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Abstract: The tibiofibula is anatomically superficial and is the main weight-bearing bone of the lower extremity, which can easily cause violent injuries. The patient in this case was hit by a heavy object and his body twisted, causing a tibiofibular fracture, in which the tibial fracture fracture line was closer to the ankle joint than the fibular fracture line, which was confirmed by X-ray examination, and the fracture stability was poor, and surgical treatment was used for internal fixation, and the patient gradually regained weight-bearing walking function after surgery with rehabilitation training.
Basic information】Male, 42 years old
Disease Type】Tibiofibular fracture
Hospital】Harbin First Hospital
Date of consultation】08/2021
Treatment plan】Surgical treatment (incision and internal fixation)
Treatment Period】7 days of inpatient treatment and outpatient follow up
Results】Fracture repositioning and fixation, pain relief
I. Initial consultation
The patient was a 42-year-old male who suffered a tibiofibular fracture due to a heavy impact, which caused local swelling, painful deformity and limited movement. To ensure smooth healing of the fracture and to restore the continuity and integrity of the tibiofibula, the patient was advised to undergo surgery for internal fixation. Conservative treatment will not ensure accurate alignment of the fracture end and may result in malunion healing. Because of the fracture of the tibiofibula, there is local bleeding, which can easily lead to fracture complications such as osteofascial compartment syndrome and requires a high degree of patient attention. Surgical internal fixation also carries certain risks, such as infection and delayed fracture healing.
II. Treatment process
After careful consideration, the patient and his family chose to be hospitalized for surgical incision and internal fixation. During the surgery, the tibial fracture and fibular fracture sites were carefully stripped and the fracture ends were found to be relatively severely damaged and the fracture stability was poor. After the operation, we observed the sensation, movement and blood circulation of the toes in detail, and asked the patient to elevate the affected limb and start ankle and toe flexion and extension activities after the anesthesia effect was eliminated to accelerate blood circulation, prevent the formation of deep vein thrombosis in the lower limb, and promote the smooth healing of the fracture.
III. Treatment effect
After the incisional repositioning titanium plate screw internal fixation surgery, the tibial fracture end and fibula fracture end were firmly fixed, and the review radiographs confirmed that the fracture line gradually disappeared, there was continuous bone scab through the fracture end, and the fracture stability gradually improved. The patient was able to walk without weight on the affected limb out of bed and gradually regained the ability to live, so the patient was discharged home and advised to pay attention to outpatient follow-up.
IV. Notes
The patient’s tibiofibular fracture occurred at the same time, but the operation was successful and there was no danger, for which I was very happy. After discharge from the hospital, I advised the patient to pay attention to increase nutrition during the recovery process. The diet should be rich in protein and calcium-containing foods, such as milk, eggs, kelp, etc., in order to achieve a positive balance of nitrogen and calcium and promote the healing of the fracture. Avoid local weight bearing and make sure the swelling subsides as soon as possible to ensure smooth healing of the fracture. In case of delayed fracture healing, it is necessary to review the radiographs to confirm the stability of the fracture end and continue recuperation until the tibiofibular fracture is completely healed.
In addition, it is important to observe the recovery of the limb and to follow up if there is pain, swelling and other abnormalities. In addition, we should always pay attention to prevent serious trauma and protect the tibiofibula to avoid affecting normal life.
V. Personal insight
Although this patient is a middle-aged male, due to the occurrence of tibiofibular fracture, the degree of damage to the bone is relatively heavy, so the recovery time is relatively long, and it may subsequently take 3-6 months to return to normal life. Before full recovery, extra attention needs to be paid to whether there is acute aggravation of swelling and pain symptoms in the lower leg to ensure that deep vein thrombosis can be detected in time.