The tibia is the larger, weight-bearing bone of the lower leg and the second longest bone in the body, forming the main articulation with the femur at the knee and with the talus at the ankle. Its anterior border, the shin, is subcutaneous and a common site of impact injury.
| Articulations |
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|---|---|
| Landmarks |
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| Ossification | Primary centre at 7 weeks fetal. Proximal epiphysis present at birth. Tibial tubercle apophysis fuses at age 18. Distal epiphysis appears at age 1, fuses at skeletal maturity. |
The anterior crest and medial surface are subcutaneous throughout their length. Tibial plateau fractures from axial load are assessed by CT and Schatzker classification. Tibial shaft fractures are the most common long bone fracture requiring hospitalisation, treated with intramedullary nail. The tibial tubercle apophysis is the site of Osgood-Schlatter disease in active adolescents aged 10 to 15. Pilon fractures from axial loading at the ankle are among the most difficult fractures to manage due to poor soft tissue coverage and cartilage impaction.
The most common long bone fracture; because the tibia is subcutaneous many are open, and compartment syndrome is a key risk.
Valgus or axial load fractures the articular surface of the proximal tibia, often the lateral plateau, and may need fixation to restore the joint surface.
Exercise-related pain along the posteromedial border of the tibia (shin splints) from repetitive loading.
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