What Are Tibia and Fibula Injuries?

Recovering Damages for Your Injuries 

The tibia and fibula are the two long bones in your lower leg that stretch from your knee to your ankle (what you might refer to as your shin bones). It is not uncommon that these bones are fractured in car accidents involving a collision between two vehicles or when a car strikes a bicyclist or a pedestrian.

There are different types of tibia and fibula fractures that can occur, and the difference can be significant with respect to the severity of the injury, the nature of the treatment, and the duration of the recovery.

If you have been the victim of an accident in which you have injured your lower leg, you will need a lawyer who understands the significance of lower leg fractures, how they occur, and the medical and financial consequences on your recovery. At Foster Wallace, we understand the nature of tibia and fibula fractures and how they can affect your quality of life during and after recovery from an accident. Contact our personal injury lawyers today to discuss the nature of your broken leg and how we can help you to recover maximum damages for your injury.

What Are the Tibia and Fibula?

The tibia is the large bone of the lower leg (the front of your shin). The tibia is the bone that bears most of your body weight.

The fibula is the smaller bone located on the outside portion of the lower leg. It supports the tibia and stabilizes the lower leg muscles. It is connected to the tibia by a ligament called the “syndesmosis.” The fibula is hollow at its center and does not bear much of your body weight. The tibia and fibula function together to support your weight and to attach ligaments to the ankle and knee joints.

Because the fibula does not serve to support your body weight, it is often used in surgical procedures to provide bone matter to other parts of the body. A person can usually function well even though parts of the fibula bone have been extracted from the lower leg.

What Type of Tibia and Fibula Injuries Are Common in Car Accidents?

There are several different types of tibia and fibula injuries, depending on the nature and severity of the injury. There also are low-energy and high-energy injuries. Low-energy tibia and fibula injuries are common in children, whose bones are not fully developed and may fracture easily by the mere twisting motion; they do not require significant impact to produce injury. However, in adults, tibia and fibula injuries are more commonly high-energy injuries caused by more significant impacts, such as those that occur in many contact sports or as a result of car accidents.

Tibia Fractures

Tibia fractures sometimes occur in car accidents, bicycle accidents, and pedestrian accidents. Tibia fractures can be easy to fix but can be difficult to heal after resetting and can involve significant complications, such as infection, soft tissue damage, and nerve damage.

Contrary to what you might think, it is unlikely that you will fracture your tibia in a frontal impact or rear-end collision. It is difficult to break the tibia bone unless there is direct impact, which more commonly occurs with side-impact collisions, especially with high-impact vehicles like trucks. The most critical tibia injury occurs when the tibia is crushed by the interior of the vehicle upon impact. If the tibia fracture is “open,” in which the broken bone punctures the skin, you will likely also suffer nerve and blood vessel damage. A tibia fracture also could be “closed,” in which the bone is fractured but does not break the skin and is contained inside the leg.

A closed tibia fracture could be minor and only require a boot or cast. However, a major tibia fracture could also involve a fracture of the fibula, which may require surgery and could take months to more than a year to fully heal.

With an open tibia fracture, in which the bone juts through your skin, surgery is required and there is a significant risk of infection depending on the severity of the open wound. This can lead to further complications. With an extreme open fracture resulting in complications, amputation may be required.

The most common tibia fracture in a car accident is a tibial shaft fracture in which the bones are broken into several fragments and the bones are displaced (meaning the broken parts of the bones are not aligned). It is possible to avoid surgery and set the bones by wearing a long leg cast (hip to ankle) for up to eight weeks, but these unstable fractures normally require surgery to align the broken bones.

Fibula Fractures

Fibula fractures also may occur in several ways. The most common fibula fractures are:

• Ankle fractures
• Fractures in conjunction with the tibia (“tib-fib” fractures)
• Fibula shaft fractures

The most common symptoms associated with the fibula fracture include:

• Pain directly over the fibula bone, on the outside portion of the leg
• Swelling in the area of the fracture
• Bruising over the site of the injury

These fractures can normally be identified with a standard X-ray. The most common of these are the ankle fractures, which result from turning, buckling, or twisting the ankle. These fractures often occur to an isolated part of the end of the fibula at the ankle joint and are treated similarly as a badly sprained ankle. A brace is normally sufficient to support the ankle, or crutches may be used for several weeks until swelling and pain subside.

However, more serious fibula fractures—typically to the inner side of the ankle—often require surgery to stabilize the ankle joint. Without surgery, the ankle joint may not align correctly and this can lead to the development of ankle arthritis.

How Do You Treat an Injured Tibia and Fibula?

Often, a closed fracture to the tibia is not considered critical unless complications arise. Injuries could be long-term if they involve nerve or blood vessel damage. However, with a non-critical closed fracture, it could take 6 to 8 weeks for the fracture to heal.

