Broken leg (leg fracture)

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

A broken leg (leg fracture) can injure various bones - thighbone, tibia and / or fibula. A broken leg is painful and always a case for the doctor! But laypeople can also help the injured person immediately after the accident. Read here how you can tell if a leg is broken, how to properly provide first aid and what the doctor can do.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. S82S72

Brief overview

What to do if you have a broken leg Immobilize, make an emergency call, cool (closed leg) or cover with sterile (open leg)
Broken leg risks: i.a. Concomitant injuries to ligaments, nerves or vessels, severe blood loss, compartment syndrome, wound infection
When to the doctor A broken leg should always receive medical attention to prevent complications and permanent damage.

Caution!

Thigh fractures are often caused by falls from a great height, for example in a traffic accident at high speed or a fall from scaffolding.
The ankle is stabilized by ligaments. These can tear if the ankle breaks.
A broken leg can heal particularly well if the metabolism works well and the break is properly cared for from start to finish. That means: resting or surgery as well as targeted exercise / rehab in order to maintain and rebuild the muscles.

Broken leg: how to tell

Do you suspect a broken leg? These symptoms substantiate the suspicion:

The leg can only be moved to a limited extent or not at all.
A swelling has formed in the injury area.
The injury area is painful (severe).
The leg or parts of the leg are in an unnatural position.
A crunch can be heard when moving the injured area.

The first three points (restricted mobility, swelling, pain) are called unsafe fracture signs by medical professionals. They can have various causes, so they are not necessarily a sign of a broken leg. Symptoms 4 and 5, on the other hand, are considered reliable signs of fracture: an unnatural position of the leg and a crunch when moving are unmistakable indications that the leg is broken.

Symptoms such as 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, when the skin over the fracture site is not injured.

When a leg breaks, at least one of the three long bones in the leg bursts: the shinbone (tibia) and / or fibula in the lower leg and / or the thighbone (femur).

Tibia and fibula

Tibia and fibula fractures usually result from violent rotation, for example in a snowboard accident.

You can read more about the causes and treatment of these types of broken legs in the article Fractured fibula and broken tibia.

If the tibial bone breaks in the upper section, one speaks of a tibial head fracture.

This is often caused by jumps from great heights. You can find out more about this form of leg fracture in the article Tibial head fracture.

The most common injury in the area of the lower leg, however, is the ankle fracture - a break in the area of the ankle that usually happens when the foot is twisted.

thigh

The thigh bone is the largest bone in the human body. So it normally takes very great forces 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 femoral fracture post.

With a fractured thigh, those affected cannot stand or walk. In addition, they may lose a lot of blood, so their blood pressure drops sharply and they can go into shock.

People with osteoporosis often break their thighs with a comparatively harmless fall or impact. The fracture line then usually runs between the "head" and the shaft of this long bone, i.e. on 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, the first aider should do the following:

A broken leg is painful and the injured person is very likely to be restless or anxious. So calm him down and explain what you are doing. That creates trust. To protect yourself against infections, you should put on disposable gloves before treating the injured person, especially if you have an open leg. These are the first aid measures you should take 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 creates trust.
Put on disposable gloves: This is particularly advisable if you have an open leg to protect yourself from possible infections (blood contact!).
Resting: Make sure that the person concerned does not move the broken leg and does not put any weight on it. You can also pad the injured leg with a rolled up blanket, rolled up pieces of clothing, etc. to stabilize it.
Call an ambulance: Alert the ambulance and ask another first responder to do this.
Cooling closed broken legs: Carefully place an ice pack or cool pack on the injured area of the leg to prevent the pain and swelling - but not directly on the skin, but with a layer of fabric in between (risk of frostbite!). If necessary, wet cloths will do the same.
Cover open fractures of the leg: Cover open wounds with a sterile pad.
Proceed cautiously: In everything you do, pay attention to expressions of pain from the injured person.

Under no circumstances should you try to fix the fracture or move the injured leg!

