1. The Tibia is the Shinbone
There are two bones in the lower leg (shin). The smaller one is the fibula; the larger one is the tibia. You can feel the tibial crest in the front of the leg. There is not much soft-tissue coverage medially (toward the other leg). This has implications for the types of fractures you can sustain. Fractures usually result from a high-energy trauma, such as twisting falls, or even getting kicked during a soccer game. (Seeing a few of these gave me a newfound appreciation of how much force is generated by soccer players during a kick.)
2. They Can Be Tibial Plateau Fractures, Tibial Shaft Fractures and Tibial Plafond (Pilon) Fractures
The top portion of the tibia is the tibial plateau. Along with the end of the femur (thigh) bone, it forms the knee joint. The tibial plafond (pilon) is the end of the tibia that forms the ankle joint. Fractures that involve either the plateau or plafond are complex fractures, because they involve the actual joint surface. These are serious injuries, because they involve the articular cartilage. Often, these fragment the joint surface into little pieces, which are difficult to fix. The tibial shaft is the rest of the bone.
3. There May Be Open Fractures
If the fractured bone sticks out of the skin, it is normally called a compound fracture, but the proper term is an "open" fracture. This is as opposed to a "closed" fracture, which does not violate the skin. Open fractures of the tibial shaft are not uncommon, because of the minimal covering medially. It is literally skin and bones there (with a little fat in between). Open fractures pose a higher risk of infections and non-unions (in which the bone doesn't heal).
4. Some Will Heal With a Cast
Some non- or minimally displaced fractures may heal when placed in a cast. They should be followed quite closely, as the alignment can change within the cast. You may need serial X-rays to monitor this.
5. Some Will Require Surgery
Surgery can entail placing a rod down the middle of the bone--or, alternately, a plate and screws. Again, with plateau and plafond fractures, the bone can be shattered into many little pieces with cartilage damage, which makes these fractures serious injuries. If there is an open fracture, the surgeon will need to wash out the wound and sometimes place an external fixator (pins through the skin, joined by crossbars) to stabilize the fracture.
