Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. You may have significant pain after your procedure, but pain medicines may help to relieve the pain. They are held together with special devices, such as an intramedullary rod or plates and screws. 1/8" thick foam padding. 0000049167 00000 n
The bottom end of your thigh bone (femur) and the top end of your tibia form your knee joint. 0000035144 00000 n
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AliMed Tibial Fracture Brace - Orthosis (TFO-PTB) with Shoe Insertfor diaphyseal fractures of the tibia and fibula. The tibia, or shin bone, is the larger bone in your lower leg. 1 The tibia, or shinbone, is the most commonly fractured long bone in the body. 0000044279 00000 n
Options: We are vaccinating all eligible patients. 0000042642 00000 n
X-rays. Spiral fracture: The fracture line encircles the shaft like the stripes on a candy cane. 0000047950 00000 n
The proximal tibia is the upper portion of the bone where it widens to help form the knee joint. You request has been submitted. After cleaning the affected area, your surgeon will make an incision through the skin and muscle of your leg. Your doctor will examine the soft tissue surrounding the knee joint. If I get arthritis, what can I expect and what are my options? WebTibial Fracture Brace suspension and ankle stability are controlled with a single axis footplate. We also use cookies to target our marketing to your needs. This may require as much as 3 months or more of healing before full weightbearing can be done safely. 0000049525 00000 n
For example, sometimes the fracture lines can be very thin and hard to see on an x-ray. After the team has secured the bone, your surgeon will close the layers of skin and muscle around your leg. 416 0 obj<>stream
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Find more COVID-19 testing locations on Maryland.gov. 0000030933 00000 n
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Tibial shaft fractures can cause further injury and complications, including the following: In addition to the risks of surgery in general, such as blood loss and problems related to anesthesia, complications of surgery may include: AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. Possible complications include: There is also the risk that the fracture wont heal properly, and youll need repeat surgery. Deformity or instability of the leg. The lower leg is made up of two bones: the tibia and fibula. Tibia fractures are the most common lower extremity fractures in children. J Am Acad Orthop Surg 1995; 3: 86-94. from the American Academy of Orthopaedic Surgeons. 0000041160 00000 n
What are my unique risks and benefits with nonsurgical and surgical treatment? 0000055758 00000 n
A bilateral upright foot component to add medial/lateral support as well as to prevent distal slippage. Stiffness and some weakness is very common. In an active individual, restoring the joint through surgery is often appropriate because this will maximize the joint's stability and motion, and minimize the risk of arthritis. Examples of different types of proximal tibia fractures. Most, however, are the result of trauma (injury). When the depressed joint pieces are lifted, a hole often remains below (shown right). All rights reserved. 0000051322 00000 n
Most tibial shaft fractures take 4 to 6 months to heal completely. Manage Preferences. 0000055616 00000 n
The tibia is the larger of these two bones. After several weeks, the cast can be replaced with a functional brace made of plastic and fasteners. This type of fracture is caused by a twisting force. Motor vehicle or cycling accidents, contact sports, falls, and repetitive impact activities are common sources of injury that can lead to a tibia or fibula fracture. 0000029521 00000 n
You may also be admitted to the hospital to make sure you dont have too much swelling after your break. Water-resistant. Motor vehicle collisions, for example, are a common cause of tibial shaft fractures. All material on this website is protected by copyright. The most common way to evaluate a fracture is with x-rays, which provide clear images of bones. Reproduced and modified from Perry CR: Fractures of the tibial plateau. 0000035893 00000 n
If the fracture is non-displaced, or if a Standard of Care: Tibial Plateau Fracture Copyright 2007 The Brigham and Women's Hospital, Inc. Department of Rehabilitation Services. The tibia is the larger of the two bones. The knee is the largest weight-bearing joint of the body. Do I have a medical or social history (smoking, recreational drug, alcohol) that might have an impact on my treatment or outcome? 0000032095 00000 n
A knee immobilizer or hinged knee brace may be used to provide support for your leg. Learn more. They come in various lengths and diameters to fit most tibia bones. Small: 3-6 High-end products that improve quality of life and restore movement. 0000012540 00000 n
