Thetibiais the large shin bone located between the knee and the ankle. This part of the body is called—in medical terms—the leg. Together with the foot and thigh, the leg forms thelower extremity. (The leg is actually only the segment between the knee and ankle, even though many people refer to the lower extremity as the leg.)

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A doctor looking at a patient’s x-ray

Tibial shaft fractures can occur after falls, car accidents, and sports injuries, among other activities.

The shaft of the tibia is the central portion of the bone, not the flared ends of the bone located just below the knee or above the ankle. The medical name for the shaft of the tibia is the diaphysis of the bone. The shaft of the tibia is a hollow tube, although it does have a slightly triangular shape, with the tibial crest being the prominent ridge at the front of the shin. Fractures can also occur at the top of the shin bone (proximal tibia fractures) or at the bottom of the shin bone (distal tibia fractures).

Inside the hollow center of the shin bone is the bone marrow canal. The outer part of the bone is thick and rigid; this is called the cortex of the bone and provides the strength of the tibia. When a tibia fracture occurs, the bone is disrupted, and the stability of the leg is compromised.Tibia fractures are usually painful injuries and generally require urgent medical treatment.

Signs

Tibia fractures are typically obvious injuries, but sometimes more subtle, non-displaced fractures can be more difficult to identify. The usual signs of a tibia fracture include:

When there is a concern about a possible tibial shaft fracture, an X-ray will be obtained to determine if the bone is damaged. Most often, an X-ray test is sufficient to make the diagnosis. However, in cases such astibial stress fractures, there may still be a question about the severity of injury, and an MRI or bone scan may be performed if a fracture is suspected and the X-rays are normal.

Treatment

The most common treatments for a broken tibia shaft include:

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How External Fixation Helps Heal Serious Fractures

Healing time following a tibial shaft fracture can be highly dependent on the type of fracture, the severity of the injury and the treatment method chosen. In general, tibial shaft fractures can take 3 months for healing, and it is not unusual for fractures to take 4 to 6 months for before returning to full activities. Hearing this may be stressful, but remember that depending on your unique situation you may be able to do more sooner.

The amount of weight that is allowed to be placed on the extremity after surgery is also highly variable. In some situations with stable fractures held in place with metal implants, immediate weight-bearing may be allowed. In other situations where there is more of a concern about maintaining fracture alignment or stability, weight-bearing after surgery may be restricted until more healing has occurred.

NonunionOne particular concern with tibia fractures is called anonunion, a condition where the bone fails to heal. Nonunions are not common with everybody—they are more common after more severe injuries and open fractures, or in people with medical conditions that may impair bone healing. One of the most commoncauses of a nonunion is tobacco use, where the use of nicotine leads to delayed healing of the fractured bone, so it’s important to avoid smoking and other forms of tobacco intake. A conversation with your healthcare provider is best to determine what the best course of action is in this situation.

Nonunion

One particular concern with tibia fractures is called anonunion, a condition where the bone fails to heal. Nonunions are not common with everybody—they are more common after more severe injuries and open fractures, or in people with medical conditions that may impair bone healing. One of the most commoncauses of a nonunion is tobacco use, where the use of nicotine leads to delayed healing of the fractured bone, so it’s important to avoid smoking and other forms of tobacco intake. A conversation with your healthcare provider is best to determine what the best course of action is in this situation.

Complications of Treatment

While most tibial fractures will heal without complication, there are risks of both surgical and nonsurgical treatment of these injuries. Risks associated with surgery include infection, wound healing problems, nonunion of the fracture, and malalignment of the extremity.Nonsurgical treatment can also lead to complications including nonunion of the fracture and malalignment. Medical risks associated with surgery or immobilization can occur as well.

A Word From Verywell

Frequently Asked QuestionsA broken shin bone may have any of the following:SwellingBruisingLeg deformity (twisting, unusual angle, or shorter length)Bone “tenting” or pushing the skin upBone breaking through the skinIt often causes severe pain. You may not be able to walk on the leg or put any weight on it. Sometimes it can cause a loss of feeling in the foot.

