A tibial shaft fracture generally produces considerable pain right away. Other symptoms may include being unable to walk or bear weight on the affected limb. Leg deformity or instability. Fractures of the ankle, foot, or toes can cause similar symptoms. Tibial fractures are commonly divided into three categories based on how severe they are: open (also called compound), closed, and midshaft. Open tibial fractures involve the skin and tendons and require surgical treatment to prevent infection and maintain alignment. Closed tibial fractures do not involve the skin but may involve small bits of tendon or ligament. These injuries are usually treated with surgery to restore bone density and alignment and allow for healing. Midshaft tibial fractures fall in between these two extremes-they may or may not have involved the skin when they were first injured. Midshaft fractures are treated similarly to closed fractures except that there is no need to reduce the fracture to help align the bones. The severity of your injury will determine what type of treatment you will need. If you have an open wound on your leg or if you cannot put any weight on it, then you will need surgery to repair the damage and provide support until you heal.