Broken Leg Cast Care Facts Information Treatment

Broken Leg

WHAT YOU SHOULD KNOW

A break can occur in any of several different bones and can take a variety of forms. Healing time depends on the location and nature of the fracture, and can take from weeks to months.

Causes

A fall or accident is almost always the cause.

Signs/Symptoms

You'll experience pain, swelling, bruising, and possibly bleeding. The leg may be weak or numb, or may tingle. It may look injured or out of alignment. You may have difficulty moving it, or may not be able to move it at all.

Care

The doctor will probably need to put a cast or a splint on the leg to keep the bones from moving. A serious fracture may need surgery.

WHAT YOU SHOULD DO

* To reduce the swelling, keep the injured leg on pillows while lying down and on a stool when sitting.

* Apply ice to the injury for 15 to 20 minutes each hour for the first 1 to 2 days. Put the ice in a plastic bag and place a thin towel between the bag of ice and your cast.

* If you have a plaster or Fiberglass Cast:

o Do not try to scratch the skin under the cast by pushing a sharp or pointed object down the cast.

o Check the skin around the cast every day. You may put lotion on any red or sore areas.

o If your fiberglass cast gets a little wet, it can be dried with a hair dryer.

* If you have a plaster splint:

o Wear the splint for as long as directed or until your follow-up examination.

o You may loosen the elastic around the splint if your toes become numb or begin to tingle.

* Do not put pressure on any part of the cast or splint; it may break.

* Keep the cast or splint dry. During bathing, protect it with a plastic bag. Do not lower it into water.

* If your doctor prescribes pain medication, take no more than directed. If the medication makes you drowsy, don't drive. You may also use over-the-counter pain killers.

Seek Care Immediately If...

* Your cast gets damaged or breaks.

* You have continued severe pain or more increased swelling.

* The skin or toenails below the injury turn blue or grey, or feel cold or numb

* There is a bad smell coming from the cast.

* There are new stains coming from under the cast.

Broken Leg Overview

Your leg contains 4 bones (the femur, the patella, the tibia, and the fibula) and bends at the hip, the knee, and the ankle. After an accident, these bones may break (fracture) into 2 or more pieces.

If a broken bone has been exposed to the outside, either by a cut over the fracture or by bone sticking out through the skin, it is called an open fracture. This used to be referred to as a compound fracture.

A break in the leg may involve any of these bones:

The femur is the bone in the thigh. It is the longest and strongest bone of the body. The upper part of the femur fits into the pelvis to form the hip joint. At this joint, it can move frontward, backward, sideways, and even rotate in and out. When people speak of a "broken hip," it is this upper part of the femur that is broken.

The lower end of the femur rests on top of the tibia, forming the knee joint. At the knee, the leg can swing frontward, backward, and even rotate slightly.
The kneecap (patella) glides back and forth in front of the knee joint. The kneecap suspends the ligaments from the thigh muscle and helps to add leverage for straightening out the leg.

The tibia is the shinbone and supports the body's weight. The fibula runs alongside the tibia below the knee. It is on the outside part of the leg and is smaller than the tibia.

The ankle is composed of the bottom ends of the tibia and fibula, the connecting foot bones, and the ligaments and tendons. Severe twisting injuries to the ankle can result in fractures of the tibia or fibula near or within the ankle joint.

Broken Leg Symptoms

The major symptoms of a broken leg are pain, swelling, and deformity. A broken leg can be very obvious but may require an x-ray to diagnose.

Pain caused by a broken bone is typically severe. Holding the bone still will decrease pain. Movement of the broken bone will increase pain.
Swelling and bruising over the area of a break are common.

Deformity of the leg can occur in these forms:
Shortening: The broken leg appears shorter than the unaffected leg.
Rotation: The leg below the break is twisted.
Angulation: The leg bends at the break instead of at the joint.

When to Seek Medical Care

Some parts of the leg may be broken and still seem like a bad strain. This can often be the case of injuries around the ankle, or sometimes with the fibula, the little bone next to the shinbone.

Call your doctor if these conditions describe your situation:

You are not able to walk without a great amount of pain.
It hurts when you push on the bony parts of the leg.
You are concerned that you may have a broken leg, even if you are unsure.

f you think you or someone else has a broken leg, go to an emergency department for further evaluation. If you cannot walk, you should call 911 for an ambulance.

If you have had a surgery, or had a splint or cast placed already, return to the hospital immediately if these problems develop:

Loss of muscle strength or numbness in the leg or foot. A certain amount of strength loss is common because of the pain of the fracture, but if there is a rapid development of numbness or worsening of strength, or a significant increase in pain unrelieved by your pain medication, these may be signs of a "compartment syndrome." Compartment syndrome occurs when swelling gets so severe within the leg that it cuts off blood flow to the leg. This can cause damage to muscles and nerves of the leg.
Redness, fever, increased swelling or pain, or drainage of pus from a surgical incision are all signs of possible wound infection.

Exams and Tests

The doctor will examine the leg for evidence of a break (fracture). If the doctor suspects that a bone has been broken, x-rays will be ordered.

The doctor also will look for signs that an artery or nerve was damaged or injured. To do this, the doctor will feel for pulses and test your strength and sense of touch below the injury.

If the doctor suspects some other medical condition has caused weakening of the bone leading to the fracture, other lab tests may be ordered.

Diagnosis of stress fractures are often difficult, and special studies beyond x-rays may be needed.

Broken Leg Treatment

Self-Care at Home

If an injury happens and you suspect a break, remember the following:

Immobilize the leg as much as possible until help arrives.

Rest. Try to keep from aggravating the injury.

Apply an ice pack wrapped in a pillowcase or towel to decrease swelling.

If possible, keep the leg elevated with pillows or cushions to decrease swelling.

Often with a broken leg, an operation is necessary. For this reason, do not let someone with a broken leg eat or drink anything until seen by the doctor. Always ask the doctor if it would be OK to eat before doing so.

Medical Treatment

The type and location of a break in a leg bone will determine what treatment is needed.

If the bones have become displaced or out of alignment, they will need to be put back into alignment. This procedure is called "reduction." In order to do this, you will be given medications for pain prior to the procedure.
An emergency doctor will be able to treat many types of fractures with a temporary plaster splint and will instruct you to follow up with an orthopedic doctor (bone specialist). However, fractures of the thighbone or the shinbone typically will need further care by an orthopedist right away. This may mean a cast or even an operation.
Bones are immobilized for healing by several methods.

A plaster splint or cast often is used.
When an operation is needed, pins, screws, and metal plates or wires are often used to hold together the broken ends of a bone.
For fractures in the middle part of the thighbone (femur) or the shinbone (tibia), a metal rod sometimes is placed down through the center of the bone. This is done in the operating room.

Your doctor will also provide you with medicine for the pain.

Outlook

If treated promptly and properly, a broken leg usually will regain normal function.

Because the major bones of the leg support our weight, at least 6-8 weeks is usually required before the bone is healed.

The severity of the injury and your age may cause problems. For instance, an elderly person with a hip fracture may have difficulty regaining strength and mobility.

Someone with an open fracture, where the bone sticks through the skin, may be at increased risk for infection of the bone. If infection occurs, this may delay significantly the healing process.