Understanding your injury

Long bone fractures include breaks through the tibia or femur shaft. The bone can be cracked, displaced or broken into several pieces. An open fracture has a wound communicating with the break and needs urgent treatment. Assessment includes other injuries, the skin, circulation, nerves and the joints above and below. X-rays define the break; CT may be needed if the fracture extends towards a joint or is complex.

Treatment and the procedure

Some stable tibial fractures can be managed in a cast or brace. Many unstable tibial fractures and most adult femoral shaft fractures need fixation. An intramedullary nail is a rod inside the bone secured with screws. Plates and screws or an external frame may be better for other patterns. Open injuries may require wound cleaning, antibiotics and soft-tissue reconstruction; treatment can involve several stages. The choice reflects the bone, wound and your overall condition.

Benefits, risks and expectations

If surgery is planned, discuss bleeding, anaesthetic risks and complex regional pain syndrome as well as the risks specific to your injury. Your general health and the extent of surgery affect your personal risk.

Treatment aims to restore length, alignment and stability, allowing bone healing and progressive rehabilitation.
Discuss infection, nerve or vessel damage, compartment syndrome, blood clots, delayed union, nonunion, malunion, metalwork irritation and further surgery. Joint stiffness and persistent pain can occur.
Open wounds, bone loss and extensive muscle injury can prolong recovery. Healing on an X-ray does not immediately restore strength, endurance or confidence. Some patients need further reconstructive treatment.

Rehabilitation and aftercare

Weight bearing varies with the fracture and fixation; follow the surgeon's written plan. Physiotherapy teaches safe walking aids and permitted exercises for joint movement and strength. Attend wound, cast or frame reviews and follow any clot-prevention prescription. Keep casts dry. Support nutrition and discuss smoking cessation and bone health where relevant. Return to work, driving and sport depends on healing and function rather than a universal timetable.

When to get urgent help

Sudden severe pain, especially with tight swelling or new weakness, needs A&E assessment for possible compartment syndrome. Seek urgent review for a cold foot, fever or discharge.
New calf pain or swelling needs urgent advice. Call 999 for chest pain or breathlessness.

Your consultation

Ask about alignment, healing risks, the fixation proposed, soft-tissue treatment and your permitted loading. This overview supports personalised discussion and does not replace the consent record or discharge plan.

Your consent discussion

Use the patient pack to record your priorities, the proposed procedure, its alternatives, the benefits you hope for and risks that matter to you. A clinician will discuss your individual circumstances and complete the appropriate hospital consent process with you.

Reading or downloading a guide does not give consent. You can ask further questions, decline treatment or change your mind before the procedure.

Tibial and long bone fractures