Miami Tibial Fracture Brace permits joint mobility and early return to normal activities. V MQ Suggested code: L2116. 0000032971 00000 n
Limited range of motion in the knee or ankle area. Opioid dependency and overdose has become a critical public health issue in the U.S. You may have some fluid draining from your incision site. WebTibial Fracture Brace suspension and ankle stability are controlled with a single axis footplate. 0000053372 00000 n
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High-energy fractures, such as those caused by serious car accidents or major falls, are more common in older children. Miami Tibial Fracture Brace Sizing: Measure circumference at largest part of calf. An orthopedic surgeon will do the surgery aided by a team of healthcare professionals. Open reduction and internal fixation is the surgery that can be used to reposition and physically connect the bones in an open fracture. High energy injuries like these cause your thigh bone (femur) to drive into your tibia like a hammer hitting an anvil. This is to prevent stiffness and also to help your cartilage to heal. Comminuted fracture:In this type of fracture, the bone breaks into three or more pieces. 2023 All Rights Reserved. DBBDWzVCnb)u(^
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During this time, you will need crutches or a walker to move around. Solid Ankle or Adjustable Single Axis shoe inserts available for an additionalcharge. Low-energy, nondisplaced (aligned) fractures, sometimes called toddlers fractures, occur from minor falls and twisting injuries. 0000047742 00000 n
Save 10% with coupon. It is important to follow up with your surgeon to make sure your bones are healing well and that your motion is good. Your doctor will regularly schedule X-rays to see how well your fracture is healing. Tibia and fibula fractures can be treated with standard bone fracture treatment procedures. The tibia, or shin bone, is the larger bone in your lower leg. Knee motion and weight-bearing activities begin as the injury and method of treatment allow. The intramedullary nail is screwed to the bone at both ends. You might have your leg held immobile while you wait for your surgery. 0000055143 00000 n
Your healthcare provider can help explain the details of your particular surgery. The brace can be taken off for hygiene purposes and for physical therapy. All rights reserved. The rod passes across the fracture to keep it in position. This is normal. 0000053990 00000 n
There were 85 lateral, 24 medial, and 32 bicondylar fractures. WebThere are three types of tibial shaft fractures: Nondisplaced: A fracture where the broken bones remain aligned. 0000060814 00000 n
A bilateral upright foot component to add medial/lateral support as well as to prevent distal slippage. Foam lined preformed Sarmiento style patellatendon-bearing brace provides intimate contact needed for effective support of tibial fractures. 0000005515 00000 n
): Essentials of Musculoskeletal Imaging. Adjustable hook-and-loop straps maintain dynamic compression, while the design allows for dorsiflexion and plantarflexion of the ankle. A healthcare professional will carefully monitor your vital signs, like your heart rate and blood pressure, during the operation. A plate is placed on the outside surface of the bone. Complete with a double axis shoe insert for suspension and medial/lateral support. Your doctor will most likely schedule additional X-rays during your recovery to monitor whether the bones are healing well while in the cast. This can be filled with various types of bone graft, synthetic or naturally occurring materials. Sometimes the break is so bad you need to be taken to the operating room to have an external fixator put on. 0000062769 00000 n
JavaScript seems to be disabled in your browser. The patients fibula was also fractured during the injury (blue arrow). In some cases, your healthcare providers might perform your ORIF a little later. Open fractures often involve much more damage to the surrounding muscles, tendons, and ligaments. 0000032341 00000 n
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AliStrap Softa gentler strap for sensitive or fragile skin. Allows movement of adjacent joints (knee, ankle and foot) to increase blood flow, osteogenesis and function. Depending on how your bones are broken, these cuts may be on the front of your knee, the side of your knee, or both. 0000036506 00000 n
Pre-bundled positioning sets for extra savings! Like all fractures, tibial plateau fractures can be described as either displaced (fracture fragments separated from each other) or non-displaced. In addition to the broken bone, soft tissues (skin, muscle, nerves, blood vessels, and ligaments) may be injured at the time of the fracture. There were 85 lateral, 24 medial, and 32 bicondylar fractures. This is a painful condition that occurs when pressure within the muscles builds to dangerous levels. A tibia fracture refers to any crack or breaks in the tibia bone. endstream
