Tibia and fibula fracture

In a cruris fracture - a broken lower leg - both the shinbone (tibia) and the fibula are broken. A fracture of both bones results in instability of the lower leg.

In addition to bone injury, a cruris fracture often also involves damage to the so-called soft tissues. These are the tissues that connect, surround, and support the bone fragments. Examples of soft-tissue damage include injury to the skin and muscles or, in more severe cases, to blood vessels and nerve tissue. Especially in the case of an open fracture, in which the broken bone pierces the skin and is exposed to the outside air, there is always additional soft-tissue damage.

How does a cruris fracture occur?

A cruris fracture is a combination of a break in both the tibia and the fibula, even though the tibia is a very thick and strong bone. A trauma with a great deal of force is required to break this bone. Such a high-force trauma is also called a high-energy trauma (ongeval met veel energie). It often results from a fall from a height, a traffic accident, or a direct blow or kick to the lower leg.

What are the signs and symptoms of a cruris fracture?

A deformity of the ankle, often outward, with pain or swelling at the fracture site are the most characteristic features of a cruris fracture. Because of the instability of the fracture, it will not be possible to bear weight on the affected leg. In the case of an open fracture, a wound is visible at the fracture site and, due to soft-tissue damage, there may be sensory disturbances in the area below the fracture.

How is a cruris fracture diagnosed?

It is usually not very difficult to recognize a cruris fracture. However, additional tests in the hospital are always needed to determine the exact location and severity of the fracture. This assessment also looks at the presence and extent of soft-tissue damage.

First, an röntgenfoto will be taken to evaluate the fractures. If necessary, a CT scan or MRI scan is performed to provide more insight into soft-tissue injuries.

What does treatment for a cruris fracture look like?

A cruris fracture is usually unstable. Therefore, it is not guaranteed that the broken parts will return to their pre-injury alignment on their own. In that case, surgery is necessary. To allow the bone fragments to heal properly, they are often secured during surgery with so-called fixation material.

This fixation material may be a metal rod or a plate with screws, depending on which bone needs to be fixed. This method is also called ‘internal fixation’. In cases of severe damage, including soft-tissue injury, the surgeon may be more inclined to stabilize the bones from the outside. This is called ‘external fixation’.

Recovery time after surgery varies depending on the fixation technique used, the severity of the fracture, and the extent of soft-tissue damage. In general, the affected leg should not be loaded for the first 6 to 12 weeks. After that, it is advisable to work back to full weight bearing under the guidance of a physical therapist.