Broken Leg

Broken Leg Overview

Your leg contains 4 bones (the femur, the patella, the tibia, and the fibula) and bends at the hip, the knee, and the ankle. After an accident, these bones may break (fracture) into 2 or more pieces.

If a broken bone has been exposed to the outside, either by a cut over the fracture or by bone sticking out through the skin, it is called an open fracture. This is sometimes called a compound fracture.

A break in the leg may involve any of these bones:

  • The femur is the bone in the thigh. It is the longest and strongest bone of the body. The upper part of the femur fits into the pelvis to form the hip joint. At this joint, it can move frontward, backward, sideways, and even rotate in and out. When people speak of a "broken hip," it is this upper part of the femur that is broken.
  • The lower end of the femur rests on top of the tibia, forming the knee joint. At the knee, the leg can swing frontward, backward, and even rotate slightly.
  • The kneecap (patella) glides back and forth in front of the knee joint. The kneecap suspends the ligaments from the thigh muscle and helps to add leverage for straightening out the leg.
  • The tibia is the shinbone and supports the body's weight. The fibula runs alongside the tibia below the knee. It is on the outside part of the leg and is smaller than the tibia.
  • The ankle is composed of the bottom ends of the tibia and fibula, the connecting foot bones, and the ligaments and tendons. Severe twisting injuries to the ankle can result in fractures of the tibia or fibula near or within the ankle joint.

Broken Leg Causes

It usually takes quite a bit of force to break the bones of the leg. Bones that have been weakened somehow can be broken more easily. If the amount of force put on a bone is greater than the amount it can handle, the bone will break.

  • A leg can be broken through trauma, where there has been a large force or injury (examples: car, motorcycle, or all-terrain vehicle accidents, skiing injuries, and falls from heights).
  • Injury can cause a bone to break if the bones have been weakened by disease such as cancer or other tumors, bone cysts, or osteoporosis.
  • Sometimes, repetitive overuse of the leg, such as the movements in distance running, can result in a stress fracture.

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Broken Leg Symptoms

The major symptoms of a broken leg are pain, swelling, and deformity. A broken leg can be very obvious but may require an X-ray to diagnose.

  • Pain caused by a broken bone is typically severe. Holding the bone still will decrease pain. Movement of the broken bone will increase pain.
  • Swelling and bruising over the area of a break are common.

    • Deformity of the leg can occur in these forms:

    • Shortening: The broken leg appears shorter than the unaffected leg.

    • Rotation: The leg below the break is twisted.

    • Angulation: The leg bends at the break instead of at the joint.

When to Seek Medical Care

Some parts of the leg may be broken and still seem like a bad strain. This can often be the case of injuries around the ankle, or sometimes with the fibula, the little bone next to the shinbone.

Call your doctor if these conditions describe your situation:

  • You are not able to walk without a great amount of pain.
  • It hurts when you push on the bony parts of the leg.
  • You are concerned that you may have a broken leg, even if you are unsure.
  • If you think you or someone else has a broken leg, go to an emergency department for further evaluation. If you cannot walk, you should call 911 for an ambulance.
  • If you have had a surgery, or had a splint or cast placed already, return to the hospital immediately if these problems develop:

    • Loss of muscle strength or numbness in the leg or foot; a certain amount of strength loss is common because of the pain of the fracture, but if there is a rapid development of numbness or worsening of strength, or a significant increase in pain unrelieved by your pain medication, these may be signs of a "compartment syndrome." Compartment syndrome occurs when swelling gets so severe within the leg that it cuts off blood flow to the leg. This can cause damage to muscles and nerves of the leg.

    • Redness, fever, increased swelling or pain, or drainage of pus from a surgical incision, are all signs of possible wound infection.

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Exams and Tests

The doctor will examine the leg for evidence of a break (fracture). If the doctor suspects that a bone has been broken, X-rays will be ordered.

