K13 – Tibial Spine Avulsion Fracture

This is a break to the bone at the top of the shin bone


It can take 6 weeks for this fracture to heal.

Smoking will slow down your healing. We would advise that you stop smoking while your fracture heals. Talk to your GP or go to www.smokefree.nhs.uk for more information.

Pain and swelling:

Your knee will be swollen and you will have some pain. Swelling is often worse at the end of the day. Taking pain medication, elevating your knee and using ice or cold packs will help. More information is in the next section.

It is normal to have mild pain and swelling for 3-6 months.


You should not put any weight through your injured leg and should use crutches to move around.

Please tell the Virtual Fracture Clinic team if you are diabetic, especially if you have problems with your sensation or skin. You may need a special boot.


It is important to start ankle exercises as soon as possible. Instructions are in the next section.

Follow up:

You will receive a face to face appointment in the Fracture Clinic 2-3 weeks after your injury. If you have not received your appointment letter within 2 weeks please contact the Fracture clinic.

Any questions:

If you are concerned about your symptoms, unable to follow this rehabilitation plan or have pain other than at your knee, please contact the Virtual Fracture Clinic team.

Caring for your injury

DVT (deep vein thrombosis):

DVT (deep vein thrombosis) is a blood clot in a vein, usually the leg. Because you are non-weight bearing, you may be at higher risk of developing a DVT. You may have been given some blood thinning medication to cover you for this period of time. However, if you are under 16, you will not be given a blood thinner unless you are taking an oral contraceptive.

Symptoms of DVT in the leg are:

  • throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh
  • swelling in 1 leg (rarely both legs)
  • warm skin around the painful area
  • red or darkened skin around the painful area
  • swollen veins that are hard or sore when you touch them

If you notice any of these symptoms please call 111 immediately and get further advice or attend the Emergency Department.

Your cast: If you have any of the following please contact the plaster room.

  • any new pain unrelated to your existing injury e.g. persistent burning sensation under the casts;
  • soreness or rubbing of the cast
  • any offensive smells from the cast
  • staining or leaking through the cast from a wound discharge
  • the cast become broken, soft, dented or loose
  • the cast becomes wet

Using a cold pack will help with your pain and swelling. You can use an ice pack or bag of frozen peas wrapped in a damp towel. Put this on your knee for up to 15 minutes every few hours. Make sure the ice is not in direct contact with your skin.

Try to rest your knee, especially in the first 24-72 hours. Raise your leg on a stool or cushions to that it is above the level of your hip. This will help to reduce your swelling.

Walking and your cast

Your elbow crutches will be adjusted to the correct height, your forearms should sit within the cuff and hand grips point forward.

To stand:

  • Hold the crutches in one hand by the grips
  • Push up on the arm of the chair with the other hand, stand on your good leg
  • Slip your arms through the arm cuffs.

To sit:

  • Make sure you are close to the chair so you can feel it at the back of your legs
  • Get your balance on your good leg so your injured leg is off the floor
  • Take your crutches off your arms
  • Hold your crutches by the arm grips or lean them against the chair
  • Reach back for the arms of the chair and lower yourself into the chair
  • Never stand or sit with your arms in the crutches

Walking Non Weight Bearing with elbow crutches:

  • Keep your elbows into your sides
  • Place the crutches forwards shoulder width apart to ensure your whole body can fit through the gap
  • Lean on the crutches to take weight onto your arms and the crutches
  • Step through with your good leg
  • When you have your balance, repeat the above steps

Stairs – If you feel unsafe or unsteady, go up and down on your bottom.

If a handrail is available, use it and put your walking aid in the opposite hand. If you have a second crutch, hold it horizontally in the same hand.

  • To go upstairs, raise your good leg up first and put your weight on it, then raise your injured leg to the same step, followed by the walking aid. Remember this when going up stairs: Good leg, injured leg, crutch, repeat.
  • If going down stairs, move the crutch onto the lower step first, put your weight on the crutch as you move your injured leg onto the step alongside it. Bring your good leg onto the same step. Remember this when going down stairs: Crutch, injured leg, good leg, repeat.


Early exercise is important to recover movement and promote circulation. This will reduce the risk of developing a Deep Vein Thrombosis (blood clot). If you notice any swelling or redness in the calf, please attend A&E.

Do these exercises 3-4 times a day. Start straight away, you do not need to push into pain.

Ankle Exercises

Point your foot up and down. Repeat this 10 times.

Rest with your leg supported.

Point your foot up and down. Repeat this 10 times.

Frequently Asked Questions

I am struggling with my cast. What can I do?

If you need more advice contact the Virtual Fracture Clinic.

When can I start driving?

You can return to driving when:

  • You are no longer wearing a cast
  • You can walk comfortably
  • You can perform an emergency stop pain free

Always test your ability to drive in a safe environment first.

How can I get a certificate for work?

You can self-certify for the first 7 days following your injury. For any longer periods, please discuss the provision of a fitness to work statement with the Virtual Fracture Clinic Team, the Doctor at your Fracture Clinic appointment or your GP.

What do I do with my crutches when I no longer need them?

Crutches can be returned to the Fracture Clinic or A&E.

Contact Details for Bedford and Luton

Please contact the hospital where you attended A&E as the other site will not be able to access your notes


How do I contact the Virtual Fracture Clinic (VFC)

How do I contact the Fracture Clinic?

  • Telephone 01234 792138

How do I contact the Plaster Room?

  • Telephone 01234 792031
  • Monday to Friday 9am to 5pm (out of hours contact the Emergency Department)


How do I contact the Virtual Fracture Clinic (VFC)

  • Telephone 01582 718121
  • Messages will be checked every morning Monday to Friday (except for Bank Holidays)
  • Email VFCLuton@ldh.nhs.uk

How do I contact the Fracture Clinic?

  • Telephone 01582 497194 or 01582 718 993 (outpatient appointments)

How do I contact the Plaster Room?

  • Telephone 01582 491166 (ext. 2233)
  • Monday to Friday 9am to 5pm (out of hours contact the Emergency Department)