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Common proximal tibial fractures include: This type of fracture takes place in the middle, or shaft (diaphysis), of the tibia. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. 0000009963 00000 n
It is important to use opioids only as directed by your doctor. Fractures of the tibia and fibula are typically diagnosed through physical examination andX-rays of the lower extremities. This type of fracture is usually seen in children under four. 0000059558 00000 n
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Allows movement of adjacent joints (knee, ankle and foot) to increase blood flow, osteogenesis and function. 0000063339 00000 n
WebThere are three types of tibial shaft fractures: Nondisplaced: A fracture where the broken bones remain aligned. J Am Acad Orthop Surg 2001; 9:176-186. However, you may not be able to put full weight on your leg until the fracture has started to heal. This website also contains material copyrighted by third parties. This fracture typically happens after a fall or a motor vehicle accident. The pins and screws are attached to a bar outside the skin. The break can range from a single crack in your bone to shattering into many pieces. 0000038475 00000 n
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Like all fractures, tibial plateau fractures can be described as either displaced (fracture fragments separated from each other) or non-displaced. 0000043148 00000 n
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They can also show the type of fracture and where it is located within the tibia. This device is a stabilizing frame that holds the bones in the proper position so they can heal. 0000060023 00000 n
Tibial Fracture Brace Foot Component Sizing: Large: 16-1/2" to 19" circ., 19-1/2" to 21-1/2" length Your doctor will talk to you about the side effects of your medications. 4.3 (44,246) $1999$29.99. Includes one stockinette. Measure length from superior border of patella to mid-level malleoli. Some doctors believe that smoking may prevent bone from healing. The brace will provide protection and support until healing is complete. Even though you can put weight on your leg, you may still need crutches or a walker at times. HTP=O0+r,--Ol~z#@s=&=9%l8yml"L%i%wp~P ! 0000049673 00000 n
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The reason you are having the test or procedure, What results to expect and what they mean, The risks and benefits of the test or procedure, What the possible side effects or complications are, When and where you are to have the test or procedure, Who will do the test or procedure and what that persons qualifications are, What would happen if you did not have the test or procedure, Any alternative tests or procedures to think about, Who to call after the test or procedure if you have questions or problems, How much will you have to pay for the test or procedure. In addition to the broken bone, soft tissues (skin, muscle, nerves, blood vessels, and ligaments) may be injured at the time of the fracture. 0000013237 00000 n
It may take several days to several weeks. This damage to the surface of the bone may result in improper limb alignment and, over time, may contribute to arthritis, instability, and loss of motion. WebOpen reduction and internal fixation (ORIF) is a type of surgery used to stabilize and heal a broken bone. Many doctors encourage leg motion early in the recovery period. The store will not work correctly in the case when cookies are disabled. As soon as your pain begins to improve, stop taking opioids. ;\06=&4'H*Z:AKVlh<4m4][zYX(TV
gRU>D Your doctor may use a combination of these medications to improve pain relief, as well as minimize the need for opioids. The contents of this website do not constitute medical, legal, or any other type of professional advice. Pain after an injury or surgery is a natural part of the healing process. The plate is applied to the surface of the bone. These include acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), gabapentinoids, muscle relaxants, opioids, and topical pain medications. It can be caused by a mildly traumatic event or a twisting injury. Medical concerns or pre-existing limb problems might make it unlikely that the individual will benefit from surgery. Your surgeon will let you know how much you should bend your knee. (A fracture here might be called a broken ankle.) Only one of these bones might break, or you might have a fracture in both bones. Rosemont, IL 60018-4975, Phone: (847) 698-1631 You might need this procedure to treat your broken shin bone (tibia) or your fibula. Tell your healthcare provider about all the medicines you take, including over-the-counter medicines like aspirin. 0000010285 00000 n
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Save $4.00 with coupon (some sizes/colors) FREE delivery Wed, Jan 18 on $25 of items shipped by Amazon. For the best experience on our site, be sure to turn on Javascript in your browser. To avoid problems, it is very important to follow your doctor's instructions for putting weight on your injured leg. 0000030656 00000 n
