Understanding Tibia Fracture Healing Time in Adults: A Comprehensive Guide

What are the different types of tibia fractures?

The tibia (= shin) is one of the two bones in the leg, and it is the largest one. It is the bone in the lower leg segment that fractures most frequently.

It can break in various ways and at different locations, and in such cases, the fracture is given different names. Here are the most common ones:

1. Tibia and fibula fracture: when both the tibia and fibula are broken simultaneously.
2. Tibial plafond fracture: involving the lower part of the tibia, which is part of the ankle joint. I discuss this in my article on ankle fractures.
3. Shin splint: where the fracture line is subtle, and the bone is slightly damaged but less severe than in a complete fracture.
4. Tibial plateau fracture: affecting the upper part of the tibia, at the knee joint level.
5. Open tibia fracture: when the bone has shifted and penetrated the different layers of tissue until it breaks through the skin. These fractures require surgery.
6. Tibial stress fracture: when the fracture is not caused by a single impact or accident but by repeated minor traumas related to intensive activity.
7. Spiral tibia fracture: the bone is broken in the middle of the tibia, at what is called the diaphysis, and it is broken in a certain way, with the fracture line not being straight but “surrounding” in a spiral shape.
8. Displaced or non-displaced tibia fracture: when there is displacement, meaning that the two bone fragments (or more) are quite far apart from each other.

To determine what type of fracture or fissure you have, you can find the information in your X-ray or medical or surgical consultation report.

In any case, the general approach to treatment follows the same guidelines, regardless of the specific type of fracture.

The type of fracture is just one of the many factors taken into account to choose the most appropriate treatment.

What is the treatment for a tibia fissure or fracture?

Once a doctor has diagnosed a fracture, a treatment plan will be implemented:

1. Sometimes, surgical treatment: you will undergo surgery.
2. Most often, conservative treatment: everything else without surgery. For example, you may receive orthopedic treatment if a cast, walking boot, or brace is decided upon.

Why is surgery sometimes necessary for a tibia fracture?

If your fracture is open or severely displaced, there is a higher likelihood that surgery will be recommended.The purpose of surgery is to:

1. Realign the different bone fragments properly, known as fracture reduction.
2. Stabilize them to prevent movement when you contract your muscles or put some weight on the leg.

Several factors will be considered in the decision to operate or not:

1. The type of fracture.
2. Other associated injuries.
3. Your age.
4. Your overall health and any other existing conditions.
5. The practices of the medical and surgical teams responsible for your care.
6. Your opinion if you are asked about the matter.

The surgery usually takes place on the same day as the fracture or within a few days after.

You typically return home quickly (a few days in the hospital or clinic). Centering in a rehabilitation facility is rarely required for a “simple” tibia fracture.

Various materials for osteosynthesis can be used to stabilize the fracture site:

1. A plate and screws.
2. A nail: Tibial rod surgery, also known as intramedullary nailing of the tibia. This surgery involves the insertion of a metal rod or nail into the hollow center of the tibia bone (the medullary canal) to stabilize and align the fractured bone fragments. Tibial rod surgery is commonly performed for fractures that are difficult to treat with non-surgical methods, such as complex or displaced fractures.
3. An external fixator.

In some cases, knee arthroscopy is used to reduce the size of the incisions and the risk of infection.

How long to keep the cast for a tibia fracture?

If you are not undergoing surgery (and sometimes even if you are), you will have a cast from the ankle to below the knee (sometimes even higher).

This cast is typically kept for about 6 weeks until a follow-up X-ray is done.

During this immobilization period, you are usually advised not to bear weight on the injured lower limb.

And what if there is no cast or surgery?

Sometimes, neither a cast nor surgery is required. In such cases, an ankle brace or walking boot may be prescribed.

In this scenario, you may not be restricted from bearing weight. This is often the case for a “simple” fracture.

In any case, regardless of the treatment you have received, one way to maximize your chances of recovery is to smoke as infrequently as possible. Smoking slows down the healing of skin and bone tissues.

There is no medication or non-medication treatment to speed up bone healing or recovery after a tibia fracture. The aim is rather to interfere with the healing process as little as possible 🙂

What rehabilitation exercises are recommended for a tibia fracture?

Your doctor or surgeon will likely prescribe physical therapy sessions to oversee your rehabilitation.

The sessions can begin right away or after the follow-up X-ray.

