Multifragmentary complete metaphyseal fractures of the distal tibia are classified as 43t-M/3.2.
These fractures are often displaced and unstable.
An associated fibular fracture may have a different configuration and is classified separately.
Isolated tibial fractures often result from high-energy trauma.
Soft-tissue injuries are common and should be anticipated. Compartment syndrome and vascular injuries may also complicate these fractures.
Always consider nonaccidental injury in nonwalking children with a tibial fracture.
X-rays showing a multifragmentary metaphyseal tibial fracture in a 4-year-old patient