energy or low energy mechanisms. Patient may have leg pain, inability to weight bear or present with leg deformity.

Clinical assessment

Initial patient assessment should follow ATLS.

Important to look for

• open fracture

• compartment syndrome

• neurovascular deficit

Imaging should include full length AP and lateral XR of the tibia.

Proximal third or distal third fractures may extend into the joint. CT scan can evaluate these in more detail if suspected.

A&E management

• initial assessment as above

• provide analgesia

• prepare resus space for reduction / application of backslab

• refer to ortho oncall