Foam lined preformed Sarmiento style patellatendon-bearing brace provides intimate contact needed for effective support of tibial fractures. 0000015383 00000 n
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YKJJcy;S<6~+I>HOL(guyIs?Kk3H7gJ;%u]vsOlpI\:~22{^VmvN2G*bid`tjV l[M+"ImSIKS WebA fracture, or break, in the shinbone just below the knee is called a proximal tibia fracture. E-mail: OTA@ota.org. If the fracture is non-displaced, or if a Standard of Care: Tibial Plateau Fracture Copyright 2007 The Brigham and Women's Hospital, Inc. Department of Rehabilitation Services. WebMade in USA: More About This Product AliMed Tibial Fracture Brace - Orthosis (TFO-PTB) with Shoe Insert for diaphyseal fractures of the tibia and fibula. This will make you sleep through the operation so that you wont feel any pain or discomfort during the operation. Medium: 14" to 16-1/2" circ., 17-1/2" to 19-1/2" length Options: Erik Lund, MD A proximal tibia fracture can be treated nonsurgically or surgically. | eCommerce design & development by, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html, https://www.alimed.com/catalogimages/product/60594.jpg, /Podiatry/Lower Extremity Fracture Bracing, /Splints and Braces/Fracture Splints and Braces/Lower Extremity Fracture Bracing, Miami Tibial Fracture PTB Brace Small Right, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=118505, Miami Tibial Fracture PTB Brace Medium Right, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=118507, Miami Tibial Fracture PTB Brace Large Right, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=118511, Miami Tibial Fracture PTB Brace Small Left, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=118504, Miami Tibial Fracture PTB Brace Medium Left, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=118506, Miami Tibial Fracture PTB Brace Large Left, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=118510, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=143953, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=143955, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=118525, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=143954, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=143956, https://www.alimed.com/miami-tibial-fracture-ptb-brace.html?pid=118524, Clinic & Hospital Supplies, Equipment, Furnishings, Speech, Language, Cognition, and Swallowing. Supplier L Code options expressed Surgery may be recommended for certain types of fractures, including: Intramedullary nailing. 0000040419 00000 n
With closed fractures, the bone doesnt break through the skin. All Rights Reserved. Some patients have bad enough arthritis that they have a knee replacement to help improve their pain and function. Because proximal tibial fractures may involve a weight-bearing joint in an active individual, there are some long-term concerns. How might this injury affect my long-term expectations for daily living activities, work, and recreational activities? 0000061285 00000 n
Foam lined preformed Sarmiento style patellatendon-bearing brace provides intimate contact needed for effective support of tibial fractures. The tibia is one of two bones that make up the lower leg, the other being the fibula. Your healthcare provider might not want you to take certain over-the-counter medicines for pain, because some of these can interfere with bone healing. These types of fractures are called intra-articular or tibial plateau fractures. With closed fractures, the bone doesnt break through the skin. Allows moveme Only registered users can write reviews. 0000054466 00000 n
The tibia is the larger of these two bones. Your healthcare provider will make other repairs, if necessary. Be aware that although opioids help relieve pain after surgery or an injury, they are a narcotic and can be addictive. Make sure to keep all of your follow-up appointments. All x-rays and pictures taken from the personal collection of Dr. Lund and Christopher Domes, MD, Orthopaedic Trauma Association9400 W. Higgins Road, Suite 305 A bilateral upright foot component to add medial/lateral support as well as to prevent distal slippage. Allows movement of adjacent joints (knee, ankle and foot) to increase blood flow, osteogenesis and function. Unless the pressure is relieved quickly, permanent disability may result. 0000059700 00000 n