Frequently Asked Questions

A broken shin bone may have any of the following:SwellingBruisingLeg deformity (twisting, unusual angle, or shorter length)Bone “tenting” or pushing the skin upBone breaking through the skin

A broken shin bone may have any of the following:

It often causes severe pain. You may not be able to walk on the leg or put any weight on it. Sometimes it can cause a loss of feeling in the foot.

9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Tibia and fibula fractures in children.American Academy of Orthopaedic Surgeons.Tibia (shinbone) shaft fractures.Patel NK, Horstman J, Kuester V, Sambandam S, Mounasamy V.Pediatric tibial shaft fractures.Indian J Orthop. 2018;52(5):522-528. doi:10.4103/ortho.IJOrtho_486_17American Academy of Orthopaedic Surgeons.Fractures of the proximal tibia (shinbone).Hofmann A, Dietz SO, Pairon P, Rommens PM.The role of intramedullary nailing in treatment of open fractures.Eur J Trauma Emerg Surg. 2015;41(1):39-47. doi:10.1007/s00068-014-0485-5Cereijo C, Attum B, Rodriguez-Buitrago A, Jahangir AA, Obremskey W.Intramedullary nail fixation of tibial shaft fractures: suprapatellar approach.JBJS Essent Surg Tech. 2018;8(3):e24. doi:10.2106/JBJS.ST.17.00063American Academy of Orthopaedic Surgeons.Open fractures.Raju K, Smith TO, Hing CB, Solan MC, Nielsen DM.Surgical versus conservative interventions for treating tibial shaft fractures in adults.Cochrane Database Syst Rev. 2018;2018(4):CD011095. 2018 April. doi:10.1002/14651858.CD011095.pub2Boston Medical Center.Shinbone fracture.Additional ReadingBedi A, Le TT, Karunakar MA.Surgical treatment of nonarticular distal tibia fractures.J Am Acad Orthop Surg. 2006 Jul;14(7):406-16.Bono CM, et al.Nonarticular proximal tibia fractures: treatment options and decision making.J Am Acad Orthop Surg. May/June 2001; 9:176-186.Tejwani N, Polonet D, Wolinsky PR.Controversies in the intramedullary nailing of proximal and distal tibia fractures.J Am Acad Orthop Surg.2014 Oct;22(10):665-73.

9 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Tibia and fibula fractures in children.American Academy of Orthopaedic Surgeons.Tibia (shinbone) shaft fractures.Patel NK, Horstman J, Kuester V, Sambandam S, Mounasamy V.Pediatric tibial shaft fractures.Indian J Orthop. 2018;52(5):522-528. doi:10.4103/ortho.IJOrtho_486_17American Academy of Orthopaedic Surgeons.Fractures of the proximal tibia (shinbone).Hofmann A, Dietz SO, Pairon P, Rommens PM.The role of intramedullary nailing in treatment of open fractures.Eur J Trauma Emerg Surg. 2015;41(1):39-47. doi:10.1007/s00068-014-0485-5Cereijo C, Attum B, Rodriguez-Buitrago A, Jahangir AA, Obremskey W.Intramedullary nail fixation of tibial shaft fractures: suprapatellar approach.JBJS Essent Surg Tech. 2018;8(3):e24. doi:10.2106/JBJS.ST.17.00063American Academy of Orthopaedic Surgeons.Open fractures.Raju K, Smith TO, Hing CB, Solan MC, Nielsen DM.Surgical versus conservative interventions for treating tibial shaft fractures in adults.Cochrane Database Syst Rev. 2018;2018(4):CD011095. 2018 April. doi:10.1002/14651858.CD011095.pub2Boston Medical Center.Shinbone fracture.Additional ReadingBedi A, Le TT, Karunakar MA.Surgical treatment of nonarticular distal tibia fractures.J Am Acad Orthop Surg. 2006 Jul;14(7):406-16.Bono CM, et al.Nonarticular proximal tibia fractures: treatment options and decision making.J Am Acad Orthop Surg. May/June 2001; 9:176-186.Tejwani N, Polonet D, Wolinsky PR.Controversies in the intramedullary nailing of proximal and distal tibia fractures.J Am Acad Orthop Surg.2014 Oct;22(10):665-73.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Johns Hopkins Medicine.Tibia and fibula fractures in children.American Academy of Orthopaedic Surgeons.Tibia (shinbone) shaft fractures.Patel NK, Horstman J, Kuester V, Sambandam S, Mounasamy V.Pediatric tibial shaft fractures.Indian J Orthop. 2018;52(5):522-528. doi:10.4103/ortho.IJOrtho_486_17American Academy of Orthopaedic Surgeons.Fractures of the proximal tibia (shinbone).Hofmann A, Dietz SO, Pairon P, Rommens PM.The role of intramedullary nailing in treatment of open fractures.Eur J Trauma Emerg Surg. 2015;41(1):39-47. doi:10.1007/s00068-014-0485-5Cereijo C, Attum B, Rodriguez-Buitrago A, Jahangir AA, Obremskey W.Intramedullary nail fixation of tibial shaft fractures: suprapatellar approach.JBJS Essent Surg Tech. 2018;8(3):e24. doi:10.2106/JBJS.ST.17.00063American Academy of Orthopaedic Surgeons.Open fractures.Raju K, Smith TO, Hing CB, Solan MC, Nielsen DM.Surgical versus conservative interventions for treating tibial shaft fractures in adults.Cochrane Database Syst Rev. 2018;2018(4):CD011095. 2018 April. doi:10.1002/14651858.CD011095.pub2Boston Medical Center.Shinbone fracture.

