Fibula fracture

The smaller bone that runs parallel to the tibia on the outside of the lower leg is called fibula. Usually, fractures of the tibia and fibula occur simultaneously. If a person sustains only fibula fracture, it is because the side of the leg receives a direct blow, or it may be due to an extreme sideways bend at the ankle or knee. It may not cause any long-term complications, when there is a fracture of the fibula alone. If there is a fibula fracture alone:

• There is localized swelling and tenderness around the fracture site, along the outside of the lower leg.
  
• You may experience pain at the outside of the lower leg, that aggravates while you walk.
  
• The common peroneal nerve that crosses the fibular neck is prone to injury due to fibular neck fracture or because of the pressure of a splint or during surgical correction. A foot drop or sensation abnormalities may occur because of this.
  

The orthopedic will check for swelling, tenderness bruises, deformity and for any abrasions. Feeling the pulse along the length of the injured leg of the patient, the orthopedic will assess how one responds to touch. He will also check the normal muscle strength of the leg and the foot. This is to rule out any damage to the blood vessels or nerves by the sharp edge of the broken bone. To determine the blood flow to the leg accurately, the doctor might opt for specialized Doppler studies. To determine and confirm the location and the extent of severity of the fibula fracture, X-rays are conducted. Although some of the leg fractures take longer time to heal, normally the average healing time is six months.

By preventing accidents, many fractures can be avoided. Elders should encourage safe play among children. Careful driving and wearing seat belt will prevent fractures during driving. Osteoporosis is another condition that will result in fractures when a person falls.

Talus fracture

The talus is a turtle-shaped small bone that sits between the heel bone calcaneus and the two bones of the lower leg, the tibia and fibula. Over half of the talus is covered with cartilage. The talus is an important connector between the foot and the leg and the body. It helps to transfer weight and pressure across the ankle joint. Therefore any injury to the talus affects the ankle and the subtalar joints and multiple planes of movement of the foot and ankle are also affected. It is interesting to note that the first series of talus fractures was described in men injured in the British Royal Air Force in early 1900, when the old war planes made crash landings. The term aviators astragalus was used to describe what we now call talus fracture. Typically causes for talus fracture include fall from heights, motor vehicle collisions and injuries of the lower back.

Persons suffering from talus fracture experience acute pain and considerable swelling and tenderness in the affected area. There is inability to bear weight. Often this type of fracture is mistaken for ankle sprain. A physician relies on x rays of the foot and the ankle to ascertain the nature and kind of talus injury. In some cases, if x ray does not reveal the nature of the fracture, a CT scan is requested. Fractures in the talus can occur:

• Through the neck of the talus
  
• Through the dome of the talus
  
• Aviators fracture which occur through the neck of the talus with dislocation of the body of the talus out of the ankle joint.

Fractures of the talus are rare but when they occur they are highly complicated. Since talus has no muscle attachment and peculiar blood supply, high morbidity in the form of non-union and mal union can occur. Avascular necrosis, which means partial death of the bone, leading to a painful arthrosis condition is another common complication.

Immediate first aid has to be rendered to patients from talus fractures. A well-padded splint around the back of the foot and leg from the toe to the upper calf is placed. Foot must be elevated to the level of the heart to prevent further edema. Ice packs can be applied every twenty minutes till the physician arrives. Care should be taken not to put weight on the injured foot. Untreated talus fractures can create problems later. The foot may get impaired and the patient is at risk of developing arthritis and chronic pain. The bone may even collapse in certain cases.

Often talus fractures require surgery to minimize the complications from arising later. The surgeon realigns the bones surgically and uses metal screws to hold the pieces in place. Small fragments of bone can be removed by bone grafts which are used to restore the structural integrity of the joint.

Even after a good correction surgery, there is always the danger of deformity, arthritis and other conditions like lack of blood supply to the talus bones. The ability of the ankle to move can be affected if ankle arthritis occurs. Subtalar arthritis that is arthritis in the subtalar joint beneath the talus bone is another complication. Deformity of the foot is another problem of talus fracture. When the fracture is fixed, it becomes difficult to reposition the bone correctly and deformity may occur.