Surgical and Rehabilitation Intervention of an open mid shaft tibia Essay

Surgical and Rehabilitation Intervention of an open mid shaft tibia and fibula fracture - Essay Example Fractures of the lower leg involve fractures of tibia and fibula, of which tibia is the only weight bearing bone. Tibia is the most commonly fractured long bone in the body (Konowalchuk, 2005). These fractures occur due to direct or indirect trauma. Tibial diaphyseal fracture due to foot ball injury is mainly due to high energy (Chang et al, 2007). The most common fracture pattern is transverse AO Type 42A3 (Chang et al, 2007) (table-2). Most of the times, fracture of tibia is associated with fibula fracture also, because; the force from tibia is transmitted along the interosseous membrane to the fibula (Norvell, 2006). In about 60% to 90% of football injuries, both tibia and fibula are fractured (Chang et al, 2007; Cattermole et al, 1996). These fractures can be open or closed. Tibial fracture is open in many cases because of thin soft tissue over tibia. Hence the chances of delayed non-union and infected non-union are common in tibial fractures (Patel, 2004). The fibula is however, covered well with soft tissues (Norvell, 2006). Immediately after fracture, there is hematoma formation due to rupture of blood vessels. This hematoma fills the fracture gap and surrounds the area of bone injury (Rosenberg, 2007). A fibrin mesh is provided by the clotted blood which helps seal off the fracture site and creates a frame work for inflammation and repair. There is influx of inflammatory cells, ingrowth of fibroblasts and development of new capillary vessels. There is also release of some cytokines by the degranulated platelets and migrated inflammatory cells (Rosenberg, 2007). Time for fracture healing and extent of changes in markers of bone metabolism are mainly dependent on fracture size (Stoffel, 2007). The cytokines activate the osteoprogenitor cells in the periosteum, medullary cavity, and surrounding soft tissues and stimulate