With an open fracture that punctures the skin and requires surgery, which is more typical in high-energy impact collisions, there is higher risk of complications, such as:

• Infection. The possibility of infection requires antibiotic treatment and usually a tetanus shot.
• Bone fragments. Bone fragments must be removed from the fracture and the remaining bones must be aligned.
• Soft tissue damage. Soft tissue damage can lead to long-term injury and further complications.
• Vascular (circulation) complications. Vascular complications can affect permanent blood flow to the injured area and can result in more aggressive remedies, like amputation.

Depending on the severity of the injuries, both a tibia and fibula fracture could require different corrective measures. These may include:

• Closed reduction and immobilization. This means setting the bones without surgery being required.
• Open reduction. This means exposing the bone with surgery to set the bone (typically used for open fractures) and stabilizing the set bones with internal or external fixation.
• Internal fixation. Internal fixation means connecting the bones with screws, plates, rods, and nails that remain under the skin, inside the leg.
• External fixation. External fixation means using pins, clamps, and rods to stabilize the fractured bones from the outside of the leg, above the skin.
• Percutaneous pinning. This means inserting wires across the fractured bones to hold the pieces of the fractured bones in place until they heal, at which time the wires are then removed.

Tibia and Fibula Injuries to Bicyclists and Pedestrians

In a study conducted in Germany involving tibia and fibula fractures of 143 pedestrians and 79 bicyclists between 1996 and 2004, researchers compared the characteristics of the fractures and injury patterns for pedestrians and bicyclists.

The study revealed the following:

The study revealed that the location of the fractures at the lower leg of the pedestrians was frequently situated below the point of impact with the vehicle’s bumper. The bumper height and the fracture height overlapped in only 1.5% of the cases. This was also true for the bicyclists, but the bicyclists suffered fractures much more frequently in the lower region of the tibia/fibula, near the ankle.

The study also specifically compared the fractures of the two groups in relation to the development and design of the front bumpers of the automobiles that struck the subjects over that time. The study compared four different designs of front bumpers on the vehicles:

• Oldest bumper design = protruding and rectangular
• Newest bumper design = significantly rounded and integrated into the front of the vehicle

The researchers concluded that the height of the bumper had very little correlation to the height of the leg fractures. However, “the bumper shapes of the newer cars [after 1995] with integrated and rounded bumper shapes showed fewer fractures altogether” and generally produced easily treatable fractures that did not require treatments possibly leading to complications. For both pedestrians and bicyclists, “the older, protruding bumper shapes or those with a distinct pointed shape of the bumper resulted more frequently in complex fractures as compared to the newer . . . integrated and rounded shapes, having a more extensive impact transfer area.” Thus, the researchers concluded that the altered design of the bumper lowered the incidence of fractures and prevented complicated fractures involving complex long-term consequences.

Finally, the study compared the effect of the impact velocities on the fractures of the two groups. The researchers concluded that lower impact velocities created a “pushing-away” motion of the leg of the pedestrians, which caused a direct momentum and a relatively higher position of the fracture. In collisions with greater impact velocities, the lower leg, as a rule, was pulled under the bumper of the car, which shifted the position of the fractures downwards. Comparatively, 77% of the pedestrian fractures occurred in the middle portion of the bones, whereas the bicyclists suffered more fractures near the ankle.

Ultimately, in addition to the conclusion that distinctly rounded bumper shapes resulted in “fewer fractures and low-complexity fractures,” the researchers concluded that although it would be better for bicyclists to have a higher impact load and avoid ankle joint injuries, “[c]ompar[ed] to the situation of pedestrians it is much safer for the bicyclists.”

What Damages Can You Recover for a Broken Tibia or Fibula?

If you are struck by a vehicle in a car accident caused by the driver of the vehicle and suffer a fracture of the tibia or fibula, you may be entitled to compensation for your damages.

Damages may include:

Medical costs.

• You may recover for any expenses associated with the medical treatment of your broken leg, including:
  • Ambulance
  • Surgery
  • Medical supplies (cast, boot, brace)
  • Doctor visits
  • Pain medication
  • Antibiotics
  • Treatment
  • Rehabilitation

Pain and suffering.

Lost wages.

• The average tibial fracture, which generally does not heal well, heals in about 4 months and requires long periods of rehabilitation. Some patients may remain disabled for as long as a year. The prognosis for fractures with significant soft tissue damage is worse. During this time, the victim may be out of work, particularly if their work involved physical activity. The different kinds of fractures and the variables that affect the location and severity of the fractures can have significant financial consequences.

The Nature of Your Tibia or Fibula Fracture May Affect the Amount of Your Recovery

Tibia and fibula fractures often result from car accidents. To receive the appropriate compensation for your injuries, you need an attorney who understands the significance of tibia and fibula fractures and the factors that lead to different kinds of injury for each.