There are three main bones in the leg. The femur is the long bone in the thigh that connects the hip to the knee; it is also the longest and strongest bone in your body. There are two bones in your lower leg, below the knee: the tibia (lower leg bone) and a smaller and thinner bone called the fibula. A leg fracture or broken leg occurs when one or more bones break or crack.
Leg fractures usually occur as a result of falls, car accidents and sports injuries. As you age, your bones can become weaker, leading to bone fractures. Treatment for a broken leg depends on which bone is broken and how severe the fracture is. You may need surgery, but sometimes a cast or brace is enough to help you recover.
There are several types of bone fractures, which differ depending on the force that causes the fracture. They include:
- Transverse fracture: The fracture goes straight across the leg.
- Oblique fracture: The fracture cuts diagonally across the bone.
- Spiral fracture: The fracture wraps around the bone like a spiral staircase.
- Moderate fracture: The bone breaks into three or more pieces.
- Open fracture: A broken bone protrudes through the skin.
If the ends of the broken bone have moved out of place, it is further classified as a displaced fracture. In a nondisplaced fracture, the broken pieces of bone are still aligned properly.
When you break your leg, you’ll know right away that something is wrong. Symptoms can vary depending on where the break is, but here are some common signs to look out for:
- Severe pain: A broken leg is usually painful, especially when you try to move it or put weight on it.
- Swelling and bruising: The area around the fracture may be swollen or appear bruised (discolored).
- Movement difficulties: You will usually not be able to put on weight or walk. You may also have trouble bending your knees or ankles.
- deformity: Your leg may appear crooked, bent at an odd angle, or shorter than the other leg.
- Numbness or tingling: You may lose feeling in your foot.
If you have an open fracture, where the bone has broken through the skin, go to the emergency room right away. Open fractures have a higher risk of infection because bacteria can enter the wound. It is best to have your symptoms evaluated by a healthcare professional, even if you are unsure of the severity of your injury.
Most broken legs are caused by a blow or a direct blow to the area, such as:
- accidents: The impact of a car or motorcycle accident can cause a broken leg. This also applies to accidents in which you were involved as a pedestrian. For example, if you are hit by a moving vehicle while you are walking, the force can break your leg or other bones in your body.
- Downfalls: Falling from a high place, such as a ladder or roof, can break your leg when you land. In older people with weaker bones, tripping while walking can sometimes cause a fracture.
- Sports injuries: Sports, such as skiing, can lead to broken legs. Twisting movements or collisions with other players can put a lot of stress on the bones, causing fractures.
Risk factors
Although anyone can break a leg, some people are more likely to experience this injury. This means they have a risk factor for injury. However, not all people with risk factors will break their leg.
- Age and Gender: Young men between the ages of 15 and 35 are more likely to break their tibia. In women, the risk of fracture increases around the age of 60.
- Disease: Conditions such as osteoporosis or bone cancer can thin and weaken bones over time, making them brittle and easily broken. Many people don’t realize they have osteoporosis until they break a bone.
- High impact activities: Playing contact sports such as football or soccer or engaging in activities such as skiing or riding a motorcycle can increase the chances of breaking your leg from falls, crashes or high-force impacts.
- Lack of calcium or vitamin D: Calcium and vitamin D are important for strong bones. Without enough of these nutrients, your bones can break more easily.
To diagnose a broken leg, a healthcare professional will generally ask about how the injury happened and your medical history. They will then examine your leg. During the exam you can:
- Check skin temperature and pulse to look for damage to blood vessels
- Test for sensation near the injured area to see if there is any nerve damage
- Examine the joints above and below the injury, such as the hip, knee, and ankle
Although a broken leg may be obvious based on your symptoms and how the injury occurred, health care providers will generally also order an X-ray. This imaging test provides a clear picture of the bones in your leg and can help confirm if there is a fracture and what type.
A health care provider may also recommend a magnetic resonance imaging (MRI) or computed tomography (CT) scan. These tests can provide more detailed pictures of your bones and soft tissues.
The goal of treatment is to return the broken parts to their proper place and prevent them from moving so that the leg can heal properly. Treatment can vary if the fracture occurs at any end of the bone, especially near the hip, knee, or ankle. You may be given pain medication, either over the counter or with a prescription, to help manage the discomfort.
Below are common treatments for leg fractures in the middle part of the bones, also called the shaft.
Non-surgical treatment
If a healthcare professional thinks your tibia (lower leg bone) can heal without surgery, they may put a splint on your leg to immobilize it (keep it still). This provides support but leaves room for swelling. Swelling is common in the first few weeks after a fracture. Once the swelling goes down, you may be given a full cast or brace.
