Prognosis
The prognosis after a lower leg fracture is generally relatively good. However, depending on the severity, it can take a relatively long time before the leg can be fully loaded again. Especially open lower leg fractures usually heal much worse than closed fractures.
Care should always be taken to avoid infections, especially in the case of open fractures. If intramedullary nails were used as a treatment method, an infection is particularly feared and should be treated as soon as possible. The most common complications after surgery for a lower leg fracture are permanent malpositioning and joint instability. Even after objectively optimal surgery, such damage cannot be excluded. Especially in the case of complicated fractures, several operations may be necessary before a satisfactory result can be achieved.
Healing, healing time, healing duration
The duration of the treatment of a lower leg fracture depends on the type of fracture and how the fracture is treated therapeutically. Usually, the bone healing time for adults is six weeks. It takes between two and twelve weeks on average until the leg can be fully loaded again.
If the lower leg fracture is treated surgically using screws and plates, the materials can be removed again after one year at the earliest, but usually after about 18 months. This is again carried out as part of a minor surgical procedure, so that a further stay in hospital is necessary. Once the lower leg fracture has healed and can be loaded again, physiotherapy should follow, regardless of whether the lower leg fracture was healed conservatively or surgically.
Physiotherapy serves to strengthen the weakened muscles of the lower leg and to restore mobility. If the fracture of the lower leg has been treated surgically, physiotherapy can take place shortly after the fracture has been stabilised. Initially, the leg is then partially loaded with approximately 20 kg.
If a plaster cast has been applied, physiotherapy can only take place after the cast has been removed. The rehabilitation (Reha) is an important part of the aftercare of a lower leg fracture operation. Adequately performed, it can significantly shorten the overall treatment time and help to restore the patient to the same level of health as before the fracture as quickly as possible.
It is also essential for maintaining the success of the therapy: Once successes have been achieved – e.g. freedom from pain or resumption of sporting activities – they are not always permanent per se. Only a consistent and long-term continuation of the exercise of the affected leg keeps the risk of relapses or permanent loss of movement or strength low.In a broader sense, rehabilitation of a lower leg fracture begins on the first day after surgery. The physiotherapists and, if necessary, occupational therapists working in the hospital can, for example, use lymph drainage to accelerate the drainage of lymph fluid from the operating area, while the nursing staff and surgeons are responsible for treating the surgical scars.
Both the quickest possible reduction of swelling and the complication-free healing of the wounds are important first steps in the rehabilitation of a lower leg fracture. Afterwards, the hospital may already be able to apply for inpatient or outpatient rehabilitation. In this rehab in the narrower sense, the focus is first of all further on the promotion of the leg’s decongestants and on the monitoring of wound healing.
Depending on the type of lower leg fracture, light weight training for the affected leg can be started after 1-3 weeks – but always without any load on the leg! The appropriate exercises are taught to the patient by the physiotherapist present. The time at which crutches can be used to exert the first partial load on the leg varies between 2 weeks and up to 3 months, depending on the type of lower leg fracture. During the steady increase in the load on the leg, the physiotherapist should focus on adequate gait training to prevent the creeping in of malpositions.
