Radiographs of Fracture Tibia and Fibula

Tibia and fibula often fracture together. The levels of fracture could be same or differ depending on the pattern of injury.In this article, pictures of fracture tibia and fibula are being shown.

Image 1 – Open, Comminuted Fracture Tibia and Fibula

Open fractures occur when the covering skin layer is breached by external force or the fracture fragment injuring from within.

Open fractures are very common occurrence in leg bones because the soft tissue envelopes are very thin around the bones especially tibia in its antero medial aspect.

open-fracture-tibia-fibula-comminuted

A 20 year old young male was hit by a motorbike while he was attempting to cross the road. He presented to casualty with large wound over the middle third circumference of the leg.

The tibia and fibula were bared and comminuted fragments could be seen and there appeared a bone loss.

Image 2 – Xray of Malunited Fracture of Tibia and Fibula

A 35 years old young male visited the out patient department with history of trauma to ankle two days back. The ankle was swollen. The leg showed a varus deformity and marks a scar that of secondary healing  and multiple small round scars in linear fashion probably from pin insertion.

An xray of leg with ankle was done and revealed  old malunited fractures of tibia and fibula with varus angulation. The deformity is evident on anteroposterior view. The injury was 2 years old

malunited-fracture-tibia-fibula-varus-angulation

  Image 3 – Fracture Tibia with Segmental Fracture Fibula

A 32 years old young male suffered an injury after he collided with a tractor. He sustained injuries on his right leg and the xray revealed fracture of tibia with segmental fracture of fibula.

A segmental fracture is defined as a comminuted fracture in which one of the fragments have complete cortex.

Segmental fractures signify a substantial trauma.

 Image 4 – Xarys of Fracture Shaft of Tibia and Fibula

The image in the xray belongs to a 34 years old male who suffered fractures of right tibia and fibula in motor vehicle accidentfracture-tibia

The fracture was successfully managed by closed reduction and internal fixation using locked intramedullary nail.

 Image 5 – United Fibula Fracture With Ununited Tibia Fracture

Following xray belongs to 49 years old lady with fractures of tibia and fibula in lower third of the leg

united fracture and ununited tibia fracture

Xray Showing United Fibula and Ununited Tibia Fractures

The xray shows a united fracture fibula whereas fracture of tibia is ununited. The xray was taken after 6 months of non operative treatment.

Image 6 – Fracture Upper End Tibia and Fibula

Following a road traffic accident a young man presented with swelling around the knee. Xray showed fractures of uper end of tibia and fibula Anteroposterior view of fractures of tibia and fibula

Here is the lateral view

Lateral view of fracture of upper end of tibia and fibula

There was no neural deficit associated with the injury. The injury was managed by above knee slab .

Image 7 – Comminuted Fracture in Distal Tibia and Fibula

These xrays show comminuted fracture in distal tibia with fracture lines extending till articular area, something like Pilon fracture. Also seen is fracture of the fibula.

fracture-tibia-distal-third-comminuted-ap

Comminuted Fracture of Distal End Of Tibia

Lateral view

Lateral View of Comminuted Fracture of Distal Tibia

Lateral View of Comminuted Fracture of Distal Tibia.

 

Image 8 – Midshaft Fracture of Tibia and Fibula

The following xray is follow up of a mid shaft fracture of tibia and fibula which was managed conservatively in a plaster cast.

Image 9 - Midshaft Fracture Tibia and Fibula With Previous United Ipsilateral Fracture Distal Tibia Fibula

Xrays of 53 years old truck driver who had open fracture tibia and fibula in a united previous fracture of tibia and fibula in lower third area.

Fracture Mid Tibia Fibualr In Previous United Fracture Distal Third Tibia Fibula

Fracture Mid Tibia Fibualr In Previous United Fracture Distal Third Tibia Fibula

Image 10 – Spiral Fracture Tibia with Fracture Fibula

AP and Lateral Views of fracture of tibia and fibula in distal third of leg.

Spiral Fracture of Lower tibia with fracture fibula

Spiral Fracture of Lower tibia With Fracture Fibula

Fracture of the tibia is spiral in nature and is comminuted.

The patient was treated with external tubular fixator and skin grafting.

Image 11 – Fracture Distal Tibia and Fibula

Comminuted fracture of tibia and fracture of fibula in distal leg.