For my part, I prefer to see patients at least once at the very beginning, to assess what they can do during this recovery period to avoid deconditioning and stiffness as much as possible.

What is the purpose of physical therapy?

• To reassure you by addressing your concerns and fears.
• To inform you about what you can or cannot do to maximize your chances of healing and quickly returning to your usual condition.

Now, are there specific rehabilitation exercises to do in all cases? No, it really depends on the difficulties you are experiencing and the stage of rehabilitation you are at.

For example, in the case of a tibial pilon or plateau fracture, the knee or ankle joint may become stiff. Specific exercises can be performed to prevent or reduce this stiffness.

In cases of fractures in the middle of the tibia (tibial diaphysis), the risk of stiffness is less significant.

In this case, you will be advised to do more general physical maintenance exercises, adapted to the postoperative instructions you received (partial weight-bearing, non-weight-bearing, weight-bearing as tolerated based on pain, etc.).

Broken Tibia: Can you walk?

You can walk after a tibia fracture, but you will often need to adapt your way of walking.

In the vast majority of cases, you will need crutches or a walker to relieve weight-bearing on your injured leg.

And very often, weight-bearing will be “restricted.” Or rather, you will be advised not to put too much weight on the fractured leg (usually around 10% of body weight). In this case, you may be instructed to:

• Walk without bearing weight (non-weight-bearing).
• Walk with touch weight-bearing (partial weight-bearing).
• Walk with partial weight on the affected leg.

To become aware of this weight, you can stand on a scale (the foot of the fractured side on the scale, the other foot on another surface at the same height). Practice putting 10% of your body weight on the scale.

Don’t panic if you occasionally put more weight on the leg. You won’t cause further damage in just a few seconds of excessive weight-bearing! It’s the repeated weight-bearing over several days that could potentially be harmful.

Less commonly, full weight-bearing may be allowed. In that case, you should adjust based solely on pain levels.

However, even then, crutches are often necessary for a few weeks.

Walking is possible with a broken tibia, but often only with partial weight-bearing on the foot.

Broken Tibia: How long until you can walk normally?

Whether you have full weight-bearing from the beginning or not, it usually takes several weeks to resume “normal” walking.

In general, people start walking quite well between 1.5 to 2.5 months after the fracture. However, this varies significantly from person to person:

• Some individuals experience minimal pain when they resume walking.
• Others may have significant pain and apprehension, which may require a gradual return to walking over several weeks.

It typically takes 1.5 to 3 or 4 months to walk normally again after a tibia fracture.

What is the healing time for a tibia fracture?

In the table below, I summarize the usual recovery time for various stages after a tibia fracture. When empirical data from published studies was not available, I relied on my experience to provide these estimates.

Stage	Usual Timeframe from Day of Fracture
Reduced Pain	1-3 weeks
Bone Consolidation	6-8 weeks
Leg/Foot Swelling Subsides	Several weeks to months
Walking with Crutches Resumes	Immediately
Walking without Crutches Resumes	4 weeks – 3 months
Able to Drive a Car	4 weeks – 12 weeks (faster for automatic cars and if the left leg is fractured)
Returning to Work	1-4 months (depending on the type of profession). The recommended sick leave durations by the French Social Security range from 28 days to 240 days.
Getting Back to Sports!	12 to 54 weeks (3 months to 1 year) for operated tibial shaft fractures and 28 to 182 weeks (6 months to several years) for non-operated tibial shaft fractures (Robertson 2015)
Full Functional and Muscular Recovery	4 months – 1 year

88% of patients who had an extra-articular tibial fracture (thus all fractures except those of the tibial plafond or plateau) without infection:

• Are satisfied with their recovery,
• And return to their activities before the injury (Cochrane 2018).

Tibial rod surgery: Recovery Time

The tibial rod helps stabilize the fracture, but complete bone healing can take several months. It may take around 6 to 12 weeks for the initial healing, and then additional time for the bone to strengthen fully.

Return to sport after shin fracture

Regarding the rate of return to sports, for fractures of the tibial diaphysis:

• 67% for non-operated fractures,
• 92% for operated fractures (Robertson 2015).

In 13% of cases, there is a delay in healing, where the bone does not heal properly (Cochrane 2018). However, this complication does not necessarily hinder the resumption of daily activities.

The total healing time after a tibial fracture is a few months.