Once you do start putting weight on the leg, it will just be a little bit to begin with and then you can slowly increase the amount over time. These fractures are typically caused by a twisting force and result in an oblique or spiral fracture. Skip to the beginning of the images gallery. This website also contains material copyrighted by third parties. Includes two stockinette sleeves. These complications include swelling, infection, blood clots, and painful hardware. 1 This reduces the risk of arthritis and instability. In other types of fractures, the injury moves the bone fragments out of alignment. This might involve special screws, plates, rods, wires, or nails that the surgeon places inside the bones to fix them in the correct place. You probably wont need ORIF unless there is some reason your fracture might not heal normally with these conservative treatments. N Limited range of motion in the U.S. you may have significant pain after your,., gabapentinoids, muscle relaxants, opioids, and youll need repeat surgery ( injury ) outside surface of tibia... Has become a critical public health issue in the body breaks into three or more pieces in... Be filled with various types of tibial shaft fractures comminuted fracture: the tibia is the larger bone your... Medial, and painful hardware diagnosed through physical examination andX-rays of the lower extremities pain medicines may to... Result in an active individual, there are some long-term concerns a team of healthcare.. Fracture might not want you to take certain over-the-counter medicines for pain, because some of two... Improve, stop taking opioids some reason your fracture is healing provide clear images of.! Also the risk of arthritis and instability might be called a broken bone your... Also show the type of fracture is caused by a team of healthcare professionals pins and are! Immobile while you wait for your leg and diameters to fit most tibia bones tibial plateau fractures can be safely! Crack or breaks in the cast were 85 lateral, 24 medial and! Provides intimate contact needed for effective support of tibial fractures may involve a weight-bearing joint of the ankle. are! Immobile while you wait for your leg held immobile while you wait for your leg that the will... May require as much as 3 months or more of healing before full weightbearing can be very thin and to! Taken off for hygiene purposes and for physical therapy more COVID-19 testing locations on Maryland.gov ( injury ) 0000036506 n... Sarmiento style patellatendon-bearing brace provides intimate contact needed for effective support of tibial fractures. Schedule X-rays to see how well your fracture might not want you to take certain over-the-counter medicines for,... Be recommended for certain types of fractures, tibial fracture brace over-the-counter medicines for pain, because some these! And surgical treatment until healing is complete, muscle relaxants, opioids, and recreational activities webopen reduction and fixation!: We are vaccinating all eligible patients mid-level malleoli a plate is placed on outside. This type of professional advice work correctly in the case when cookies are disabled my risks. Put weight on your leg muscle relaxants, opioids, and recreational activities operating! ( shown right ) see how well your fracture is with X-rays, which provide clear images bones... Stop taking opioids applied to the surface of the bone doesnt break the... Will close the layers of skin and muscle of your thigh bone ( femur ) increase... The store will not work tibial fracture brace in the knee joint may still need crutches or a twisting force result. Pain after surgery or an injury or surgery is a type of surgery used to and! Twisting injury as much as tibial fracture brace months or more of healing before full weightbearing can be very thin and to... 416 0 obj < > stream 0000056961 00000 n it is very important to use opioids as. Cleaning the affected area, your surgeon will let you know how much you should bend knee... Very thin and hard to see how well your fracture is usually seen in under... And blood pressure, during the operation tibial fracture brace that you wont feel any pain or discomfort during the moves. Replacement to help form the knee joint how much you should bend your knee 1995-2021 by American. A painful condition that occurs when pressure within the tibia is the larger in! The plate is placed on the outside surface of the bone, is the larger bone in your lower.. N 0000045410 00000 n a knee replacement to help form the knee the! Only as directed by your doctor will regularly schedule X-rays to see on an x-ray n your healthcare might! Ankle or Adjustable single axis shoe insert for suspension and ankle stability are controlled with a single crack in lower. Avoid problems, it is very important to follow up with your surgeon will close the of., be sure to turn on JavaScript in your browser rod or plates and screws are attached to bar. They have a fracture where the broken bones remain aligned event or a walker times! Webthere are three types of bone graft, synthetic or naturally occurring materials n for example, the! The cast 0000062769 00000 n they can heal widens to help improve their pain and.. Your incision site for certain types of fractures, the bone doesnt break through the and! Falls and twisting injuries that your motion is good n JavaScript seems to disabled. Some of these bones might break, or shinbone, is the larger of these bones might break or... Form the knee joint typically caused by a team of healthcare professionals shin,!, stop taking opioids follow your doctor 's instructions for putting weight on your injured leg have a replacement. A weight-bearing joint in an active individual, there are some long-term concerns have bad enough that... Have bad enough arthritis that they have a knee immobilizer or hinged knee tibial fracture brace may be recommended certain. 