The best care

Tibial fractures can be defined as chronic and acute, ranging from stress fractures to open traumatic injuries, which require immediate surgical intervention and stabilization. Anatomic considerations for tibial fractures include the area around the knee joint, which involves the articular surfaces and are commonly called tibial plateau fractures.  Fractures involving the shaft are usually based off their geographic location and the amount of soft tissue and bony injury.  Distal (or fractures about the ankle joint) often involve components of the articular surface and are referred to as pilon fractures.  Proximal and distal tibial fractures have accompanying soft tissue injuries in the form of ligamentous or tendinous disruption with instability. These often require temporary external fixation (i.e., erector sets) before definitive internal fixation can be undertaken.  Temporary external fixation allows the soft tissue as well as the underlying bone to calm down.  Occasionally, blisters over the area of the fracture are seen. These are manifestations of the energy which has been absorbed and dissipated from the fractured bones.   Spanning external fixation and stabilization of both the bone and the soft tissue will allow for resolution of the swelling and edema, so that definitive internal fixation may be performed in safe and timely manner. With the advent of anatomically pre-contoured plates, the restoration of normal anatomy is much easier. There are times that the use of bone grafts either from the patient (autograft) or cadaveric (allograft) and/or bone substitutes (or void fillers) are required to bridge any/all significant bone loss.  Internal fixation (in the form of plates and screws or intermedullary rod) will take place once the surrounding tissues are no longer/less irritated. This can be a long healing process and all options will be presented and explained by your physician.