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Proximal tibia fracture management with plating and nail fixation for tibia shaft fractures

Fractures in the tibia (or shinbone) can occur in a variety of different ways. One of the most common treatments for tibia fractures is intramedullary nail fixation. Nail fixation restores the joint’s mobility and reduces the risk of arthritis. During the nail fixation procedure, I will insert a metal rod into the marrow canal of the tibia and across the fracture. The metal rods or nails are available in various lengths, so I will choose the correct size for your particular injury before screwing them to the bones. The nails then keep the bones in a stable position while they heal. This process takes between 12 and 16 weeks.

Firstly, I begin by reducing the fracture fragments correctly before using an intramedullary rod, screws and plates to fix them in place. If the top part of the tibia breaks but the joint remains intact, I use a rod or plate to secure the fracture. A rod is inserted into the middle of the bone (medullary cavity). A plate is positioned on the outside of the bone. In some severe cases, the fracture penetrates and extends into the joint. Should this occur, I will elevate the fragmented pieces to restore joint mobility. By lifting these broken pieces back in place, a cavity sometimes remains. The bone will collapse if the hole remains as is, which is why I fill it using a graft from the patient’s body or a bone bank.

Tibia fractures can also be treated with the use of plates and screws. This is relatively uncommon and usually reserved for fractures close to the tibia's top end or bottom end. During the procedure, I will reduce the bone fragments before placing the screws and plates on the outer surface of the bones. The plates will help to keep the bones aligned.

Pain after the surgery is to be expected. However, there are medications prescribed for short-term use. These prescribed medicines will alleviate pain after the operation and promote a faster recovery.


A tibia fracture is a break in the lower part of the leg. This injury occurs due to extensive pressure on the bones in the lower leg. Usually, the pressure is more than the leg can withstand.

When the tibia’s broken ends fail to align, you will need surgery to reduce and align the ends of the bone.

Within six weeks, you should return to your usual routine activities. After surgical repair of the fracture, mobilisation is quick, but full recovery can take considerable time.


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Address Johannesburg Surgical Hospital, 219 Beyers Naude Drive, Northcliff Randburg 2195