Boot-Top Fracture

Boot-top Fracture

A boot-top fracture is a high-impact injury that causes the tibia and fibula to break. When sufficient force is applied, both bones will snap just above the boot top if the boot is rigidly fixed. This type of injury is commonly seen among skiers, hockey players, and construction workers, all of whom wear a boot that is tightly held in place and extends part way up the lower leg. This is a serious injury as it leaves the leg unstable because both bones are broken. It is a traumatic injury that requires immediate medical attention.

The tibia, or shin bone, is the second longest bone in the body; it is located at the medial side of the leg. The fibula is the smaller bone of the lower leg, located in a position that is lateral to the tibia.

The signs and symptoms of a boot-top fracture are severe pain, swelling and bruising over the area of the break as well as deformity of the leg. The broken leg may appear shorter than the unaffected leg. The leg below the break may be twisted or may be bent at the break instead of the knee joint. The person may also go into shock.

If an injury happens and a fracture is suspected, the leg should be stabilized as soon as possible in order to prevent further injury. If possible a splint should be applied and the leg should be immobilized. Ice should be applied to decrease swelling, if possible, keep the leg elevated to decrease swelling and prevent further swelling. It may be necessary to keep the patient conscience if they are suffering from shock.

Prevention of a boot-top fracture primarily involves avoiding putting oneself at risk for such trauma to the leg bone. The risk of sustaining this type of injury may also be reduced by building strong muscles to help prevent falls and staying active and agile. Eating a diet rich in calcium and vitamin D will help build strong bones and may aid in avoiding such fractures.

Aligning and securing the bones is the main consideration for treatment of a boot-top fracture. Several options exist depending upon the details of the injury. Using x-ray, the orthopedic surgeon will determine which procedure is best. The least invasive procedure is a