Fractures of the tibia and fibula March 2018 | by EMauthor Principles •·Always include the knee and the ankle in the x-ray • Always exclude a compound fracture • Assess neurovascular status • Assess for compartment syndrome Tibial shaft fracture with or without fibula fracture •Undisplaced fracture oIV analgesia oApply an above knee bivalved cylinder with knee at 15 deg flexion and foot plantigrade oAlways x-ray after plaster application oRefer to orthopaedics for admission because of risk of compartment syndrome ■The orthopaedic team may want to examine prior to cast application •Displaced or unstable fracture oIntravenous analgesia oWill require GA for plaster application or internal fixation oRefer to orthopaedics, may apply temporary splint plaster in the interim with attempt at aligning the leg Isolated fibula fracture •Ensure that tibia is not fractured or no significant injury around knee •Treat either with tubigrip or below knee walking cast for lower fibula and tubigrip for the upper fibula |
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