Fractures of the lower bones of the leg are produced more frequently by direct than by indirect violence and hence are frequently compound.
The lines of fracture in the fractures by direct violence are transverse or oblique and both bones are usually involved near the middle third and less frequently in the lower and upper thirds.
In the fractures by indirect violence the mechanism is usually one of torsion and hence the lines of fracture are spiral with the fibular fractures at a lower or higher level (fig. 1 A).
The associated injuries are few, lacerations of the muscles and engagement of the skin on one of the projecting fragments of the tibia being the most frequent. Vascular injuries are rare. Involvement of the external popliteal nerve is also rare.
The symptoms are those of fracture, the most marked being the immediate disability and deformity with abnormal motion in the
HITZROT JM. FRACTURES OF BOTH BONES OF THE LEG. JAMA. 1929;92(4):282-285. doi:10.1001/jama.1929.02700300006002