A broken leg is a fracture of one or more bones of the leg: the femur, the fibula or the tibia. The femur—the longest and hardest bone of the body—is also known as the thigh bone. The fibula and tibia are the two bones of the lower leg, below the kneecap.

Fractures to any bone in the leg are medical emergencies. They are usually extremely painful, and weight bearing may be difficult or impossible. People who suspect they have fractured their femur, tibia or fibula should seek medical attention immediately.

Note that not all femur fractures are the same. If the fracture occurs in the upper third of the femur or the femoral head (a protruding ball that inserts into the socket of the hip), the injury is technically considered a hip fracture.

Symptoms

Some symptoms of a broken leg bone may vary depending on the type, location and severity of the fracture, but pain—which can be severe—and difficulty or inability to put weight on the injured leg are common symptoms present in almost all leg fractures. Other symptoms can include:

• An obvious deformity
• Bruising
• Swelling
• Tenderness

Causes

There are many potential causes of broken bones in the leg. In general, tibia and fibula fractures are more common than femur fractures. The femur, in addition to being the longest bone in the body, is also the strongest by most measurements. Therefore the femur usually fractures only in high-energy trauma events such as car accidents, as opposed to more low-energy events such as falls from standing height, unless there is some mitigating circumstance.

Common causes of leg fractures include:

• Car accidents
• Falls
• Sports injuries

Osteoporosis, although not a cause of fractures, greatly increases the risk of occurrence, even femur fractures. Osteoporosis is largely an age-related condition that causes gradual bone density loss. People with osteoporosis have weaker-than-normal bones, so that even a lower-energy trauma can cause a fracture. People at risk for osteoporosis should have a DXA scan to check their bone density.

Diagnosis

Diagnosing a fracture to one of the leg bones usually begins with a physical examination and medical history of the patient. In the medical history, doctors will want to hear about any recent injuries that might have caused a fracture, as well as any evidence of osteoporosis.

During a physical exam, the doctor may be able to diagnose a fracture to the femur, tibia or fibula by sight alone, if there is an obvious deformity. The doctor may also gently manipulate the leg or ask the patient to stand or walk to see if he or she has signs of pain or other symptoms.

An X-ray is the most helpful imaging study to diagnose fractures. The calcium in bones absorbs X-rays very well, making bones very clear on X-rays. Fractures are usually clearly apparent when examining an X-ray.

If X-rays prove inconclusive, the doctor may then order a computed tomography (CT) scan. CT scans are a series of X-rays taken in rapid succession from multiple angles. The result is a more complete look at a bone, including a cross-section.

Treatment

Treatment of a broken leg will vary depending upon what bone or bones are fractured, the severity of the fracture or fractures and their location. Initial treatment is usually done in an emergency room or trauma center. The fractured bone must be lined up (reduced) and set in place, then immobilized so that it can heal properly.

Setting the bone may simply require immobilization with a cast, but many times a fracture requires surgery. Surgery takes the form of either internal or external fixation. Internal fixation uses hardware such as plates, screws or pins to hold the broken ends of the bone together. External fixation is similar, but the hardware is attached to a metal frame on the outside of the skin.

Most patients need some form of immobilization, such as a cast, on their broken leg. Keeping the bone immobile allows the two ends to knit back together correctly. If the bone is not immobilized, it may heal incorrectly.

A cast or boot, along with crutches or a cane, will be necessary for about six to eight weeks. Once the cast is removed, physical therapy is usually needed to restore strength in the leg muscles and range of motion of the joints in the leg.

If you have experienced a fracture of the femur, tibia or fibula, request an appointment with University Orthopaedic Associates right away. Our trauma and fracture experts will be able to reduce and set your fracture and get you started on the road to recovery. We have both imaging and physical therapy available on-site.