Proximal tibial fracture

　　The main cause of fractures at the upper end of the tibia is due to the action of external violence, forming forms of direct and indirect violence.
　　Indirect violence: Fractures occur at a location far from the point of contact with the violence, where the force is transmitted, leveraged, or twisted to break at a point far from the point of application.
　　Direct violence: It is common for injuries to be caused by compression, impact, or beating, with the fracture line being transverse or comminuted; sometimes both lower legs may break at the same level, with severe soft tissue injury often leading to open fractures. Sometimes, although the skin is not broken, the contusion is severe, blood circulation is poor, secondary necrosis occurs, and the bone is exposed, leading to osteomyelitis due to infection. Indirect violence is often seen as a fall from a height, a sprain or slip caused by running and jumping.

　　1. Swelling Local swelling occurs after trauma, reaching a peak after 72 hours, and then gradually subsides

　　2. Compression by plaster After simple fractures are reduced manually and fixed with plaster, as the limb swelling gradually increases, there may be compression by the plaster, leading to obvious swelling, ecchymosis, numbness at the upper end of the tibia, and it is necessary to go to a medical institution to release the pressure in time to avoid necrosis of the limb.

　　3. Stiffness of the joint The tibia is fixed for a long time, and venous and lymphatic return is not smooth, leading to serous fibrous exudation and fibrin deposition in the joint cavity, fibrous adhesion, and contraction of the soft tissues around the joint, resulting in joint dysfunction.

　　4. Formation of deep vein thrombosis in the lower limb The tibia is located in the lower leg. If the lower limb is immobilized for a long time, venous blood return is slow, and in addition to the hypercoagulable state caused by the injury, thrombosis is easy to occur. It is necessary to strengthen physical exercise, and at the same time, devices such as elastic stockings and foot venous pumps can be used to prevent its occurrence.

　　After a fracture at the upper end of the tibia, the fracture line may affect the articular surface and even cause collapse, separation, and displacement of the articular surface. If not treated well, it often leads to traumatic arthritis or even disability! In addition, patients with fractures at the upper end of the tibia may also experience symptoms such as bruising at the affected area, marked tenderness, swelling, hematoma, and the ability to bend the leg only to 90 degrees, with the heel not being able to touch the ground when standing, which may also be a symptom.

　　Because the upper end of the tibia is located in the lower leg, it is necessary to protect the safety of the lower leg well, which requires everyone to prioritize safety in daily life and work, and to pay attention at all times to reduce the occurrence of fractures. Children are not steady on their feet and are prone to falls, especially not to play at high places. Children should be educated and watched to avoid injuries. Adolescents play more and are curious, so parents and teachers should do a good job of education and not climb walls or trees. Young and middle-aged people should concentrate on their work and riding bicycles, and pay attention to safety in all aspects. The elderly have difficulty moving their hands and feet, and should not go out in snowy and rainy weather or at night as much as possible. When going out, someone should hold the arm or use a cane, and there should be lighting tools when going out at night. It is best not to ride a bicycle on the street, and do not go to crowded public places.

　　Moreover, it is easy to cause a sprain of the lower leg or directly cause a proximal tibia fracture during exercise. One must always be careful when playing football, doing aerobics, and other sports, and protective pants can be worn if necessary.

　　X-ray examination is of great importance for the diagnosis and treatment of proximal tibia fracture:

　　All patients suspected of having a proximal tibia fracture should undergo routine X-ray imaging examination, even if there are obvious clinical manifestations of fracture, X-ray imaging examination is still necessary, which can help understand the type and specific situation of the fracture, and has guiding significance for treatment.

　　X-ray examination is mainly to judge the following points:

　　(1) Is the proximal tibia fracture traumatic or pathological

　　(2) Is the proximal tibia fracture displaced, and how it is displaced

　　(3) Is the alignment of the proximal tibia fracture satisfactory, and is it necessary to correct it

　　(4) Is the proximal tibia fracture fresh or old

　　(5) Is there any joint or bone injury nearby

　　Avoid eating crucian carp, rooster, pickled bamboo shoots, ginger, high-calcium and high-protein foods, etc. Some people think that after a fracture, more calcium intake can accelerate the healing of the broken bone. However, scientific research has found that increasing calcium intake does not accelerate the healing of the broken bone, and for long-term bedridden fracture patients, there is also a potential risk of increased blood calcium levels, while blood phosphorus levels decrease at the same time.

　　The conventional treatment of proximal tibia fracture in Western medicine is usually external fixation with plaster or surgical plate and screw internal fixation, and after fixation, it is long-term rest and self-recovery, during which there may also be some anti-inflammatory, analgesic, and blood circulation medicine, etc., such treatment is very slow. It takes 3 months to recover quickly, and 6 months to recover slowly, but some may not be completely cured for a year or even two. How long it takes to recover depends on individual differences.

　　It is not recommended to operate on the proximal tibia fracture, otherwise it is easy to damage the root and it is very difficult to recover!