Brief overview
- What to do if you have a broken leg? Immobilize, make an emergency call, cool (closed leg fracture) or cover with a sterile dressing (open leg fracture)
- Leg fracture – risks: including concomitant injuries to ligaments, nerves or vessels, severe blood loss, compartment syndrome, wound infection
- When to see a doctor? A broken leg should always be treated by a doctor to prevent complications and permanent damage.
Attention!
- Femur fractures are often caused by falling from a height, for example from scaffolding or a traffic accident at high speed.
- The ankle is stabilized by ligaments. These can tear if the ankle breaks.
- A leg fracture can heal particularly well if the metabolism works well and the fracture is treated professionally from start to finish. This means immobilization or surgery, followed by targeted exercise/rehab to maintain and rebuild the muscles.
Broken leg: How to recognize it?
Do you suspect you have broken your leg? These symptoms confirm the suspicion:
- The leg can only be moved to a limited extent or not at all.
- Swelling has formed in the area of injury.
- The injury area hurts (severely).
- The leg or parts of the leg are in an unnatural position.
- A crunching sound can be heard when moving the injured area.
Symptoms such as a relieving posture and an open wound with visible bone fragments are also possible. In the latter case, there is an open leg fracture – in contrast to a closed leg fracture, in which the skin over the fracture site is not injured.
In a leg fracture, at least one of the three long bones in the leg bursts:
- the shin bone (tibia) and/or
- the fibula in the lower leg and/or
- the thigh bone (femur).
Tibia and fibula
Tibia and fibula fractures are usually caused by a violent twist, for example in a snowboarding accident.
You can read more about the causes and treatment of these types of leg fracture in the article Fibula fracture and tibia fracture.
If the tibia bone breaks in the upper section, this is referred to as a tibial plateau fracture.
This is often caused by jumping from a great height. You can find out more about this type of leg fracture in the article Tibial plateau fracture.
However, the most common injury in the lower leg area is an ankle fracture – a fracture in the ankle joint area that usually occurs when the foot is twisted.
Femur
The femur is the largest bone in the human body. It therefore normally takes a lot of force for it to break (for example in a traffic accident). You can find everything you need to know about this type of broken leg in the article Femur fracture.
People with osteoporosis often break their thigh as a result of a relatively harmless fall or impact. The fracture line then usually runs between the “head” and the shaft of this long bone, i.e. at the neck of the bone. You can find out more about this so-called femoral neck fracture in the article Femoral neck fracture.
Broken leg: What to do?
If someone has broken their leg, first aiders should proceed as follows:
A broken leg is painful and injured people are very likely to be restless or even anxious. Therefore, reassure those affected and explain what you are doing. This builds trust. To protect yourself from infection, you should put on disposable gloves before you help – especially in the case of an open leg fracture. You should take these first aid measures if you have a broken leg:
- Reassure the patient: Especially with children, it can also be helpful to explain the next steps to them – this builds confidence.
- Put on disposable gloves: This is particularly advisable in the case of an open leg fracture to protect yourself from possible infection (blood contact!).
- Immobilize: Make sure that the affected person does not move or put weight on the broken leg if possible. You can also pad the injured leg with a rolled-up blanket, rolled-up items of clothing etc. to stabilize it.
- Cool closed leg fractures: Carefully place an ice pack or cool pack on the injured area of the leg to relieve pain and swelling – but not directly on the skin, with a layer of fabric in between (risk of frostbite!). If necessary, wet cloths will also do.
- Cover open leg fractures: Cover open wounds with a sterile wound dressing.
- Proceed with caution: Pay attention to the injured person’s expressions of pain in everything you do.
Never try to “set” the fracture and do not move the injured leg!
Broken leg: Risks
A broken leg can be accompanied by serious injuries and various complications. Without treatment, they can sometimes be dangerous or lead to permanent restrictions.
Possible concomitant injuries and complications of a broken leg include
- Skin and soft tissue damage (especially in the case of an open leg fracture)
- Ligament injuries: Especially if a joint or a bone close to a joint breaks, surrounding ligaments are usually also affected.
- Blood loss: If a bone in the leg breaks, blood vessels can also rupture. A so-called fracture hematoma then forms. If the injured person loses a lot of blood, they can go into shock.
- Vascular and nerve injuries
- Pseudarthrosis: No new bone tissue forms between the bone fragments to bridge them, but the fragments remain connected in a mobile manner. This “false joint” can be painful and restrict mobility. The femur is particularly susceptible to pseudoarthrosis.
Broken leg: When to see a doctor?
If the broken leg is treated by a specialist at an early stage, this improves the chances of recovery and prognosis. Complications and permanent consequences (such as permanent restriction of movement) can usually be avoided. You should therefore always have a broken leg examined and treated by a doctor as soon as possible.
Broken leg: Examination by a doctor
The medical expert for a broken leg is a specialist in orthopaedics and trauma surgery. He or she will first ask you or the injured person questions to get a precise picture of how the accident happened, the symptoms and any previous and underlying illnesses (medical history). Doctors ask questions such as:
- How did the accident happen?
- Where exactly do you have pain?
- How would you describe the pain (stabbing, dull, etc.)?
- Do you have any other complaints (e.g. numbness, tingling)?
- Have you ever had a hernia before?
- Are you aware of any pre-existing/underlying conditions (e.g. osteoporosis)?
The doctor can use imaging procedures to confirm the suspicion of a broken leg and determine the type of fracture more precisely. An X-ray examination (in two planes – from the front and from the side) is usually carried out. If even more precise clarification is required, a computer tomography (CT) or magnetic resonance imaging (MRI), which also shows soft tissue defects, may be considered. These more complex procedures may also be necessary in preparation for surgical treatment of the leg fracture.
Broken leg: Treatment by the doctor
How the doctor treats the leg fracture depends on which bone is broken. It is important to know exactly where the fracture is located and whether it is a simple or complicated fracture. A compound fracture is present, for example, if the bone has splintered into many small pieces. Any accompanying injuries also play a role in the choice of treatment.
In general, the aim of treatment is to restore the fractured bone to a functional state as quickly as possible. This can be achieved through conservative therapy or surgery.
You can read more about the treatment of bone fractures in the article Fracture: Treatment.
Follow-up treatment of a leg fracture
Once the two bone ends have grown back together stably, this does not mean that the recovery process is complete. Only professional rehabilitation will heal the fracture completely. In such an individually designed rehabilitation program, patients train the mobility of the joints with particularly gentle exercises and also rebuild the previously weakened muscles in a targeted manner. Depending on the patient’s needs, rehabilitation can be carried out on an outpatient or inpatient basis.
Broken leg: Progression and prognosis
With the right treatment, a broken leg usually heals well and without consequences. However, this is not always the case with open comminuted fractures or additional vascular injuries. If the wound area becomes infected, blood poisoning (sepsis) can even develop, which in particularly serious but rare cases can lead to amputation of the affected leg.
