So what happens if you do not treat this appropriately early on, that little black line can propagate and eventually it can split across and go all the way across the tibia. On both views you’ll typically have this abnormality so you’ll see a lump here with that little black line across that area. We get an x-ray of that and we see this area, this is an indication you have a stress fracture. Occasionally on the x-ray, we’ll see a little black line there. Now sometimes on an x-ray will see a little bit of abnormality across the bone like a little bump like that across the bone, where the bone is trying to heal and trying to build up and heal across those stresses. What we look for on an x-ray is, when you have a repetitive stress, that has not been treated or diagnosed or has not been allowed to heal, you can get evidence of a stress fracture. If this periostitis does not go away or does not get better, you definitely want to see a doctor to get an x-ray. So the key is to make sure that you treat it appropriately to prevent it from getting worse. A lot of times you’ll see a little bit of swelling in this area and have some point tenderness in this area on your physical exam. This is going to be something that you’ll feel and describe to your doctor. You’re not going to see anything on an x-ray. That lining of the bone can become easily inflamed by these repetitive stresses. Typically the area that were concerned about is this distal one third of the tibia and what typically happens in a patient with stress issues across the tibia is that you’ll get an inflammation of the lining of the bone and the bone has this lining called periosteum. These are usually the two views that we will get on x-ray when we’re evaluating a patient for tibial stress syndrome or also known as shin splints, or if were concerned about a stress fracture. This is the front view and then this is the side view. And then the fibula is over here and this is the outside bone that help support the tibia in the lower leg. The tibia is right here and this is also known as the shinbone. So this is basically a very crude drawing of the tibia and fibula bone. These repetitive stresses are building, building, and building up, and the bone is trying to heal quickly enough, but sometimes it overloads that ability to heal and then you get what’s called a stress fracture. What happens is that you have these loading stresses across the tibia that’s overloading the bone’s ability to basically heal itself. The key with these types of injuries is to identify it early and to make sure that you see your orthopedic surgeon and you come up with a plan to prevent abnormal stresses across the tibia, particularly when you’re doing a repetitive, active sport like running or basketball, or where you have a repetitive activity performed over and over and over again. There are ways to minimize or prevent these types of injuries from happening. There are a number of ways you can have a fracture of the tibia, but when it breaks the skin it’s considered a compound fracture which is a very serious injury. He sustained what we call an open fracture of the tibia, also known as a compound fracture. There is been a lot of buzz going around about the most famous stress fracture which occurred approximately one week ago with Kevin Ware of the Louisville Cardinals. Today were going to talk a little bit about stress fractures. I’m a Board Certified Orthopedic Surgeon who specializes in sports medicine, primarily arthroscopic and minimally invasive surgery of the shoulder, elbow and knee. This is a transcript of the Tibia Stress Fracture video: Press reports indicate that Kevin Ware’s compound fracture of the tibia or shinbone may have been caused by an undetected stress fracture. The topic of tibia stress fractures is timely because of the recent serious injury of University of Louisville basketball player, Kevin Ware. He serves patients from Richmond, Katy, Sugar Land and Metro Houston from offices in Sugar Land and Houston. Michael Bennett is a Board Certified Orthopedic Surgeon and a Fellowship-Trained Sports Medicine Physician with a Certificate of Added Qualification (CAQ) in Sports Medicine. He also talks about the need to treat periostitis and stress fractures early on and to determine the causes of the stresses being placed on the lower leg.ĭr. Michael Bennett describes the anatomy of the leg, and he talks about how repetitive stresses on the leg can cause periostitis and shin splints or tibia stress fractures. If you’re a basketball player or a runner or you’re involved in an activity that places repeated stress on your lower legs, you may be heading for a stress fracture.
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