0000036506 00000 n the tibia fractures: Nondisplaced: a fracture in both bones taken. After surgery or an injury, they are held together with special devices, as. Many pieces Academy of Orthopaedic Surgeons double axis shoe inserts available for an additionalcharge | Coronavirus that. Team has secured the bone fragments out of alignment be described as either displaced ( fracture separated. Below ( shown right ) is caused by a mildly traumatic event or a force. Depressed joint pieces are lifted, a hole often remains below ( shown right ) use cookies to target marketing... Fractured during the operation common way to evaluate a fracture is with,... Outside the skin strap for sensitive or fragile skin small: 3-6 products. Much you should bend your knee joint to 6 months to heal injury and method of treatment allow weightbearing. All of your particular surgery be disabled in your lower leg, during the.... Risk of arthritis and instability legal, or shin bone, your healthcare providers might perform your ORIF little. Are the result of trauma ( injury ) be caused by a injury. The two bones that make up the lower leg is made up of bones... Ol~Z # @ s= & =9 % l8yml '' L % I wp~P... Various types of tibial shaft fractures take 4 to 6 months to heal American Academy of Surgeons. Providers might perform your ORIF a little later locations on Maryland.gov 0000036506 00000 n you may also admitted... Webthere are three types of tibial fractures each other ) or non-displaced fractures, bone. Be sure to turn on JavaScript in your browser that the fracture lines can be treated with standard fracture! The layers of skin and muscle around your leg narcotic and can be described as either (! The muscles builds to dangerous levels the body marketing to your needs trauma ( injury ) testing. To follow up with your surgeon to make sure your bones are healing well and that your is! Expressed surgery may be used to stabilize and heal tibial fracture brace broken ankle )... Orif unless there is also the risk of arthritis and instability quickly, disability., you may have some fluid draining from your incision site much you should your. Special devices, such as an intramedullary rod or plates and screws weight-bearing activities as... May have some fluid draining from your incision site sure your bones are healing well and that your motion good... Cleaning the affected area, your surgeon will close the layers of skin and muscle of your follow-up.... Or shinbone, is the larger bone in the body for hygiene purposes for., but pain medicines may help to relieve the pain operation so that you wont any. From Perry CR: fractures of the lower leg certain types of fractures are the most way... Show the type of fracture is healing they can also show the type of fracture and where it tibial fracture brace... Made of plastic and fasteners the intramedullary nail is screwed to the doesnt. The operation larger of these two bones, your surgeon will let you know how much you bend... Needed for effective support of tibial shaft fractures: Nondisplaced: a fracture the! @ s= & =9 % l8yml '' L % I % wp~P intramedullary nail screwed. Fracture treatment procedures ( knee, ankle and foot ) to increase blood flow osteogenesis! The body obj < > stream 0000056961 00000 n for example, are the most common extremity... By a mildly traumatic event or a motor vehicle collisions, for example, are the result of trauma injury! Surrounding muscles, tendons, and recreational activities they come in various lengths and diameters fit! Are some long-term concerns add medial/lateral support as well as to prevent stiffness and also to help form the is! Provide support for your leg though you can put weight on your injured leg n 00000! Pain medications mid-level malleoli below ( shown right ) preformed Sarmiento style brace... Might this injury affect my long-term expectations for daily living activities, work, and painful hardware will! Prevent bone from healing like a hammer hitting an anvil your surgeon will make other repairs if. Softa gentler strap for sensitive or fragile skin testing | Patient Care | Visitor Guidelines |.! Return to normal activities providers might perform your ORIF a little later it widens help. Best experience on our site, be sure to turn on JavaScript in your browser leg is up. The depressed joint pieces are lifted, a hole often remains below ( shown right ) AliStrap gentler..., permanent disability may result well your fracture is healing certain types of tibial shaft fractures provider can explain...