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Broken Leg

Medically Reviewed by Hansa D. Bhargava, MD on August 24, 2020

What Is a Broken Leg?

A broken leg is when you break one of the bones in your leg. It can happen lots of ways, like falling or getting into a car accident.

Your leg has four bones (the femur, the patella, the tibia, and the fibula). If there’s an accident, any one of these bones may break (fracture) into two or more pieces.

  • Femur. This is the bone in your thigh. It’s the longest and strongest bone in your body. The upper part of the femur fits into the pelvis (the bone that supports your spinal column) 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’s this upper part of the femur that’s 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.
  • Patella. The kneecap (patella) glides back and forth in front of the knee joint. The kneecap connects your thigh muscle to the tibia. It also helps protect your knee.
  • Tibia. This is the shinbone. It supports your body's weight.
  • Fibula. The bone runs alongside the tibia below your knee. It’s on the outside part of the leg and is smaller than the tibia.

The ankle is made up of the bottom ends of the tibia and fibula, the connecting foot bones, and the ligaments and tendons. Serious twisting injuries to the ankle can result in fractures of the tibia or fibula near or within the ankle joint.

Types of Leg Breaks

There are many types of breaks. What type you have depends on the force it takes to break and the way it breaks.

Types of breaks include:

  • Comminuted, when the bone breaks in three or more pieces and there are fragments where the bone broke
  • Compression, when the bone is crushed
  • Greenstick, when the broken bone isn’t completely separated (an incomplete fracture)
  • Oblique, when the bone break is diagonal
  • Segmental, when the bone is broken in two pieces (meaning there’s a “floating” part of bone)
  • Spiral, when the bone break is spiraled, usually because of a twisting injury

If you can see the bone when it’s broken -- either because there’s a cut over the fracture or the bone is sticking out through the skin -- it’s called an open fracture. This is sometimes called a compound fracture.

Broken Leg Symptoms

Breaking your femur takes a lot of force, so it’ll probably be obvious if you break it. The major symptoms of a broken leg are pain, swelling, and deformity. Less obvious breaks might need an X-ray to diagnose.

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Signs you might have a broken leg are:

  • Bruising
  • Not being able to walk
  • Serious pain that gets worse when you move and gets better when you’re still
  • Swelling
  • Tenderness
  • A change in the form of your leg

If a leg is broken, it can change form in the following ways:

  • Rotation: The leg below the break is twisted.
  • Angulation: The leg bends at the break instead of at the joint.
  • Shortening: The broken leg appears shorter than the unaffected leg.

If you think your child or toddler might have a broken leg, they might cry or stop walking on it without saying why.

When to seek medical care

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

Call your doctor if:

  • You can’t walk without being in a lot of pain
  • It hurts when you push on the bony parts of the leg
  • You’re worried you might have a broken leg, even if you’re unsure

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If you think you or someone else has a broken leg, go to an emergency room for further evaluation. If you can’t walk, you should call 911 for an ambulance.

If you’ve recently had surgery, or had a splint or cast placed already, return to the hospital fight away if you have these problems:

  • Loss of muscle strength or numbness in the leg or foot. Some loss of strength is common because of the pain of the fracture, but if you notice you’re quickly losing strength, having numbness, or suddenly have a lot of pain that doesn’t go away with your pain medication, it could be a sign of a "compartment syndrome." Compartment syndrome happens when swelling gets so serious in your leg that it cuts off blood flow to it. This can cause damage to the muscles and nerves in your leg.
  • Redness, fever, lots of swelling or pain, and pus draining from a surgical cut are all signs of possible wound infection.

Broken Leg Causes

It usually takes quite a bit of force to break bones in your leg. If your bones have been weakened somehow, they 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.

Some of the ways your leg may break include:

  • Car or motorcycle accidents. You can break the bones in your leg when your knee hits the dashboard during a car crash. It’s possible to break all three of the bones in your leg when you get into an accident.
  • Falls. Falling, especially from somewhere high, can break one or both of the bones in your lower leg, but falling usually won’t break your thighbone (femur).
  • Overuse. It’s possible to get stress fractures -- tiny cracks in your bones -- when you put pressure on them often, like with long-distance running. Stress fractures can also happen with activities like ballet and basketball.
  • Sports injuries. Getting hit during contact sports, like martial arts or football, can cause broken bones, too. So can hyperextending your leg.