Fracture of Tibia and Fibula In Distal Part of Leg

Fracture of Tibia and Fibula In Distal Part of Leg

The tibia was fixed with distal tibia anatomical plate and fibula was fixed with one third tubular plate.

Image 12 – Xray of Fracture Upper Tibia and Fibula

Fracture of upper third shaft of tibia in a 60 years old lady.

Fracture Upper Third of Shaft of Tibia

Fracture Upper Third Shaft of Tibia

The fracture is comminuted and has a large butterfly fragment.

Image 13 -Xray of Open Comminuted Fracture of Tibia and Fibula

 

63 years old man met with an accident when his bike collided into another. He suffered an open fracture of tibia and fibula.

Xray of the injured leg is shown be

Open Fracture Tibia and Fibula

Open Fracture Tibia and Fibula

The patient was treated with cleaning of the wound and fixation with interlocked medullary nail.

 

Image 14 – Fracture Of Tibia With Segmental Fracture Fibula

Following xray of leg in 28 years old lady shows a fracture of tibia and a semental fracture of tibia.

Fracture of TIbia With Segmental Fracture of Fibula

Fracture of TIbia With Segmental Fracture of Fibula

The Patient was treated with closed reduction and internal fixation using intramedullary interloacking nail.

Image 15 – Distal Tibia and Fibula Fracture Fixed With Interlock Nail and One Third Tubular Plate

Fracture of tibia and fibula in distal part following a household injury in 43 years old lady. This is an xray after 4 weeks of surgery.

Fracture of Tibia and Fibula

Distal Tibia and Fibula Fracture Fixed With Interlock Nail and One Third Tubular Plate

The tibial fracture has been fixed by interlock nailing and fiular fracture using one third tubular plate.

Image 16 – Fracture of Distal Third Tibia With Comminuted Fracture of Fibular Shaft – Xrays

AP and Lateral View Xrays of Fracture Tibia and Fibula in an adult patient

Fracture of Tibia and Fibula

Fracture of Tibia and Fibula

The fracture in tibia is oblique whereas fracture of fibula is comminuted.

Image 17 – Xray United Fracture of Shaft of Tibia and Fibula

24 years old male was treated non operatively for minimally displaced fracture of shaft of tibia with undisplaced fracture of fibula. Above knee cast was given for one month followed by patellar tendon bearing [PTB] cast for another month.

FOllowing xray is after two months of initial injury after PTB cast was removed.

United Fracture of TIbia and Fibula

United Fracture of TIbia and Fibula

The fracture is united well in acceptable position.

Image 18 – Fracture Tibia Operated With Dynamic Compression Plate with Fracture Fibula

Xray of fracture tibia in 25 years old male operated with 12 hole dynamic compression plate and bone grafting.

fracture tibia operated with dcp and bone grafting.

Fracture Tibia Fixed With 12 Hole Dynamic Compression Plate and Bone Graft

The xray as taken after 4 weeks of surgery.

Image 19 – Fracture Tibia Fibula With Intramedullary Locking Nail In Situ

Fracture of distal third of tibia and fibula after tibia has been fixed with interlock nail.

Fracture of TIbia and Fibula with Tibia Fixed With Interlock Nail

Fracture of TIbia and Fibula with Tibia Fixed With Interlock Nail

The xray is two weeks after the surgery.

Image 20 – Fracture Lower Tibia Fibula With Undisplaced Fracture of Medial Malleolus

53 years old man struck by a motorcycle and injured his leg. xray revealed a comminuted fracture of tibia, fracture of fibula and an undisplaced fracture of medial malleolus.

Fracture Tibia and Fibula With Fracture Of Medial Malleolus

Fracture Tibia and Fibula With Fracture Of Medial Malleolus

Image 21 – Fracture Upper End Tibia With Fracture Fibular Neck

43 year old male having a motor vehicle injury got his knee injured. Here is the xray picture of the knee and leg

Fracture Upper End Tibia With Fracture Fibular Neck

Fractuer Uppper End Tibi Wuth Fractyre Fibular Nec

As the xray shows, there is a fracture of upper end of tibia and fibular neck.

The arrow marks the fracture of medial malleolus

Image 22 – Operated Intraarticular Fracture Distal Tibia and Distal Fibula Fracture

Intra-articular fracture of distal tibia and fracture of distal fibula [lateral malleolus fracture] treated by open reduction and internal fixation.