Healthcare professionals may also perform a non-surgical procedure called closed reduction, which pushes the ends of the bone back into their proper position. No incisions are made in the skin during this procedure.
Femur (femur) fractures usually require surgery. You may be fitted with a full leg splint to temporarily immobilize your broken femur before undergoing surgery.
Surgical treatment
Surgery is usually necessary for certain types of fractures, such as open fractures or when pieces of bone have moved out of place. Most femur fractures require surgery, usually within 24 to 48 hours. Possible operations include the following:
- Open reduction internal fixation (ORIF): An orthopedic surgeon makes an incision and uses metal pieces to stabilize the bones while they heal. ORIF can be performed using intramedullary nailing or plates and screws.
- Intramedullary nailing: The surgeon places a metal rod through the center of the bone to hold the broken pieces in place. Then the rod is attached with screws at both ends. The bone pieces are repositioned and held in place with metal plates and screws attached to the outer surface of the bone.
- External fixation: The surgeon places metal pins or screws into the bone above and below the fracture. The pins are then connected to the frame outside the leg. This keeps the bone properly aligned during healing.
Your surgeon will let you know when to put weight on the injured leg. You may need to use crutches or a walker for support.
physical therapy
The muscles around your broken leg may become weak and tight during healing. Your surgeon will likely recommend physical therapy (or physiotherapy) to help you regain strength and mobility.
A physical therapist (PT) will teach you the exercises. They will also show you how to properly use crutches or a walker while your leg heals.
Although accidents cannot always be prevented, you can take steps to reduce your chances of breaking your leg or other bones:
Get enough calcium and vitamin D
Eating foods rich in calcium and vitamin D can help keep your bones strong. Strong bones can help reduce the risk of breaking bones if you fall. Good sources include dairy products, leafy greens like kale, and fatty fish like sardines. You can also get vitamin D by spending limited time in the sun.
Exercise regularly
Regular exercise helps maintain strong bones and reduces the risk of fractures. Try to get about 30 minutes of moderate activity a day, such as brisk walking, and include muscle-strengthening exercises twice a week. Staying active can improve your balance and leg strength, preventing falls.
Create a safer home environment
Removing electrical cords and removing loose rugs can help eliminate tripping hazards. For added safety, install handrails on stairs and handrails in the bathroom.
Review your medications
Some medications can make you dizzy or drowsy, increasing the risk of falling and breaking a bone. Ask your doctor or pharmacist to review your medications to see if any may increase your risk.
Use protective equipment
Wear protective equipment if you are doing activities where falls are common. The same goes for sports with a risk of being hit or kicked in the legs, such as football, soccer or hockey. Protective gear can’t prevent all injuries, but it softens the blow, reducing your chances of a fracture.
A broken leg usually heals well with prompt and proper treatment. However, some complications can affect your recovery. Complications of a broken leg can include:
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- Stiffness and pain: As your leg heals, the muscles and joints around the fracture may become less flexible. This can sometimes lead to pain and limited movement in the knee or joint.
- Nerve or blood vessel injury: In some cases, a broken bone can damage a nearby nerve or blood vessel, causing numbness, tingling, or circulation problems.
- Post-traumatic arthritis: Breaking a bone in your leg can increase your risk of developing arthritis. Arthritis causes the cushioning cartilage in your joint to wear away, leading to pain and stiffness.
- Improper bone healing: If the parts of the broken bone are not properly aligned during the healing process, the bone may not heal properly. This can affect the mobility and appearance of the leg.
- Fat embolism: Broken bones can release fat from the bone marrow into the bloodstream. This fat can travel to the lungs and cause a blockage, or fat embolism, preventing the body from getting oxygen.
- Compartment syndrome: This condition develops when the pressure in the muscles rises to dangerous levels. The pressure can prevent blood flow and oxygen from reaching muscles and nerves, causing tissue death. Compartment syndrome is a medical emergency.
- infection: Open fractures have a higher risk of infection. Signs of infection include redness, swelling, increased pain, or a temperature over 100 degrees Fahrenheit (38 degrees Celsius). Long-term antibiotics may be needed.
If you experience any worrying symptoms or your recovery is not progressing as expected, contact your doctor.
A broken leg can happen from falls, car accidents or sports injuries. A fracture can be simple, where the bone is broken in two, or compound, where the bone is broken into multiple fragments.
Typical symptoms of a broken leg include intense pain, swelling, bruising, and difficulty moving the leg. Treatment may include a splint, cast, or surgery. If you suspect you have broken your leg, seek medical attention immediately.