What is a Leg Fracture?
A Leg fracture is a term for a fracture or break to the femur bone (Thigh bone). The femur is the long thigh bone that interconnects the knee and pelvis. The main portion of the bone is a long straight shaft which at the bottom is shaped into two smooth condyles that form the top of the knee joint. The top of the femur is shaped into a thin neck (femoral neck) at the end of which is a smooth ball (femoral head) that fits perfectly into the Hip socket on the pelvis. Fractures that occur below the femoral head and neck are classed as leg fracture and this includes a femoral shaft fracture and a supracondylar fracture (the upper end of the knee joint). Any fractures above the femoral neck are classed as hip fractures.
Why & when a Leg Fracture happens?
Leg fractures are most common in the younger population and are normally the result of high impact trauma like car or motorcycle accidents including a pedestrian being hit by a car and severe falls. This is very unlike the hip joint where most fractures are caused by underlying bone weakening and occur mostly in the elderly. However any bone weakening conditions like osteoporosis, metabolic diseases or cancer do increase the likelihood of leg fractures. In these circumstances even minor injuries like mild falls, side impacts or landing awkwardly on one leg can result in a leg fracture. Due to the fact that most leg fractures occur after trauma there is quite often multiple fractures and associated injuries to other areas of the body.
What to do if a Leg Fracture is suspected after trauma
If you suspect someone has sustained a leg fracture after any type of trauma then you must immediately call for medical help. As mentioned previously most people injured high impact accidents may have sustained other injuries as well as a leg fracture making medical attention vital. It is important to make sure the individual is safe and comfortable without having to move the individual as any walking or weight bearing will be very painful. On arrival paramedics will stabilise the leg, normally on a stretcher before taking the patient to accident and emergency.
What does a Leg Fracture feels like
A leg fracture from trauma causes a very intense immediate sharp pain around the fracture site this pain can radiate up into the groin and down into the knee. In some instances pain is only felt radiating down to the knee with no pain on hip movements. The fracture is often accompanied by swelling and bruising and aggravated by most movements this makes weight bearing and walking excruciating. Some people find having their leg outstretched supported with their knee and foot turned out is the most comfortable position to stay in. In cases where the there is a complete break the fractured leg may appear to be slightly shorter than the other. The intense pain after a break will last for several hours which will be aggravated or prolonged by any treatment options like manipulation or traction. Post-surgery or treatment when the bone starts to heal there will be a dull continuous ache from the swelling and healing process that will last weeks to months. During the healing process the bone is trying to knit together and re-unite this stage can be quite painful and it is very important to rest through this stage to ensure that the bone reconnects properly. The soft tissue surrounding the fracture also starts to form scar tissue to bind everything together allowing the structure to try and restore its original state and function.
How will a Leg Fracture be diagnosed?
Patients will be taken to A&E and a full examination will be done to rule out any additional injuries. Your doctor will order an X-ray of the leg to confirm the diagnosis and identify the location and the extent of the fracture. Occasionally if the extent of the fracture isn’t fully visible on an X-ray then an MRI or a CT scan will be orderedas this will give a more detailed view of the fractured site. Doctors will also use an MRI scan to assess whether the pain felt after trauma is coming from injury to the leg muscles, ligaments or joint capsule and not indeed from a fracture. The occurrence of a leg fracture from mild trauma may prompt doctors to investigate for any underlying bone weakening conditions.
What treatment options are available for a Leg Fracture?
The treatment options and healing times for leg fractures varies depending on the position and severity of the fracture and also on the complications from any additional injuries. In most cases of leg fractures do not need surgery however it is occasionally necessary to surgically stabilise multiple fractures or complete breaks. Traction or manipulation may be used to correct the position of the fractured bone and a splint or a cast will be used to reinforce and stabilise the fracture until it is well healed. Patients will initially have to rest and avoid weight bearing and will be required to use Crutches whilst recovering. The doctor will most likely prescribe anti-inflammatory medication and painkillers for pain relief and to reduce any swelling. A Leg fracture can take anything from 8 -12 weeks to heal if not longer for more severe breaks. Patients will be referred through to a physiotherapist who will provide exercises to strengthen leg and hip muscles to aid the healing process. It is vital that during the healing process the patient still tries to move a lot to reduce the risk of a DVT. Fluctuating pain levels will be experienced throughout the healing process however most of the discomfort towards the end of the healing process comes from stiffness levels caused by long term immobility. The rehabilitation exercises as well as massage and some manipulative therapies can aid in recovering your hip, knee and low back flexibility.