Leg Fracture

What is a leg fracture?

A leg fracture is a break in one or more of the bones in your leg. There are three long bones in your legs. The femur is the largest bone and goes from your hip to your knee. The fibula and tibia are the two bones in your lower leg that go from your knee to your ankle. When you have a leg fracture, you may not be able to move like you normally do. Having your leg fracture treated may decrease your symptoms such as pain. Treatment may allow you to return to the activities you enjoy, such as sports.

What causes a leg fracture?

Femur fractures are more common in men between the ages of 15 to 50. Females older then 50 with osteoporosis (brittle bones) are at an increased risk for leg fractures. The following are the most common causes of leg fractures:

• Accidents: Car and sports accidents are common causes of leg fractures. Being hit in the leg by a sharp object may also lead to a fracture.
  
  
• Fall: Falling from an area off the ground, such as when on a ladder, may cause a leg fracture. Falling from a standing position may also cause a leg fracture if your bones are weak.
  
  
• Stress: Stress fractures occur when the muscles attached to bone become tired from using them too much. Muscle stress leading to a leg fracture is common in runners, and those sports that include jumping and leaping.

What are the different types of leg fractures?

• Non-displaced: A fracture is non-displaced when the bone cracks or breaks but stays in place.
  
  
• Displaced: A fracture is displaced when the two ends of the broken bone are no longer attached.
  
  
• Open fracture: An open fracture occurs when the broken bone breaks through your skin.

What are the signs and symptoms of a leg fracture?

You may have any of the following:

• Decreased leg movement, or an inability to move your injured leg.
  
  
• Deformity (your leg is shaped different then normal).
  
  
• Hip, thigh, and groin pain that worsens when you stand on your injured leg. The groin is the area where your hips and upper legs meet.
  
  
• Pain that worsens when you move your leg.
  
  
• Skin bruising or blistering in the area of your leg injury.
  
  
• Swelling of your injured leg.
  
  
• Tenderness (pain when touched) over the injured area.
  
  
• Weakness or numbness (loss of feeling) in your leg.

How is a leg fracture diagnosed?

Your caregiver will check the skin over your injured leg for any open breaks in the skin. He may touch areas of your leg to see if you have decreased feeling. He also may check for any problems with your leg movements. You may need any of the following:

• X-ray: An x-ray is a picture done to check your leg for broken bones.
  
  
• Bone scan: This is a test done to look at your leg bones. You are given a small, safe amount of radioactive dye in an IV. An IV is a tube placed in your vein for giving medicine or liquids. Pictures are then taken of your leg bones to look for fractures.
  
  
• Computed tomography scan: This is also called a CT scan. A CT scan is an x-ray that uses computers to take pictures of your leg. Your caregiver may use this test to look for broken bones and other leg injuries. You may be given a dye before the pictures are taken to help caregivers see the pictures better. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to shellfish or have other allergies.
  
  
• Magnetic resonance imaging scan: This test is also called an MRI. During an MRI, magnetic waves are used to take pictures of the bones, and other tissues in your leg. You will need to lie still during an MRI. Never enter the MRI room with any metal objects. This can cause serious injury.

How is a leg fracture treated?

Treatment depends on what kind of fracture you have, and how bad it is. You may need any of the following:

• Brace, cast, or splint: A brace, cast, or splint may be put on your leg to decrease your leg movement. Braces, casts, and splints work to hold the broken bones in place. These devices may help decrease pain, and prevent further damage to your broken bones.
  
  
• Medicine: Medicines may be given to help decrease or take away your pain. You may need antibiotic medicine to prevent or treat an infection by germs called bacteria. Blood thinners also may be given to decrease your risk for blood clots.
  
  
• Physical therapy: Your caregiver may have you to go to physical therapy. A physical therapist will help you with exercises to improve the movement of your leg. The exercises can also help make your leg bones and muscles stronger.
  
  
• Surgery: If you have an open fracture, you may need debridement before your surgery. Debridement is when your caregiver removes damaged and infected tissue, and cleans your wound. Debridement is done to help prevent infection and improve healing. Surgery to fix your broken leg may include the following:
  
  
  • External fixation: During external fixation, screws may be put through your skin and into your broken bones. The screws will be secured to a device outside of your leg. External fixation will allow your bones to be held together so they can heal. External fixation is often done if you have severe (very bad) tissue damage, or you have many injuries. You may still need open surgery on your leg to fix injured areas after the external fixation is removed.
    
