How it happens
The upper part of the tibia breaks when the leg goes to sideways when you fall. The same basics apply here. Everything depends on how bad was your fall. A slow impact will cause simple fractures while high energy impacts will break the bone into pieces.
The surrounding soft tissues (Skin, Muscles, blood vessels and nerves) will also be damaged
Extent of injury
The fracture opens into the knee joint most of the time. There will be disruption of the tibial surface of the joint. Bleeding into the knee will produce knee swelling.
There will be a chance of excessive swelling of the calf if blood vessels carrying oxygen to the leg are damaged or associated with a severe crushing.
Please try and keep the leg straight. You need to splint the leg from mid-thigh region to the ankle with a suitable device. Applying some ice will cool down the knee region.
You need to keep the limb elevated with some support all times
Please do not apply any ointments, warm herbal pastes over the injured area as they will damage/burn the skin.
You may use a clean cloth/suitable dressing to cover any wounds
Please do not give anything to drink and Eat until you are advised to do so by a medical professional.
Giving a pain killer with a sip of water is accepted.
Please take any medical records/medications alone with you.
Examination and tests
You and your leg will be examined. Any associated injury will be looked for.
Your leg will be x-rayed. A CT scan will be done if details of the fracture deemed necessary. This will help in planning operation.
Big operation ?
This is a safe operation. It will take about 90-120 minutes to fix the fracture. It can be done under a general or spinal anesthesia.
Operation when and how
Simple fractures could be operated without delay. The main operation will be delayed when there are swelling/wounds over the injured area.
Associated blood vessel injuries will need additional operations before fracture fixation. In such instances your leg will be fixed using an external metal frame which runs across the knee. The definitive fixation will wait until the wounds heal or the swelling settles.
How is it fixed ?
The main aim of the operation is to reconstruct the joint surface and then fix it to the shaft of the bone. You will have a cut at side of the upper part of the leg. There will be an additional cut at the inner side at the same level in complex fractures.
Minor breaks can be fixed screws. There are specially designed metal plates to fix fractures of this part of the bone. Few chips of bone (bone graft) may be taken from your waist (ilium) in certain occasions. Your leg will be supported with a plaster of Paris half cast.
Uncomplicated cases could be discharged in couple of days. However Some will need longer stays if wound complications occur or if they need additional treatment for other conditions.
When can you start moving
When the wound heals, swelling settles the knee can be mobilized without weight bearing on the operated leg. The knee motion will be controlled with a knee brace. During this time you could walk on the other lag using a pair of crutches.
tial weight bearing could be begun at about 10 weeks, aiming full weight bearing at 12 weeks after the operation. however time frame may be different in complex injuries
Know complications of injury
There are some complications of this injury. Stiffness of the knee is the commonest out of these. You could develop osteoarthritis of the knee.