Tibial fractures are the most common type of long bone fractures. They are usually caused by direct trauma and may occur proximally (tibial plateau fracture), at the shaft, or distally. The fracture may solely involve the tibia or the fibula, or it may involve both. As only a small amount of tissue covers the bone structures, there is a higher risk of open fracture, neurovascular injury, compartment syndrome, and wound infection. Depending on the location and stability of the fracture, treatment may involve casting, intramedullary nailing, open reduction and internal fixation, or external fixation.
Subtypes and variants
Toddler fracture 
- Definition: a nondisplaced fracture of the distal tibial shaft, usually following acute trauma (e.g., falling, tripping), causing rotation of the body around a fixed foot
- Epidemiology: commonly seen in children between nine months and three years of age 
- Etiology: trauma (e.g., low energy fall from a chair or table, tripping while running)
- Abnormal gait (limping or inability to bear weight)
- Localized tenderness over the distal tibial shaft
- Treatment: immobilization with a long cast, controlled ankle movement walker boot, short cast, or splint 
- Clinical examination: peripheral perfusion, motor function, and sensation
- X-rays: knee and ankle (anteroposterior and lateral views)
- MRI: can be useful to assess injuries to the meniscus and the ligaments associated with tibial plateau fractures.
- Joint aspiration: can be performed
- Conservative treatment
- Surgical treatment
- Patients with tibial fractures should be monitored for:
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We list the most important complications. The selection is not exhaustive.