Tibial Shaft Fractures Workup

  • Author: Brian K Konowalchuk, MD; Chief Editor: Carlos J Lavernia, MD, FAAOS   more...
 
Updated: Feb 10, 2012
 

Laboratory Studies

  • When a previously healthy patient presents with a fractured tibia that is treated nonoperatively, laboratory studies are not necessarily required.
  • If the patient is a surgical candidate, a complete blood cell count, chemistry panel, and a type and cross-match should be performed, along with any other tests in the hospital protocol.
  • If the tibia was broken with minimal trauma, the physician should pay particular attention to the serum calcium and phosphorus levels; metabolic or endocrine causes may account for the decreased bone density related to the fracture.
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Imaging Studies

  • Along with a complete history and physical examination, radiographs are invaluable in making a diagnosis and determining treatment. The standard protocol is to obtain anteroposterior and lateral radiographs of the injured leg. The ipsilateral knee and ankle are also often radiographically imaged because concomitant injury to one or both of these joints is common.
  • If further imaging is necessary to define the fracture pattern or associated soft-tissue injury, a CT scan and an MRI also may be obtained.
  • A bone scan can provide evidence of a stress fracture if the physical examination and radiograph findings are unclear. An arteriogram is useful if vascular compromise is suspected.
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Contributor Information and Disclosures
Author

Brian K Konowalchuk, MD  Staff Physician, Department of Orthopedic Surgery, University of Minnesota College of Medicine

Brian K Konowalchuk, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Coauthor(s)

Nicholas J Wills, MD  Fellow, Twin Cities Spine Center

Disclosure: Nothing to disclose.

Brian Tollefson, MD  Flight Surgeon, United States Air Force

Disclosure: Nothing to disclose.

Marc Swiontkowski, MD  Chair, Professor, Department of Orthopedic Surgery, University of Minnesota at Minneapolis

Marc Swiontkowski, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Orthopaedic Association, and Canadian Orthopaedic Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Charles T Mehlman, DO, MPH  Professor of Pediatrics and Pediatric Orthopedic Surgery, Division of Pediatric Orthopedic Surgery, Director, Musculoskeletal Outcomes Research, Cincinnati Children's Hospital Medical Center

Charles T Mehlman, DO, MPH is a member of the following medical societies: American Academy of Pediatrics, American Fracture Association, American Medical Association, American Orthopaedic Foot and Ankle Society, American Osteopathic Association, Arthroscopy Association of North America, North American Spine Society, Ohio State Medical Association, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Shepard R Hurwitz, MD  Executive Director, American Board of Orthopaedic Surgery

Shepard R Hurwitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for the Advancement of Science, American College of Rheumatology, American College of Sports Medicine, American College of Surgeons, American Diabetes Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Association for the Advancement of Automotive Medicine, Eastern Orthopaedic Association, Orthopaedic Research Society, Orthopaedic Trauma Association, and Southern Orthopaedic Association

Disclosure: Nothing to disclose.

Dinesh Patel, MD, FACS  Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital

Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Carlos J Lavernia, MD, FAAOS  Adjunct Clinical Professor, Department of Orthopedic Surgery, University of Miami School of Medicine; Medical Director, Orthopedic Institute at Mercy Hospital

Carlos J Lavernia, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Hip and Knee Surgeons, Arthritis Foundation, Biomedical Engineering Society, Florida Orthopaedic Society, and Orthopaedic Research Society

Disclosure: Zimmer Stock Implant Designer

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Standard anteroposterior radiograph of a tibial shaft fracture with intramedullary nail fixation. Note the commonly associated fibular fracture that is also apparent.
Radiograph demonstrating a displaced tibial shaft fracture with associated fibula fracture.
External fixation of an open tibial shaft fracture. Note the fasciotomy incision along the lateral aspect of the left leg.
Open tibial shaft fracture.
Infection after internal fixation of an open tibial shaft fracture.
 
 
 
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