OPEN FRACTURE OF DISTAL TIBIA AND FIBULA

I. Introduction

A fracture is a break in the structural continuity of bone. It may be no more than a crack,
a crumpling or a splintering of the cortex; more often the break is complete and the bone
fragments are displaced. If the overlying skin remains intact it is a closed (or simple)
fracture; if the skin or one of the body cavities is breached it is an open (or compound)
fracture, liable to contamination and infection. Open fracture means that skin around the
fracture site has been punctured and exposed to external environment, it increases the risk
for bacterial infection.(1)
Fracture divides into fracture because of trauma, stress, and pathological fracture.
Trauma fracture divides into direct trauma and indirect trauma. Stress fracture usually
happens to athletic people with repetitive movement on the same place. Pathological
fracture happens may occur even with normal stresses if the bone has been weakened by
a change in its structure example in osteoporosis.(1)
There are two types of fracture : 1. Complete fracture, the bone is split into two or
more fragments. The fracture pattern on x-ray can help predict behavior after reduction:
in a transverse fracture the fragments usually remain in place after reduction; if it is
oblique or spiral, they tend to shorten and re-displace even if the bone is splinted. In an
impacted fracture the fragments are jammed tightly together and the fracture line is
indistinct. A comminuted fracture is one in which there are more than two fragments;
because there is poor interlocking of the fracture surfaces, these are often unstable. 2.
Incomplete fracture, the bone is incompletely divided and the periosteum remains in
continuity. In a greenstick fracture the bone is buckled or bent (like snapping a green
twig); this is seen in children, whose bones are more springy than those of adults.
Children can also sustain injuries where the bone is plastically deformed (misshapen)
without there being any crack visible on the x-ray. In contrast, compression fractures
occur when cancellous bone is crumpled. This happens in adults and typically where this
type of bone structure is present, e.g. in the vertebral bodies, calcaneum and tibial
plateau.

Tibial plafond fractures also known as pilon fractures, occur at the end of shin
bone and just above the ankle joint and often involve the cartilage surface of the ankle
joint.