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Treatments and drugs
By Mayo Clinic staff
Treatment of a broken leg will vary, depending on the type of break. Fractures are classified into one or more of the following categories:
- Open (compound) fracture. In this type of fracture, the skin is pierced by the broken bone. This is a serious condition that requires immediate, aggressive treatment to decrease your chance of an infection.
- Closed fracture. In closed fractures, the surrounding skin remains intact.
- Incomplete fracture. This term means that the bone is cracked but it isn't separated into two parts.
- Complete fracture. In complete fractures, the bone has snapped into two or more parts.
- Displaced fracture. In this type of fracture, the bone fragments on each side of the break are not aligned. A displaced fracture may require surgery to realign the bones properly.
- Comminuted fracture. This term means that the bone is broken into several pieces. This type of fracture also may require surgery for complete healing.
- Greenstick fracture. In this type of fracture, the bone cracks but doesn't break all the way through — like when you try to break a green stick of wood. Most broken bones in children are greenstick fractures, because a child's bones are softer and more flexible than those of an adult.
Setting the leg
Initial treatment for a broken leg usually begins in an emergency room or urgent care clinic. Here, doctors typically evaluate your injury and immobilize your leg with a splint. If you have a displaced fracture, your doctor may need to manipulate the pieces back into their proper positions before applying a splint — a process called reduction. Depending on the amount of pain and swelling you have, you may need a muscle relaxant, a sedative or even a general anesthetic before this procedure.
Immobilization
Restricting the movement of a broken bone in your leg is critical to proper healing. To do this, you may need a splint or a cast. And you may need to use crutches or a cane to keep weight off the affected leg for six to eight weeks or longer.
Medications
To reduce pain and inflammation, your doctor may recommend an over-the-counter pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) or a combination of the two. If you're experiencing severe pain, you may need an opioid medication, such as codeine.
Therapy
After your cast or splint is removed, you'll likely need rehabilitation exercises or physical therapy to reduce stiffness and restore movement in the injured leg. Because you haven't moved your leg for a while, you may even have stiffness and weakened muscles in uninjured areas. Rehabilitation can help, but it may take up to several months — or even longer — for complete healing of severe injuries.
Surgical and other procedures
Immobilization heals most broken bones. However, you may need surgery to implant internal fixation devices, such as plates, rods or screws, to maintain proper position of your bones during healing. These internal fixation devices may be necessary if you have the following injuries:
- Multiple fractures
- An unstable or displaced fracture
- Loose bone fragments that could enter a joint
- Damage to the surrounding ligaments
- Fractures that extend into a joint
- A fracture that is the result of a crushing accident
- A fracture in particular areas of your leg, such as your thighbone
Most internal fixation materials are left in place. Others may be removed after your bone heals, while some are made of materials that are absorbed into your body. Complications are rare, but can include wound-healing difficulties, infection and lack of bone healing.
For some injuries, your doctor may also recommend an external fixation device — a frame outside your leg attached to the bone with pins. This device provides stability during the healing process and is usually removed after about six to eight weeks. There's a risk of infection around the surgical pins connected to the external fixation device.
- Fracture. Dorland's Illustrated Medical Dictionary. 31st ed. Philadelphia, Pa.: W.B. Saunders; 2007. http://www.dorlands.com/def.jsp?id=100042444. Accessed April 17, 2009.
- Shinbone fractures. American Academy of Orthopaedic Surgeons. http://www.orthoinfo.aaos.org/topic.cfm?topic=A00161. Accessed April 17, 2009.
- Lower leg. Marx JA, et al. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2006. http://www.mdconsult.com/das/book/body/132163627-9/830723266/1365/146.html#4-u1.0-B0-323-02845-4..50059-7--cesec116_2508. Accessed April 17, 2009.
- Thighbone (femur) fractures. American Academy of Orthopaedic Surgeons. http://www.orthoinfo.aaos.org/topic.cfm?topic=A00364. Accessed April 20, 2009.
- Fields KB. Overview of tibial fractures. http://www.uptodate.com/home/index.html. Accessed April 20, 2009.
- Fields KB. Stress fractures of the tibia and fibula. http://www.uptodate.com/home/index.html. Accessed April 20, 2009.
- Fractures of the lower extremity: Shaft of the femur. In: Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/132633798-5/831634018/1584/388.html#4-u1.0-B978-0-323-03329-9..50054-4--cesec111_2919. Accessed April 20, 2009.
