Patient education: Lower leg fracture (The Basics)

What is a lower leg fracture? — A "fracture" is another word for a broken bone. The bones in the lower leg are the tibia (shinbone) and fibula (figure 1). They are part of the knee and ankle joints.

There are different types of fractures, depending on which bone breaks and how it breaks. When a bone breaks, it might crack, break all of the way through, or shatter.

If a broken bone sticks out of the skin or can be seen through a wound, doctors call it an "open" fracture. If the bone does not stick out of the skin or cannot be seen through a wound, doctors call it a "closed" fracture.

A lower leg fracture can happen because of:

●A sports injury or other accident

●Twisting the foot or ankle

●Falling or jumping from a height

●A direct blow to the lower leg

A "stress fracture" is a type of fracture caused by repeated strain on a bone over time. Stress fractures in the lower leg bones can happen in people who do the same type of activity over and over. Examples include running, walking, jumping, or any sport or activity that involves these actions.

What are the symptoms of a lower leg fracture? — Symptoms depend on which bone breaks and the type of break it is. Common symptoms can include:

●Pain, swelling, or bruising over the area

●The area looking abnormal, bent, or not the usual shape

●Limping or being unable to put weight on the leg

●Numbness in the area of the broken bone

If a fracture injures a nerve, this can also cause symptoms in nearby areas. For example, a break to the shinbone might cause pain, tingling, or weakness in the ankle or foot.

Is there a test for a lower leg fracture? — Yes. The doctor or nurse will ask about your symptoms, do an exam, and take an X-ray.

They might also do other imaging tests, such as a CT, MRI, or ultrasound. Imaging tests create pictures of the inside of the body.

How are lower leg fractures treated? — Treatment depends on the type of fracture you have and how serious it is. The goal is to have the ends of the broken bone line up with each other so the bone can heal.

If the ends of the broken bone are already in line with each other, the doctor will put on a cast, splint, or brace. This will keep the bone in the correct position so it can heal.

If the ends of the broken bone are not in line with each other, the doctor will need to line them up:

●Sometimes, they can move the bone to the correct position without doing surgery, and then put a cast, splint, or brace on. This is called "closed fracture reduction."

●For more serious fractures, they might need to do surgery to put the bone back in the correct position. This is called "open fracture reduction." During surgery, the doctor puts the bones back in position. To do this, they can:

•Use screws, pins, rods, or plates to fix the bones inside the body

•Put pins or screws through the skin and into the bones, and then attach the pins or screws to a bar that is outside of the skin

If any of the broken bones are near the knee, the doctor might limit how much the knee can bend or straighten. For stress fractures, the doctor might recommend limiting activities that are causing pain for a time.

What other problems can happen? — Sometimes, within a short period of time following injury, a lower leg fracture leads to an abnormal buildup of pressure in a group of muscles in the leg. This is called "acute compartment syndrome." The main symptom is pain that suddenly gets much worse. Although this is uncommon, it is an emergency and needs to be treated as soon as possible with surgery.

Call your doctor or nurse right away if you have a lower leg fracture and your pain suddenly gets worse.

How long do lower leg fractures take to heal? — Most lower leg fractures take weeks to months to heal. The doctor or nurse will talk to you about when to return to things like work, sports, or other activities.

Healing time also depends on the person. Healthy children usually heal much more quickly than older adults or adults with other medical problems.

How do I care for myself at home? — To care for yourself or your child at home:

●Follow the doctor's instructions for wearing the splint, brace, or cast. This supports and protects the bone as it heals. Some fractures are placed in a cast right away. Other fractures are not put in a cast until after the swelling goes down.

●Do not get a cast wet unless the doctor says that it is waterproof.

●Follow instructions about putting weight on the leg. Some people are not allowed to put any weight on the leg. Others are allowed to put a little weight on the leg. Often, people will use crutches or a walker to help them move around.

●Follow instructions for limiting activity and movement until the bone is healed. The doctor or nurse will tell you what activities are safe to do.

●Prop the injured leg on pillows, keeping it above the level of the heart. This might help lessen pain and swelling.

●The doctor might recommend an over-the-counter pain medicine. These include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve).

●Some people get a prescription for stronger pain medicines to take for a short time. Follow the instructions for taking these medicines.

●Ice can help with pain and swelling:

•Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and the skin.

•Use the ice (or other cold object) for at least 6 hours after the injury. Some people find it helpful to ice longer, even up to 2 days after their injury.

●Eat a healthy diet that includes plenty of calcium, vitamin D, and protein (figure 2).

●If you smoke, try to quit. Broken bones take longer to heal if you smoke.

●Some people need to work with a physical therapist (exercise expert) after their fracture heals. The physical therapist will suggest exercises and stretches to strengthen your leg muscles and keep them from getting stiff.

When should I call the doctor? — Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You feel short of breath or have trouble breathing.

●You have sharp or severe chest pain.

●You are coughing up blood.

●You have severe pain in the leg that suddenly gets worse soon after injury

Call the doctor or nurse for advice if:

●You have less feeling or movement in your toes.

●Your leg or foot becomes swollen or starts to hurt more.

●The skin becomes red or irritated around the cast, or redness starts to spread up your leg.

●The splint or cast feels too tight and uncomfortable, or your toes turn pale, blue, or gray.

●You have a fever of 100.4°F (38°C) or higher, or chills.

●There is a bad smell or drainage coming from the splint, cast, or the wounds on your leg.

●The cast feels too loose, you notice a crack in the cast, or the cast becomes soft.

●The cast gets wet, and it is not supposed to get wet.

More on this topic

Patient education: Fractures (The Basics)
Patient education: How to care for your cast (The Basics)
Patient education: How to care for your child's cast (The Basics)
Patient education: How to use crutches (The Basics)
Patient education: Calcium and vitamin D for bone health (The Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (The Basics)
Patient education: Giving your child over-the-counter medicines (The Basics)
Patient education: Quitting smoking (The Basics)
Patient education: Acute compartment syndrome (The Basics)

Patient education: Quitting smoking (Beyond the Basics)
Patient education: Calcium and vitamin D for bone health (Beyond the Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (Beyond the Basics)