Proximal Tibia Fracture (Top of Shin)

Description

This is a break of the upper part of the tibia (shinbone), near the knee. It can happen from a fall or a sports injury, and some involve the growth plate at the top of the shin.

How it happens (the mechanism)

A force to the upper shin — often a blow to the outer knee or a fall — breaks the proximal tibia. One particular pattern in young children is worth knowing about: as it heals, the leg can gradually drift into a slight knock-kneed position over the following months (sometimes called a Cozen phenomenon). This surprises families, but it almost always corrects itself with growth, which is why it is watched rather than rushed to surgery.

Symptoms

Pain, swelling, and tenderness at the top of the shin, with reluctance to bear weight or bend the knee.

Doctor examination and imaging

The doctor checks alignment and the leg’s circulation and feeling; X-rays show the fracture, and follow-up films track both healing and the leg’s alignment as the child grows.

Treatment

A well-aligned fracture is treated in a long-leg cast for several weeks; a shifted one is realigned first. The temporary knock-kneed drift, if it appears, is usually observed, as it tends to remodel on its own over a couple of years.

Recovery and long-term outlook

Most heal well, and the alignment usually settles back to normal with growth. Knowing about the possible knock-kneed phase in advance is what spares families worry and unnecessary treatment.

When to call the doctor

Call the office right away if your child’s toes become numb, pale, blue, or cold; pain keeps worsening even after raising the leg and giving medicine; swelling does not improve with elevation; the cast feels too tight, cracked, or wet, or smells bad; or your child develops a fever.

Learn more

OrthoInfo (AAOS) — Growth Plate Fractures: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.