What is a broken leg?
Your leg has three long bones, the femur in your upper leg and the tibia and fibula in the lower leg. The patella, or knee cap, is located between the lower and upper leg bones. The tibia, or shin bone at the front of your leg is the most commonly broken bone in the leg. A broken leg can be simple or complex and the break’s severity depends on several issues, including its cause, other tissue damage, and your overall health.
There are several types of leg fractures. These are some of the most common types:
Stable: The bone is broken but has not moved out of place.
Displaced: The bone moved after it broke and the ends do not line up.
Transverse: The break is straight across the bone.
Oblique: The break is angled and could become unstable and move out of place.
Spiral: The break appears like a spiral and can be either stable or unstable.
Comminuted: The bone has shattered and is very unstable.
Impacted: The broken end of one part moves into the other broken end.
Open or compound: There is an open wound or break in the skin near the site of the broken bone.
Stress fracture: The break is caused by repeated stress to the bone.
Hairline fracture: The break is partial and can be difficult to see on an X-ray.
A broken leg is a serious injury. While most broken legs heal with a cast or a brace, you may need surgery to reset or repair the bone before it can be immobilized.
Left untreated, a leg fracture may not heal properly causing such complications as malformation of the bone, nerve injury, or tissue damage. Seek immediate medical care if you have signs of a broken leg to reduce the risk of complications. A fracture in the upper part of the femur (thigh bone) could cause life-threatening injuries because of the bone’s proximity to surrounding blood vessels and nerves.
What are the symptoms of a broken leg?
The most common symptom of a broken leg is pain that worsens when you move your leg or put weight on it. The pain is usually quite severe.
While pain is usually the first and most severe sign of a broken leg, other common broken leg symptoms include:
Obvious deformity (leg turns at an odd angle or there is a bump over the fracture site)
The injured leg is shorter than the other
Serious symptoms that might indicate a life-threatening condition
Open, or compound fractures occur when the broken bone or parts of the broken bone pierce the skin causing an open wound. An open fracture can cause blood loss and leaves your body vulnerable to infection in the wound and the bone itself.
Trying to walk on a broken leg could destabilize broken bones and cause more injury. Do not try to stand or walk. Call 911 or have someone drive you to the closest emergency department while you keep your weight off your leg.
What causes a broken leg?
Bones are usually quite strong and if you are healthy, they are hard to break. As a result, most broken legs are caused by a trauma or an accident. For example, you could break the lower part of your fibula or tibia (your ankle) by twisting it or tripping while walking. Fractures higher in the fibula or tibia, or in the femur are often caused by an impact, such as a car accident or hard fall. If the force on the leg is greater than the bone strength, a break will occur.
Stress fractures are not caused by a trauma or accident. These breaks are the result of repetitive activities or overuse, such as running or dancing, or changing an activity your body hasn’t yet adapted to.
Other causes of leg fractures include cancer, noncancerous tumors, and gunshot wounds.
What are the risk factors for a broken leg?
Anyone is at risk of breaking a leg. It could happen if you step off a sidewalk and roll your ankle, if you fall down the stairs, or if you are in a car accident. You may also have an increased risk of a leg fracture if you:
Are older and have mobility problems
Experience dizziness or light-headedness
Take medicines that make you get up at night to go to the bathroom (you may be disoriented and more likely to stumble or fall)
Have rheumatoid arthritis
Have osteoporosis (thinning bones)
Have muscle-wasting diseases, such as muscular dystrophy, in which the muscles are not strong enough to protect your bones
Have a bone disease, such as osteogenesis imperfecta (brittle bone disease)
Reducing your risk of leg fracture
You may be able to lower your risk by:
Following regular training recommendations for your sport or activity and strengthening your leg muscles to protect your bones
Taking precautions when you’re in a situation where you could fall, such as climbing ladders, changing lightbulbs, or other activities involving balance from a height.
Using proper equipment for your activity, such as shock-absorbing shoes for running
Practicing balance exercises or doing yoga
Removing objects around the house that could make you trip, such as scatter rugs, clutter, and electric cords
Using a walking aid if needed
As you get older, your risk of osteoporosis increases, especially for postmenopausal women. Speak with your doctor about this possibility. A bone density scan can show if you have osteoporosis and how far it has progressed.
If you take medicine that makes you dizzy or light-headed, or medicine that makes you feel the need to rush to the bathroom, speak with your doctor to see if there are alternate medications you can take to reduce this fall risk.
How is a broken leg treated?
Broken legs are first treated in an emergency department or urgent care facility. The emergency room doctor must take an X-ray to see where your leg is broken and what type of leg fracture it is. Other tissue damage to the affected limb will be assessed. Doctors can treat many fractures by applying a cast, splint or brace to keep your leg immobilized for 6 to 8 weeks.
If the bone has been displaced (the broken ends do not line up), your doctor will have to reduce the fracture—align the bones—before immobilizing your leg. The doctor in charge of your care may refer you to an orthopedic clinic so an orthopedic specialist can follow your healing progress until it is time to remove the cast, brace or splint.
You may need crutches for the entire time your leg is immobilized. However, depending on where the break is and how severe it is, your doctor may fit you for a ‘walking cast,’ or brace. This type of immobilization keeps your bones in alignment but allows you to walk without crutches if you prefer.
If your leg fracture is complicated or unstable, surgery may be necessary. Your doctor will recommend surgery if the fracture:
Needs plates or screws to fasten the bones together
Cannot be reduced with a closed procedure
Has damaged surrounding tissue
Is the result of a crushing injury (often from a car accident) or a penetrating wound
Is in a sensitive area such as the upper thigh
Some types of leg fractures require traction to prevent the bone from moving back into the unnatural broken position while it mends. An orthopedic surgeon can apply traction either from the outside (the leg is wrapped and attached to a weight system) or by placing pins into the thigh bone through the skin and attaching the pins to weights. The pins are temporary.
You may need pain medication at first, but the pain usually diminishes as the bone starts to heal.
Open fractures are more complicated to treat. If you have an open fracture, you have a wound where the bone pierced the skin. This wound must be cleaned and closed, and watched for signs of infection while it heals. Casts, braces and splints are still possible, but the cast may have a window cut in it so you can see the wound. Or, the brace may leave an opening where the wound is accessible so you can change the dressing.
Once your leg no longer needs to be stabilized, you may be referred to a physical therapist who will work with you to regain muscle strength in your leg.
What are the potential complications of a broken leg?
Most people heal well after sustaining a fractured leg, but there are some possible complications that could occur. These include:
Damage to the tissues and blood vessels around the broken bone
Infection in the bone or wound
Acute compartment syndrome, which is when pressure builds up in the muscle and blood flow decreases. This deprives the muscle of oxygen and nutrients resulting in tissue death and possibly gangrene.
Fat embolism, which is when bone marrow leaks from the broken bone and travels through the blood stream to your lungs
A broken leg is a common injury among both adults and children. With quick treatment, most bones heal well, leaving no lasting effects from the injury. It is important to receive proper treatment as quickly as possible to increase the chances of a full recovery.