    
  • Open reduction and internal fixation: During internal fixation surgery, your caregiver will make an incision (cut) in your leg to straighten your broken bones. He will use screws and a metal plate, nails, wires, or rods to hold your broken bones together. This surgery will allow your broken bones to grow back together.
  
  
• Traction: You may need traction when your broken bones are displaced. Traction pulls on the bones to put them back into place. A pin may be put in your bone or cast and hooked to the traction device. Weights are hung from the traction device to help pull the bones into the right position.
  
  
• Electrical stimulation: During electrical stimulation, electric currents are placed on your injured leg. The currents help increase the blood flow to your leg to help with healing. This treatment may be used along with other treatments for your leg fracture.
  
  
• Ultrasound therapy: Ultrasound treatments use sound waves directed into your leg. The sound waves work by helping the bones in your leg heal. You may need this treatment along with other treatments.
  
  
• Tetanus shot: You may need a tetanus shot if you have breaks in your skin from your injury. A tetanus shot is a shot of medicine to prevent you from getting tetanus. The shot is normally given into your arm. You should have a tetanus shot if you have not had one in the past 5 to 10 years. Your arm can get red, swollen, and sore after getting this shot.

What can I do to help my leg fracture heal?

• Rest: You may need to rest your leg and avoid activities that cause leg pain. Rest is most commonly used to treat a stress fracture.
  
  
• Elevation: You may use pillows to keep your leg at, or above the level of your heart. Elevation helps decrease swelling and pain, and improves blood flow.
  
  
• Ice: Ice causes blood vessels to constrict (get small) which helps decrease swelling, pain, and redness. Put crushed ice in a plastic bag and wrap it with a towel. Place the ice bag on your leg for 15 to 20 minutes every hour as long as needed. Use the ice for as long as your caregiver says you should. Do not fall asleep on the ice as it may cause frostbite.
  
  
• Diet: Poor nutrition can lead to poor healing of your leg fracture. Eat a variety of healthy foods from all the food groups every day. Include whole grain bread, cereal, rice, and pasta. Eat a variety of fruits and vegetables, including dark green and orange vegetables, and legumes (dry beans). Include dairy products such as low-fat milk, yogurt, and cheese. Choose protein sources such as lean meat and poultry (chicken), fish, beans, eggs, and nuts.
  
  
• Keep normal blood sugar levels: People with diabetes may have poor wound healing. Keeping your blood sugar levels normal may improve your healing. Ask your caregiver what your blood sugar level should be.
  
  
• Quit smoking: Smoking can make it harder for your leg fracture to heal. Smoking also harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.

What are the risks of having a leg fracture?

• If you need a brace, cast, or splint, you may get skin sores. Full leg casts can lead to knee stiffness. Even with a cast or surgery, the bones in your leg may not heal right. During surgery, the nerves, blood vessels, and tissues in your leg may be damaged. You may get an infection, and have leg pain after surgery. You may have numbness or weakness in your leg. Decreased movement from traction may lead to skin sores or a lung infection.
  
  
• Having a leg fracture increases your risk of getting a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• Without treatment, the bones in your leg may not heal properly. If your fracture heals on its own, your leg may be deformed. You may not be able to move your leg as well as you did before your injury. You may have pain, and you may lose feeling in your leg. You may have tissue damage, and get a severe leg infection. Severe infections may lead to a bone infection, and you may need your leg amputated (removed). Severe infections and other problems may even lead to death.

Where can I find more information?

Contact the following:

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont , IL 60018-4262
  Phone: 1- 847 - 823-7186
  Web Address: http://www.aaos.org/
  

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

When should I call my caregiver?

Call your caregiver if:

• You have a fever.
  
  
• You have leg pain at rest.
  
  
• You have chest pain or trouble breathing that is getting worse over time.
  
  
• You have questions or concerns about your injury, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911:

• The skin or toes of your injured leg become swollen, cold, or turn blue.
  
  
• The pain in your injured leg gets worse.
  
  
• You have no feeling in your leg below your injury.
  
  
• You have bleeding from a leg wound that will not stop.
  
  
• You suddenly feel lightheaded and have trouble breathing.
  
  
• You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
  
  
• Your leg feels warm, tender, and painful. It may look swollen and red.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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