A fracture, or break, in the shinbone just below the knee is called a proximal tibia fracture. The proximal tibia is the upper portion of the bone where it widens to help form the knee joint.
In addition to the broken bone, soft tissues (skin, muscle, nerves, blood vessels, and ligaments) may be injured at the time of the fracture. Both the broken bone and any soft-tissue injuries must be treated together. In many cases, surgery is required to restore strength, motion, and stability to the leg, and reduce the risk of arthritis.
There are several types of proximal tibia fractures. The bone can break straight across (transverse fracture) or into many pieces (comminuted fracture). Sometimes these fractures extend into the knee joint and separate the surface of the bone into a few or many parts and these types of fractures are called intra-articular or tibial plateau fractures.
A proximal tibia fracture can be treated non-surgically or surgically. There are benefits and risks associated with both forms of treatment. Whether to have surgery is a combined decision made by the patient, the family, and the treating surgeon. The preferred treatment is accordingly based on the type of injury, the general needs of the patient including expectations, lifestyle, and medical condition.
In an active individual, restoring the joint through surgery is often appropriate because this will maximize the joint’s stability and motion, and minimize the risk of arthritis.
In other individuals, however, surgery may be of limited benefit. Medical concerns or pre-existing limb problems might make it unlikely that the individual will benefit from surgery. In such cases, surgical treatment may only expose these individuals to its risks (for example anaesthesia and infection).