Introduction-Tibial shaft fractures are one of the most common diaphyseal fractures treated by orthopaedic surgeons. A unique program he implements has attracted more than 700 medical students and young doctors to train with the Medical Clinic of Big Sky.I. Jeff Daniels has been practicing medicine in Big Sky since 1994, when he and his family moved here from New York City. Or you could make skiing down the Big Couloir your proof of recovery.ĭr. Although one might ski a little more cautiously, as would happen after any serious injury. If the knee and ankle joints aren’t involved, full recovery is expected without any long-term problems or effect on athletic ability. Recovery after surgery takes a couple of months. Nearly all patients are stable enough to get to an orthopedic surgeon in Bozeman in a private vehicle, avoiding an expensive ambulance ride. Once the leg is exposed, we wrap it in fast-drying splinting material to hold it steady, because preventing any movement is the best way to control the pain. The room was full of burnt plastic and we couldn’t cut through the metal cables effectively. We will never try to cut off a ski boot – we did that once and two hours into the process regretted the decision. Getting the ski boot off might be a challenge and pain medication or sedation is sometimes required. However, in my 22 years of experience in Big Sky, I’ve seen very few open tib-fib fractures. We make sure that the bones have not punctured through the skin, causing what is called an “open” fracture, which is more serious due to the possibility of infection. When we see a tib-fib fracture in the clinic, our first objective is to x-ray the leg, and then stabilize the fracture with the ski boot off. This type of break usually occurs by a simple sideways fall, with the top of the boot pressing into the fibula and snapping it. Casts and crutches are usually unnecessary if the knee and ankle aren’t injured. But the leg retains its stability because the much thicker tibia remains intact. It starts at the outer side of the knee and ends at the ankle, and if broken in the middle is somewhat painful. Metal rods, plates and screws are needed to hold everything in place after the ends of the bones are realigned.Ī more benign lower leg fracture just involves the fibula, the thin bone on the outside of the leg. Kids’ fractures are usually of a spiral nature, whereas adult fractures are like taking a thick branch and breaking it over your knee. Because of the anatomy of this area and possibility of severe swelling, surgery to fix this fracture is considered an emergency and usually done within 24 hours of the injury.Īdults nearly always require surgery but kids, whose bones are softer, don’t experience the same devastating breaks and can often heal just with a cast. This injury is sometimes referred to as a “boot top” fracture. One of the most severe injuries on the ski hill is a fracture of both bones in the lower leg, the tibia and fibula, and we treat an average of two or three per month here in Big Sky.īecause of the rigid nature of ski boots and the forces put on the leg by the weight of the ski and boot during a tumbling or twisting fall, the two bones of the lower leg are very vulnerable to breakage.
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