  • The doctor also will look for signs that an artery or nerve was damaged or injured. To do this, the doctor will feel for pulses and test your strength and sense of touch below the injury.
  • If the doctor suspects some other medical condition has caused weakening of the bone leading to the fracture, other lab tests may be ordered.
  • Diagnosis of stress fractures are often difficult, and special studies beyond X-rays may be needed.

Broken Leg Treatment Self-Care at Home

If an injury happens and you suspect a break, remember the following:

  • Immobilize the leg as much as possible until help arrives.
  • Rest. Try to keep from aggravating the injury.
  • Apply an ice pack wrapped in a pillowcase or towel to decrease swelling.
  • If possible, keep the leg elevated with pillows or cushions to decrease swelling.
  • Often with a broken leg, an operation is necessary. For this reason, do not let someone with a broken leg eat or drink anything until seen by the doctor. Always ask the doctor if it would be OK to eat before doing so.

Medical Treatment

The type and location of a break in a leg bone will determine what treatment is needed.

  • If the bones have become displaced or out of alignment, they will need to be put back into alignment. This procedure is called "reduction." In order to do this, you will be given medications for pain prior to the procedure.

  • An emergency doctor will be able to treat many types of fractures with a temporary brace or plaster splint and will instruct you to follow up with an orthopedic doctor (bone specialist). However, fractures of the thighbone or the shinbone typically will need further care by an orthopedist right away. This may mean a cast or even an operation.

  • Bones are immobilized for healing by several methods.

    • A plaster splint or cast often is used.

    • When an operation is needed, pins, screws, and metal plates or wires are often used to hold together the broken ends of a bone.

    • For fractures in the middle part of the thighbone (femur) or the shinbone (tibia), a metal rod sometimes is placed down through the center of the bone. This is done in the operating room.
  • Your doctor will also provide you with medicine for the pain.

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Next Steps Follow-up

From the emergency department, you will usually need to follow up with an orthopedic doctor. This bone specialist will guide you in further follow-up appointments and rehabilitation as necessary.

Prevention

To decrease your risk of injury from a car accident, use a seat belt. For children, use a safety seat appropriate for the child's age and weight.

  • If participating in sports in which high speeds or heights are present, only participate to your experience level and make use of proper protective gear.
  • Use such assistance as a walker or cane, as instructed by your doctor, if you are at risk for falling or have an unsteady walk.
  • Talk to your doctor about screening for diseases that may weaken bones.

Outlook

If treated promptly and properly, a broken leg usually will regain normal function.

  • Because the major bones of the leg support our weight, at least 6-8 weeks is usually required before the bone is healed.
  • The severity of the injury and your age may cause problems. For instance, an elderly person with a hip fracture may have difficulty regaining strength and mobility.
  • Someone with an open fracture, where the bone sticks through the skin, may be at increased risk for infection of the bone. If infection occurs, this may delay significantly the healing process.

Multimedia

Media file 1: Broken leg. Fracture of the femur (thigh bone). Courtesy of Kevin Reilly, MD, Department of Emergency Medicine, University of Arizona.

broken leg 1

Media file 2: Broken leg. Fracture of the femur (86 year old). Courtesy of Lisa Chan, MD, Department of Emergency Medicine, University of Arizona.

broken leg 2

Media file 3: Broken leg. Fracture of the tibia and the fibula (a "tib-fib" fracture), seen from the side. Courtesy of Lisa Chan, MD, Department of Emergency Medicine, University of Arizona.

broken leg 3

Media file 4: Broken leg. Fracture of the tibia and the fibula, after fixation in the operating room with metal rod and screws. This is one method of maintaining bone position to allow healing to occur. Courtesy of Kevin Reilly, MD; Department of Emergency Medicine, University of Arizona.

broken leg 4

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Synonyms and Keywords

leg fracture, femur, patella, tibia, fibula, open fracture, compound fracture, closed fracture, broken leg

WebMD Medical Reference from eMedicineHealth Reviewed by Neha Pathak, MD on February 12, 2017

Sources

Broken Leg from eMedicineHealth

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