Distal Tibia Distal Fibula Treated With Open Reduction and Internal Fixation

Distal Tibia Distal Fibula Treated With Open Reduction and Internal Fixation

The tibia has been fixed by distal tibia anatomical plate and fibula has been fixed using one third tubular plate.

Image 22 – AP and Lateral Views of Interlocked Fracture Tibia

Following xray are of 49 years old truck driver who met with accident and had closed fracture tibia and fibula and a heel flap avulsion.
The tibia was treated with closed reduction and internal fixation using intramedullary interlocked nail.

Intramedullary interlocked nail for tibia fracture

Intramedullary interlocked nail in lower third fracture of tibia

Also visible [arrow] in the image is Steinmann pin used to fix heel flap.

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Comments

  1. Michael says

    I have a question on how to speed bone healing. I had an external fracture of my tibia and fibula on November 28th, 2009. It has been about 2 months. UCLA put a titanium rod with 4 screws (2 below the knee and 2 above the foot) to stabilize. So far we are seeing no fracture healing so I am not allowed to put weight on the leg yet.

    What can I do to help the circulation of this fracture which should increase the healing process? Dr just told me time and elevation. Is there anything else I can do?

  2. Dr Arun Pal Singh says

    @Michael,

    Unfortunately, you cannot force your bone to heal faster.

    Joint movement around the fracture is encouraged [Consult your doctor before doing it], to increase circulation of the bone.

    But as such there is nothing like faster or speed bone healing, at least till now.

  3. Michael says

    Thank you

    I can move my knee and foot….just cannot put weight on my leg.

    I take calcium liquid and eat lots of protein. I guess there is not much more I can do to speed things along. I just get impatient…

  4. Dr Arun Pal Singh says

    @Michael,

    I can understand. Injury limits the activity.

    But healing takes time. All the best.

  5. June White says

    I fractured my right foot and had an open fracture of my fibula and tibia in my left leg in Turkey, which required pinning from the knee to the ankle, I had no insurance!! however, I am so pleased to have my legs…. Anyway I am now on my 11th week and although there has been progress it is very slow… I expected to be ok after about 6 to 8 weeks; I am still in a brace for my left leg and still not driving… Anyone else in the same situation??? Trying not to get down.. hubbie does not see the dirt in the house like me!! Must add though, I am a School Bursar at a Special School and did not have a day off!! But…. due to the Ash I did have an extra 2 weeks off! Due to my injuries my husband had to come over to Turkey and look after me and we had to book 2 extra seats for my legs!! Am I ever going to walk normally??

  6. Dr Arun Pal Singh says

    @June White,

    Usually 6-8 weeks time is for bone to unite. The coming back to normal self takes much longer. Even the bone might take longer time to unite in some cases.

  7. Raja says

    Dear Dr.

    I had an accident and fractured fibual bone near ankle, Dr. has done POP (cast) on that area and advised me rest for six weeks. Can I move my leg during that tenure without putting weight on that, sleep aside or I should sleep straight and can have intercourse as I am newly married.

    plz suggest me.

  8. Dr Arun Pal Singh says

    @Raja,

    With POP on you can keep your leg either way while sleeping.

    Do I need to answer the other query?

    The decision lies entirely between your discomfort and the desire for pleasure.

  9. Mehul says

    dear dr.

    my question is i had a compound communitive tibia and fibula fractures its multiple fracture 5 fractures on my left foot on 12 july 2010 so i got a plate nd 2 screw now its all fine bt i also have a screw on in ankle..i cannot move my foot from bootom to top though can move my foot from the toe also my thumb is locked i feel..i need ur help suggest me something…

  10. Dr Arun Pal Singh says

    @Mehul,

    Would you please post more details. There is not enough information to work upon.

    If posible send xray images to contact [at] boneandspine [dot] com.

  11. Bishwa Subedi says

    Dear sir,

    I had an external fracture of my tibia and fibula on 16th july 2010. in a bike accident. I underwent an operation after 16 days. There is steel screwed inside. Now, I don't have any pain in my leg.I can move it either. When can I drive the bike and play football? Please suggest me.

  12. Dr Arun Pal Singh says

    @Bishwa Subedi,

    You should ask this to your treating doctor as he would be in better position to answer the query.

