Daniel Green, Philip Henman, Mamoun Kremli
Simple complete metaphyseal fractures of the distal tibia are classified as 43t-M/3.1.
An associated fibular fracture may have a different configuration, may involve the physis, and is classified separately.
Isolated tibial fractures are often undisplaced, and those with an associated fibular fracture are often displaced.
A transverse fracture is often more stable than an oblique pattern.
Tibial fractures with a fibular fracture at the same level are less stable.
They are usually caused by a direct injury, or indirectly, eg, falls from heights.
Always consider nonaccidental injury in nonwalking children with a tibial fracture.
X-rays showing a simple metaphyseal tibial fracture with an associated fibular fracture in a 4-year-old patient