Fracture Care · Knee, leg & ankle
Tibial shaft fracture
Tibial Shaft Fracture (Broken Shin Bone) — Intramedullary Nailing
The condition
The tibia (shin bone) is the main weight-bearing bone of the lower leg. A tibial shaft fracture is a break along its long middle part, often with a break in the thinner outer bone (fibula) too. It usually follows a fall, sports injury, or car crash and causes pain, swelling, deformity, and an inability to stand.
The surgery
Through a small incision at the front of the knee and small incisions near the ankle, the bone is lined up and a metal rod (nail) is passed down the center of the shin bone, then locked with screws at each end. The fibula is sometimes fixed with a plate as well, though often this is not required. The final plan is determined during surgery.
Recovery at a glance
- Weight-bearing
- Full weight as comfort allows with crutches or a walker, unless told otherwise. The device is weaned as your walk normalizes, typically by 6–12 weeks.
- Motion
- Knee and ankle motion start right away; a straight knee and good upward ankle bend are the priorities. Bike and pool from 6 weeks.
- Daily life
- Desk work often within 2–4 weeks. No driving while taking narcotic pain medication.
- Running
- Typically ~4 months, once x-rays show healing and strength reaches 80% of the other side.
- Sports
- Agility and sports between 4 and 6 months; full release typically 4–6 months.
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: The nail holds the bone in line so you can walk soon after surgery, and most fractures heal reliably. Risks are uncommon and include infection, blood clots, pain at the front of the knee, especially with kneeling (common), the bone healing slowly or not at all, the bone healing out of line, dangerous swelling of the leg muscles (compartment syndrome; rare), injury to nearby structures (such as nerves or blood vessels), stiffness, persistent pain, and the need for further surgery. These will be reviewed with you in detail before surgery.
Patient Surgical Information
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Before & after every surgery