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In children, child abuse can break leg bones. If a child can’t walk and has a broken leg, that could be a sign of child abuse.

An injury can also cause a bone to break if your bones are weakened by diseases or conditions, including:

Broken Leg Diagnosis

The doctor will check your leg for signs of a break (fracture). If the doctor thinks a bone has been broken, they’ll order X-rays.

The doctor also will look for signs that an artery or nerve was damaged or injured. To do this, they’ll feel for pulses and test your strength and sense of touch below the injury.

If the doctor suspects some other medical condition has weakened the bone, leading to the fracture, other lab tests may be ordered.

It’s often tough to diagnose stress fractures, and special studies beyond X-rays may be needed.

Broken Leg Treatment

If you have a broken leg, you’ll need to take care of it right away when you’re at home.

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Treating a broken leg at home

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

  • Keep your leg as still as possible until help arrives.
  • Rest. Try to keep from making the injury worse.
  • Put an ice pack wrapped in a pillowcase or towel on your leg to ease swelling.
  • If possible, keep your leg raised with pillows or cushions to reduce swelling.
  • Often with a broken leg, surgery is necessary. For this reason, don’t 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 for a broken leg

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’ll need to be put back into alignment. This procedure is called "reduction." To do this, you’ll be given medications for pain before the procedure.
  • An emergency doctor will be able to treat many types of fractures with a temporary brace or plaster splint and will tell you to follow up with an orthopedic doctor (bone specialist). Fractures of the thigh bone or the shinbone typically will need further care by an orthopedist right away. This may mean a cast or even an operation.
  • Your bones will be kept from moving so they can heal using several methods:
    • Setting your leg: When you first get diagnosed, a doctor will keep your leg still with a splint. Your doctor might keep the splint on for a day to let the swelling go down.
    • Immobilization: Next, your doctor might use a splint or cast to stop your bones from moving around. You might also need crutches or a cane to get around easier. If that’s the case, you’ll probably use your crutches or cane for about 6-8 weeks.
    • Medications and treatment: Your doctor might suggest you take over-the-counter pain medication (like acetaminophen or ibuprofen) to help with the pain and swelling. But if your pain is severe, they might give you stronger painkillers.
    • Therapy: Once your leg heals and the doctor takes off your cast or splint, you’ll probably need some sort of therapy. Therapy will help your leg get back to normal, since your muscles will have weakened. It can take a few months or longer for your leg to heal completely.
    • Surgery: Although a cast or splint is usually all most broken bones need, you could need surgery, depending on your break. If you need surgery, pins, screws, and metal plates or wires are usually used to hold together the broken ends of a bone. For fractures in the middle part of the thigh bone (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.

Broken Leg Complications

Although not everyone will have other problems that stem from breaking their leg, some complications are possible, including:

  • Arthritis. Your break can cause arthritis to pop up years later.
  • Blood vessel or nerve damage. When you break your leg, you could also damage the blood vessels or nerves that are nearby.
  • Bone infection (osteomyelitis). If you had an open fracture, that means the bone was exposed to the outside air, including germs and fungi. Those could give you an infection in your bone.
  • Compartment syndrome. Swelling, pain, and sometimes disability in the muscle near the break can happen with this rare condition. It’s more common with car accidents because it’s considered a “high-impact” injury.
  • Delayed or poor healing. A serious broken leg might not heal quickly. It also might never fully heal, depending on the break. This is more common if you have an open fracture involving your tibia, since there’s less blood flow to the bone.
  • Legs that are different sizes. If your child breaks a leg, one leg could end up shorter than the other. This is because children’s bones are still growing. But this is rare, especially with the right treatment
  • Pain in your ankle or knee. Your ankles or knees could hurt because of your break.

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 appointments and rehabilitation as necessary.

Broken Leg Prevention

To lessen 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 you play sports that involve high speeds or heights, play only at your experience level and use the right protective gear.
  • Use assistance, like 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.

Broken Leg Recovery

If treated promptly and properly, a broken leg usually will regain normal function. How severe the injury is and your age will play roles in how you recover. For instance, an elderly person with a hip fracture may have a hard time getting their strength and mobility back.

WebMD Medical Reference

Sources

SOURCES:

eMedicineHealth: “Broken Leg.”

Mayo Clinic: “Broken leg: Symptoms & Causes,” “Broken leg: Diagnosis & Treatment.”

American Academy of Orthopaedic Surgeons: “Patellar (Kneecap) Fractures.”

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