Broken leg: lower leg and upper leg

A broken leg often occurs after a fall, playing a sport, a blow to the leg or as a result of stepping. But osteoporosis also plays a role in bone fractures. The upper leg can be broken (femur) but also the lower leg (fibula or tibia). Treatment can vary and recovery takes an average of six weeks.

Broken bone in the leg

Bones can break, including the leg. A bone fracture often occurs as a result of a fall, an accident or incorrect loading of the leg. Certain sports are extra sensitive to broken legs: horse riding, winter sports and contact sports (for example a hockey stick against the leg). The fracture can occur in the lower leg or the upper leg and, if unlucky, even in both parts. The lower leg contains the tibia and the fibula, the upper leg consists of one long bone: the femur. The knee can also be broken. A broken ankle or foot is not one of the leg fractures but is described separately.

Broken femur

When the femur is broken, the bone fracture is present on the upper leg. The femur can break in several places. The fracture can be located at the top of the femur, at the bottom, in the middle, the shaft, the neck of the bone, etc. The fracture can be in one place, but multiple fractures can also occur. In addition, the damage may consist of a crack or be completely broken. The femur is a sturdy bone. It will take a lot of force to break it. Certain diseases such as osteoporosis/osteoporosis can make the bone more brittle, making it easier to break. A fracture of the femur is usually the result of a fall on the thigh or a hard blow to the thigh. Sports or a balance disorder are risk factors.
A broken femur hurts and it is difficult to put weight on the leg. Loss of strength may also occur. Sometimes a piece of bone protrudes from under the skin or the leg is twisted or deformed. The pain can radiate strongly to the groin, especially when the fracture is in the upper part. If there is a fracture in the lower part, the knee may also feel painful. The skin may be swollen and there is often a bruise: a blue-purple discoloration of the skin. For treatment: see below.

Broken fibula

The fibula is part of the lower leg. The fibula is located next to the tibia and is somewhat smaller than the tibia. It’s a thin bone. The fibula is connected at the top to the knee and at both ends to the tibia. It is not a load-bearing bone. The fibula is prone to bone fractures in certain people, such as runners. People with osteoporosis are also more likely to break their fibula because the bone is so thin. Stepping is often the cause of a fracture. External violence is a less common cause, because the fibula is protected by the tibia. The fibula also sometimes breaks during a long, tiring walk/run, this is called a fatigue fracture. The position of the foot at the time of fracture often determines the location of the fracture. This can occur anywhere on the fibula. Not everyone notices a broken fibula. For example, it is more common for runners to continue running with a broken fibula. The pain can be felt in the calf, ankle or knee. Sometimes the pain is confused with a pulled muscle. The treatment depends on the type of fracture: see below.

Broken tibia

The tibia is located at the front of the lower leg and is larger than the fibula. The tibia is the thicker bone of these two. The tibia is more easily broken than the fibula because it absorbs most of the blows. Contact sports in particular are risk factors. Every year, 1,200 Dutch people break their tibia while playing football. A fall can also cause a broken bone. Patients with osteoporosis have a higher risk of breaking the tibia. Pain is felt in the lower leg and walking is often very difficult. Local swelling and bruising may also occur. The skin is discolored blue to purple. Sometimes tendons or muscles are also damaged. It is rare that a broken tibia is not felt. The treatment consists of a plaster cast or surgical intervention.

Treatment methods

Various treatments are possible for a leg fracture. Treatment is aimed at allowing the fracture to heal as smoothly as possible so that no deformities or misalignment occur.

  • Plaster: the purpose of casting the leg is to hold the fracture tightly together so that these parts can fuse together. A plaster cast is only possible if the fracture is not too large or too far apart. In children, plaster treatment is preferred. Healing takes at least 6 weeks and can sometimes take longer.
  • Plate or pin: a plate or pin is surgically inserted and is necessary when the fracture is so far apart that the parts would grow together or become crooked during healing. A plate is also installed for the same reason. Both have to be surgically removed again. Sometimes only screws are used that are placed in the broken bone.
  • Weights: sometimes other treatment is not possible and the leg is held in place using weights that pull on the leg. Gravity serves as an aid here. This is often used as a temporary solution until another treatment is possible.
  • No treatment: no treatment is also treatment. Everyone is free not to have a bone fracture treated. a broken leg heals on its own, but often not in a nice way. A crooked position may develop, which can later cause difficulties with walking.

The recovery time for a broken leg is often around six weeks, but can last longer if the doctor’s orders are not followed. There is also a chance that the bone fracture will not heal properly and surgery will be necessary, or that recovery will unexpectedly take longer than expected due to other factors such as illness or too much/wrong load on the leg. Physiotherapy is recommended because the muscles quickly relax after a bone fracture. A plaster cast in particular poses a greater risk of this.

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