Something that has always made me wonder ever since I started back in anatomy was how small the muscles of the lower legs are compared to the size of the body – yet these are responsible for keeping the body up as well as movement.
With motion a lot of it is based on the principle of them acting like springs and storing energy to release it again later. However to me they do look for small for such a purpose…
This fracture was in the tibia and fibula bones of the back leg. The type of fracture that this was, is known as a Salter Harris type II fracture, it involves the top of the bone however misses the growth plate. The
Today however I learnt that looks here are deceiving, assisting on a fracture repair where the surgery had been delayed – injury happened on Saturday and surgery was not until Wednesday – so there were already complications from the formation of fibrinous tissue and some bone remodelling. During the surgery we realised that we could not reduce and position the broken bones back together because of the muscle tension and so we detached the muscle that sits on the front of calf – the tibialis cranialis.
For such a small muscle, once it was detached the change in tension in the leg was remarkable. It allowed us to reposition the fractured part of the bone with good alignment. Once this was done it was possible to place screws into the bone to hold this in position.
Fixing the muscle back to its attachment was a lot quicker than I had expected, however to give it time to heal and regain basic strength we decided that the leg should be bandaged for a time after the surgery. The patient should recover uneventfully.