Fractured Tibia/Fibula: painless fixation through IR way

Arvind, a 33-year-old medical representative has finished his last sales call of the day and returning home. it was almost 10pm while returning back to his home on his motorcycle, a fast moving truck overtakes him, making a close turn which touches the motorcycle and because of a sudden shock, he lost his balance and hit the footpath. Arvind's leg got severely damaged that he was not able to move it and the bleeding was consistent. a local person immediately calls the ambulance and admitted him to a nearby hospital.

during examination, the doctors find out that it is an open fracture of Tibia which has also damaged the fibula. the situation was severe as it is an open fracture
open fracture: if a bone breaks in such a way that bone fragments stick out through the skin or a wound penetrates down to the broken bone, the fracture is called an open or compound fracture. Open fractures often involve much more damage to the surrounding muscles, tendons, and ligaments.
They have a higher risk for complications—especially infections—and take a longer time to heal.

immediate surgery is an important requirement of time but the biggest challenge was the profuse bleeding, damaged tissues and the pain which is unbearable.
The doctors after having a second opinion with experts came to the conclusion of applying the interventional radiology method for treatment using the minimally invasive technique.
after certain hours the treatment was successful without any damage to nearby muscles or tissues.

What is Fractured Tibia/Fibula

The tibia and fibula are the two long bones in the lower leg. They are closely linked at the knee and ankle, but they are two separate bones. 

The tibia is the bone that forms the shin and is the larger of the two lower-leg bones. 

The top of the tibia connects to the knee joint and the bottom of the tibia connects to the ankle joint.

 Although this bone carries all the body’s weight, it needs support from the fibula.

The fibula forms the calf bone. It is the smaller bone of the two lower-leg bones and runs parallel to the tibia. 

The top end of the fibula is located below the knee joint but is not part of the joint itself. The lower end of the fibula forms the outer part of the ankle joint (it can usually be seen as the bony lump on the outside of the ankle). 

The fibula doesn’t carry much weight but instead acts as a stabilizer for the tibia.

Although the tibia and fibula can break (fracture) independently from each other, 

it is more common for the two bones to break together (this is called a combined tibia/fibula fracture) because they are so close together, especially around the knee and ankle joints. 

When one bone is injured, it usually affects the other bone too.

What are the symptoms of a tibia/fibula fracture?

Generally, a tibia/fibula fracture is associated with:

pain or swelling in the lower leg area, an obvious deformity or uneven leg lengths

inability to stand or walk (more likely with the tibia; less likely if only the fibula is broken) limited range of motion in the knee or ankle area bruising or discoloration (may indicate damage to blood vessels)

What causes a tibia/fibula fracture?

Fractures happen when there’s more force applied to the bone than it can withstand.

A lower-leg fracture usually happens due to a “high-energy” force from falls, trauma or a direct blow. 

These are often caused by motor vehicle crashes or by direct contact or sudden twisting in sports. 

Whenever there is a trauma to the leg, the impact spreads between the tibia and fibula. 

Because both bones absorb the blow, the impact usually results in a combined tibia /fibula fracture.

A stress (hairline) fracture may also occur in the fibula, although it is far less common than stress fractures to the tibia, which is a weight-bearing bone.

Treatment

Vertebroplasty

Vertebroplasty is a minimally invasive treatment developed to treat pain caused by vertebral compression fractures

and has been safely performed since the late 1980s. 

Using X-ray imaging, an interventional radiologist inserts a needle into the collapsed vertebral body through a small incision in the skin. This image-guided technique allows the doctor to accurately access the fracture while minimizing trauma to surrounding tissue. 

A medical-grade liquid cement is then injected into the center of the vertebrae. As the cement solidifies, the broken bone is stabilized. The treatment is performed with the patient face-down and sedated for their comfort.

Afterward, many patients feel immediate relief from pain and can be discharged home the same day. 

Kyphoplasty

Kyphoplasty is similar to vertebroplasty and is equally effective in stabilizing compression fractures.

 As with vertebroplasty, a needle is inserted into the fractured vertebra, using X-ray imaging.

 A balloon is then positioned into the collapsed bone and inflated to create a cavity for cement injection. The cement is injected into the cavity once the balloon is removed. Many patients feel immediate pain relief and are able to resume regular activities within a few days.

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