Tibial Spine Fracture

What Are the Signs and Symptoms of Tibial Spine Fractures?

Your child may have:

• Severe swelling
• Knee pain
• Trouble moving the knee
• Severe pain with movement
• Trouble standing or walking on the injured leg

How Is a Tibial Spine Fracture Diagnosed?

Most children are seen in the emergency department (ED) or orthopedics because of swelling and pain.

Your child may have:

• X-rays to look for a fracture.
• An MRI to look more closely at the knee.

How Is a Tibial Spine Fracture Treated?

Your child will need to see an orthopedic doctor or health care provider. Their treatment plan will depend on the test results and how severe the fracture is.

Nonsurgical treatment

If the bone is still in the correct place, called a nondisplaced fracture, your child may need a knee brace or a cast.

Surgical repair

Some children need surgery to put the bone back in place. During surgery:

• Your child gets medicine to put them to sleep called anesthesia.
• The bone is put back into place using screws.
• The small cut (incision) is covered with a bandage.

After surgery, your child may need to wear a brace or cast for 4 to 6 weeks. Most children go home the same or next day. Your child’s follow-up visit is usually 7 to 10 days after surgery. It is scheduled before you go home from surgery. Follow all instructions from your child’s doctor or health care provider.

When Should I Get Help for a Tibial Spine Fracture?

Call your child's doctor or health care provider if they have these signs of an infection:

• Extreme swelling
• Drainage from the incision
• A fever over 101° Fahrenheit (F) or 38.3° Celsius (C)
• Pain not controlled by oral pain medicine

Follow-up Appointments

• Expect to bring your child for regular follow-up appointments with their orthopedic doctor.
• Write down all your questions as you think of them. Bring this list with you when you see the doctor.
• Be sure to call your child’s doctor’s office if you can’t keep an appointment.

How Can I Help My Child at Home?

Circulation Checks

You will also need to check the circulation in your child’s toes to make sure blood flow is normal. Swelling can reduce blood flow and put pressure on nerves and tissues.

• Do circulation checks 3 to 4 times each day while your child is awake for 7 to 10 days.
• Start circulation checks anytime your child has new pain or symptoms.
• Compare the injured leg to the uninjured leg.
• Do the checks:
  • Before breakfast
  • Before lunch
  • Before dinner
  • At bedtime

Normal circulation signs:

• Toes are pink
• Toes feel warm
• Little or no swelling
• No numbness or tingling
• Can move the toes
• Capillary refill is 3 seconds or less (Capillary refill means how quickly color returns after pressing on the toenail.)

If circulation checks aren’t normal:

• Your child should lie flat. Raise their injured leg above the level of their heart. Their toes should be higher than their nose. Use blankets, firm pillows, cushions, or folded towels to support the leg.
• If there is swelling, place an ice pack on the injured leg.

Activity and Physical Therapy

• After the brace or cast is removed, your child will start physical therapy to help improve movement, strengthen the knee, and improve flexibility.
• Your child may also get exercises to do at home. It’s important to follow all therapy and exercise instructions to heal.
• Your child should avoid running, jumping, contact sports, gym class, and other high-impact activities until the orthopedic provider or physical therapist says it’s safe.

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