  13. Mishie Akio Morimoto says

    Sir,

    I am a Nursing student sir, I just like to ask you about the pathophysiology of this diagnosis. I’m having some difficulties how will I start my pathophysio, since I am new to Orthopedic Field. This is the Diagnosis of my patient (Fracture, Open I, Comminuted Middle 3rd, Tibia-Fibula, left secondary to VA OTA (42/B3/3).

    one more thing sir, Can you explain to me that diagnosis, because I dont know what is OTA, and (42/B3/3).

    thank you Sir.

  14. Dr Arun Pal Singh says

    @Mishie Akio Morimoto,

    OTA stands for ORthopaedic Trauma Association and 42/B3 stands for diaphyseal fracture of tibia with fragmented wedge.

    What would you like to know in pathophysiology?

  15. DINESHKUMAR MM says

    sir,

    I met with an bike accident in bangalorel3 month back. there is a internal fracture in both Fibula & Tibia. it has been oparated and put the etitanium rod with 4 screws, 2 below the knee and 2above the foot its already 11 weeks ago drctor advaising me put the wehiht 20-30% weight. can i try to walk…

    And please sugest me i can recover narmally or not …howmany days it will takes genarally … pl sujest.

    Thank you

  16. vibhor barwadia says

    hey doctor.

    i am 23 years old and i fractured my tibia and fibula in my right leg in a bike accident in january 2011. it was a compound fracture (i.e the bone was outta my skin). i would say the fracture site is a little below the mid point of the tibia. the doctors advised me to undergo intramedullary nailing which i got done the same day. the fibula was left as it is.

    i was started on physiotherapy the very next day and have good knee movement and satisfactory ankle movement as of today i.e. four months later.

    now my query is this. there wasn't much bone growth in the first two months (i was on crutches then but no POP cast) and then the doc asked me start putting a little weight on my leg and also changed me to an elbow stick.

    only after this did i start experiencing pain around my ankle and the achilles tendon. and when i had another look at the x-ray i noticed that my bone alignment was a little skewed. my tibia is actually pointing outward to the right side below the fracture site.

    i figured that this was causing me to put weight on the wrong bones and muscles etc. i went to the doctor and he sent me on my way saying there was nothing to worry as a little skewness upto 5 degrees is permissible.

    i am not entirely convinced and dont want it to cause me any problems in the future especially to my knee.

    what should i do?

    p.s. can i send u my x rays on the email you mentioned above?

    i know this is a long one but i'm really worried because i was very active before this accident and will

    appreciate all the help i can get.

  17. Dr Arun Pal Singh says

    @DINESHKUMAR MM,

    People recover well after trauma. In your case, your treating doctor has more info on you to describe the situation.

    I think you should follow his advice.

  18. Dr Arun Pal Singh says

    @vibhor barwadia,

    Yes please! You can send the xray. BTW your doctor is right. 5 degree angulation is permissible.

  19. gladdys pagaran says

    gud day,

    i had an accident last may 28,2011 it was an open wound in my right leg due a vehicular accident and fracture my tibia and fibula, IM nailing done on my operation…..i just want to know can i jog after 6 months? because im a police trainee…i want to continue my training….thanks….

  20. Justine says

    hello,
    I am writing to you now as I have now broken my tibia three times and the fibula twice. I reject the plates and pins every time and have to be put on iv antibiotics for 8 weeks. I was operated yesterday to remove the titanium material, because one of the screws was broken and the other was unscrewed. I am confident that my leg will ever be the same. Is there any other material that can be used to heal broken bones. I have heard of hips being replaced with plastic? Any information you can provide me with or questions I should be asking my surgeon please let me know. I am not see him again until the 21 of December.

  21. apsingh1975 says

    After a fracture bone has to heal with new bone formation As yet there is nothing that can replace that. Hip is a oint and it is altogether a different thing. Is there anything you would like to know more?

  22. Justine says

    Thanks for your reply, however it did not really answer my question. Is there some sort of other material that can be used other than titanium to heel bones? As I said, this is the 3rd time that the tibia has broken. The last time they also performed a bone graft. Now that all the material is out of my leg again, I am antibiotics to help kill bateria in my system. I see my surgeon on the 21st of Dec and would like to know what other material could be inserted into my leg to keep it together other than titanium, just in case he decides not to insert anything.
    Thank you

  23. apsingh1975 says

    Rather than material, you should know what are the options for the surgery. Whether your bone needs to be fixed from outside or within. If it is infected and the infection is still active, I do not think you would be operated by internal fixation, as you were in your previous surgery.

    Take care.