Johns Hopkins Medicine.Tibia and fibula fractures in children.

American Academy of Orthopaedic Surgeons.Tibia (shinbone) shaft fractures.

Patel NK, Horstman J, Kuester V, Sambandam S, Mounasamy V.Pediatric tibial shaft fractures.Indian J Orthop. 2018;52(5):522-528. doi:10.4103/ortho.IJOrtho_486_17

American Academy of Orthopaedic Surgeons.Fractures of the proximal tibia (shinbone).

Hofmann A, Dietz SO, Pairon P, Rommens PM.The role of intramedullary nailing in treatment of open fractures.Eur J Trauma Emerg Surg. 2015;41(1):39-47. doi:10.1007/s00068-014-0485-5

Cereijo C, Attum B, Rodriguez-Buitrago A, Jahangir AA, Obremskey W.Intramedullary nail fixation of tibial shaft fractures: suprapatellar approach.JBJS Essent Surg Tech. 2018;8(3):e24. doi:10.2106/JBJS.ST.17.00063

American Academy of Orthopaedic Surgeons.Open fractures.

Raju K, Smith TO, Hing CB, Solan MC, Nielsen DM.Surgical versus conservative interventions for treating tibial shaft fractures in adults.Cochrane Database Syst Rev. 2018;2018(4):CD011095. 2018 April. doi:10.1002/14651858.CD011095.pub2

Boston Medical Center.Shinbone fracture.

Bedi A, Le TT, Karunakar MA.Surgical treatment of nonarticular distal tibia fractures.J Am Acad Orthop Surg. 2006 Jul;14(7):406-16.Bono CM, et al.Nonarticular proximal tibia fractures: treatment options and decision making.J Am Acad Orthop Surg. May/June 2001; 9:176-186.Tejwani N, Polonet D, Wolinsky PR.Controversies in the intramedullary nailing of proximal and distal tibia fractures.J Am Acad Orthop Surg.2014 Oct;22(10):665-73.

Bedi A, Le TT, Karunakar MA.Surgical treatment of nonarticular distal tibia fractures.J Am Acad Orthop Surg. 2006 Jul;14(7):406-16.

Bono CM, et al.Nonarticular proximal tibia fractures: treatment options and decision making.J Am Acad Orthop Surg. May/June 2001; 9:176-186.

Tejwani N, Polonet D, Wolinsky PR.Controversies in the intramedullary nailing of proximal and distal tibia fractures.J Am Acad Orthop Surg.2014 Oct;22(10):665-73.

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