Broken leg: risks

A broken leg can be associated with serious accompanying injuries and lead to various complications. Without treatment, they can sometimes become dangerous or lead to permanent restrictions.

Possible accompanying injuries and complications with a broken leg include:

Skin and soft tissue damage (especially with an open leg fracture)
Ligament injuries: Especially when a joint or a bone near the joint breaks, the surrounding ligaments are usually also affected.
Blood loss: If a bone in the leg breaks, blood vessels can also tear. A so-called fracture hematoma then forms. If the injured person loses a lot of blood, they can go into shock.
Compartment syndrome: Due to bruises and swelling, the pressure increases in a muscle box (= group of muscles that are surrounded by a barely stretchable connective tissue sheath called fascia). If left untreated, muscle tissue can die.
Vascular and nerve injuries
Pseudoarthrosis: No new bone tissue is formed between the bone fragments to bridge the gap, but the fragments remain flexibly connected. This “wrong joint” can be painful and restrict mobility. Particularly prone to pseudoarthrosis is inter alia. the thigh bone.

Broken leg: when to see a doctor?

If the broken leg is treated competently at an early stage, this improves the chances of recovery and the prognosis. Complications and lasting consequences (such as permanent restriction of movement) can usually be avoided in this way. Therefore, you should always have a broken leg examined and treated by a doctor as quickly as possible.

Broken leg: checkups at the doctor

The medical expert for a broken leg is a specialist in orthopedics and trauma surgery. First he will ask you or the injured person to get an idea of how the accident happened, the symptoms and any pre-existing and underlying illnesses (anamnesis). For example, he might ask:

How did the accident come about?
Where exactly are you in pain?
How would you describe the pain (stabbing, dull, etc.)?
Do you have any other complaints (e.g. numbness, tingling sensations)?
Have you ever had a break before?
Are there any known pre-existing / underlying diseases (e.g. osteoporosis)?

This patient interview is followed by a physical examination. Among other things, the doctor examines the injured leg, looks for swellings and misalignments and carefully feels the injured area. He also checks whether the leg can move normally and whether a grinding noise can be heard.

With imaging tests, the doctor can confirm the suspicion of a broken leg and determine the type of break more precisely. An X-ray examination is usually carried out. If more detailed clarification is necessary, computed tomography (CT) or magnetic resonance tomography (MRI, magnetic resonance imaging) may be considered. These memorized procedures can also be necessary in preparation for the surgical treatment of the broken leg.

Broken leg: treatment by the doctor

How the doctor treats the broken leg depends on which bone is broken, where, and whether it is a simple or complicated fracture (bone splinters into many small debris). Any accompanying injuries also play a role in the choice of therapy.

In general, the goal of treatment for a broken leg is to get the broken bone back in working order as quickly as possible. This can be done through conservative therapy or surgery.

In conservative treatment, the doctor anatomically aligns the bone and then immobilizes it with a plaster of paris or a splint. During an operation, the doctor surgically returns the bone ends to the correct position and fixes them, usually with metal pins or plates.

You can read more about fracture therapy in the article Fracture: Treatment.

Follow-up treatment for a broken leg

The recovery process for a broken leg does not stop when the ends of the bones have grown back together. Professional rehab after a broken leg can make a significant contribution to healing. It trains the mobility of the joints and helps the injured to rebuild the muscles that he lost through the immobilization. Rehabilitation is possible on an outpatient or inpatient basis.

Broken leg: course and prognosis

With the right therapy, a broken leg usually heals well and without consequences. However, this is not always the case with open debris or additional vascular injuries. If the wound area becomes infected, blood poisoning (sepsis) can develop, which may require amputation.

Broken leg: healing time

The healing time is different for a broken leg. The location and type of the fracture have an influence, among other things. For example, a thigh fracture that takes around ten to 14 weeks to heal requires a lot of patience. In addition, the healing process often proceeds more slowly with increasing age than in younger years: On average, a broken leg in children heals within three to four weeks. On the other hand, if an adult breaks a leg, recovery can take three to four months. It may take longer for older people.

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