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Date of last update: 10/01/2017.

Forum Name: Bone trauma and fractures

Question: broken Tubia and Fibula

 sr10029 - Thu Aug 11, 2005 3:53 am

My 10 year old son broke both bones five weeks ago in a road accident.

Two attempts, by surgens, to align the Tibia by manipulation have not been successful.

Nancy nails have now been inserted in order to maintain alignment.

No action has been taken with the fibula as I have been notified that this will heal itself.

Yesturday an exray revealed that the Tibula has bent again at the point of fracture.. (10 degrees).
The consultant explained that this was because the fibula bone was pushing against it.

He advised that this was acceptable and would straighten with time. He did not expect it to move out an further.He stated that action would have been necessary if the point of fracture was out by more than 15 degrees.

He will see my son now in four weeks time.

I am concerned that my son will not make a full recovery as a result of this misalignment.

Can you advise please
 Dr. Tino Anthony Solomon - Tue Oct 31, 2006 4:03 pm

Hello there,

The first point to remember and to put your mind at rest is that your consultant will be acting in the best interest of your child and, being an orthopaedic surgeon, is the most qualified to advise on the method of treatment. You should have faith in him as he will have seen thousands of cases like your son's condition. From my experience in orthopaedics and from formal training that we undergo, a fibula fracture is treated conservatively unless in specific situations such as when it is fractured in many pieces, when it can be repositioned and held with a metal plate or nail. In young children, bones tend to be more malleable than adults and thus bend more especially when under stress. The fracture itself may have been a 'greenstick' fracture, where one side of the fracture has broken and one side is bent; therefore it is classified as an incomplete break. The name comes from the analogy of breaking a young, fresh tree branch. The broken branch snaps on one side while the inner side is bent, and still in continuity. A nancy nail is an ‘intramedullary’ (through the canal of the bone) nail which gives the bone stability, but can itself also bend.

Most fractures, whether in the acute or chronic phase are managed based on angulation and/or displacement. The angle that a fragment of broken bone is, in relation to its other previously joined part, determines when fixation is needed. However, if fixation has taken place, this may need to be corrected or revised. This is a very complicated and controversial area which I will not go into, simply because I am neither qualified in the field nor do I have the experience to do so. You part is simply to maintain follow-up and if you notice any obvious change in the shape of your child's leg or he finds walking more difficult, then book an urgent appointment to see your surgeon or GP who will arrange a repeat X-ray. You are in good hands, so try not to worry!


Dr Tino Solomon
BSc(Hons) MBBS
Senior House Officer in Surgery

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