Pre-tibial Lacerations and Haematomas

It is usual for the skin on the front of the shins to become quite thin and fragile as one gets older, particularly in women, and this can be made worse by the long-term use of steroid medication.

As a result of this fragility, a small knock on the shin, such as can be sustained by a shopping trolley or a fall at home can tear the skin. This is usually called a pre-tibial laceration.

How are they treated?


Pre-tibial lacerations are becoming common as the number of older women increases and they can be troublesome. Minor cuts in the skin, or where only a small amount of skin has been lifted up to form a ‘flap’ of skin can often be treated in the casualty department with a supportive dressing and a period of resting the leg up at home, but more extensive lacerations or if the flap of skin is large, can mean that some of the skin will not survive and requires to be trimmed away (debrided) and the area of missing skin repaired with a skin graft. 

Pre-tibial lacerations are a frequent cause of unplanned admission to plastic surgery units in the elderly. The skin grafting may be possible under local anaesthetic but quite often a general or regional anaesthetic is used.  

How long you have to stay in hospital depends on a number of factors, such as how big the skin graft is and how your general health is.

Haematomas


It is increasingly common for older people to be taking blood thinning medicine such as aspirin, warfarin or clopidigrel, since these can be beneficial for preventing or after heart attacks and strokes. Unfortunately a simple knock on the skin in such people can turn into a blood clot under the skin (haematoma) if some of the small blood vessels are torn and this too can cause the skin on the front of the shin to become unhealthy and require surgery to help it heal.

Is this surgery available on the NHS?


Reconstructive plastic surgery to repair pre-tibial lacerations and haematomas is available on the NHS. In general it is quicker and easier to get these injuries healed up if they are attended to promptly so it is best to seek medical help if you think you might have a pre-tibial laceration or haematoma.
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