Fracture of the lower leg

If, after a traffic accident or an accident during sports, movement restrictions and swelling in the area of ​​the lower leg occur, a Fracture of the lower leg have occurred. Far more often, however, this injury occurs as an open fracture. Skiers and motorcyclists are very often affected.

What is a fracture of the lower leg

A Fracture of the lower leg is a fracture of one or both long bones of the lower leg. A distinction is made between the shin and the fibula. These two bones ensure the stability of the lower leg, whereby the shinbone has to carry a large part of the body weight, while the fibula has a supporting function.

Lower leg fractures occur as a result of direct or indirect forces, which can often occur in accidents in sports, at home or in traffic. Depending on the type of fracture, a distinction is also made between the compression fracture, the flexure fracture, as well as the torsion fracture and the segment fracture. All types of fractures can occur as either an open or closed lower leg fracture, but open fractures are far more common.

In the case of closed fractures, in addition to restricted movement with pronounced pain, there is also a malposition and swelling of the lower leg. An open fracture is an emergency that requires immediate medical attention.

causes

The cause of one Fracture of the lower leg is always a force acting on the lower leg area concerned. A distinction is made between fractures on the shaft of the lower leg bones and fractures remote from the body. The shaft of the bone is stronger than its structure in sections remote from the body.

While the forces in a traffic accident can have an even more pronounced effect on the bones than they do in sports, fractures on the bone shaft therefore occur mainly after traffic accidents, while fractures distant from the body occur more often after sports accidents. This type of lower leg fracture is a classic skiing injury.

Symptoms, ailments & signs

A fracture of the lower leg is usually always associated with symptoms and signs that can be diagnosed by the person concerned. In most cases, a lower leg fracture is accompanied by severe swelling that can be seen directly in the affected area. If it is an open fracture of the lower leg, then of course the fracture is visible to the naked eye.

Usually there is an audible crunch if the leg can be moved. With such a fracture, of course, the entire sequence of movements is severely restricted, so that normal gait is not possible at all. Even the smallest movements cause severe pain. For this reason, medical or inpatient treatment is essential to eliminate the symptoms described.

Anyone who refrains from medical and surgical treatment at this point is running a great risk. In such a case, the individual symptoms will worsen considerably. The pain becomes stronger, so that a sharp pain persists even when the patient is resting. Those who do not put off going to the doctor on the back burner will notice an improvement within a short time. The symptoms subside and nothing stands in the way of a full recovery.

Diagnosis & course

The diagnosis is made with an open Fracture of the lower leg confirmed by radiographs in two planes. In this way, further injuries can also be excluded or determined. It can happen that blood vessels have been injured by the lower leg fracture. These can be examined using what is known as Doppler sonography. This is a painless ultrasound examination.

Vessels can also be visualized with so-called angiography. To do this, a contrast agent is injected into the affected blood vessels so that they can be seen in a subsequent X-ray. If an injury to the tendons and ligaments is suspected, an MRI (magnetic resonance imaging) must provide information about the severity of the additional injuries.

A compartment pressure measurement is often taken if the lower leg is severely swollen. A possible increase in pressure in the patient's muscle tissue can lead to tissue damage and even death of the area affected by the fracture of the lower leg.

Complications

First and foremost, those affected suffer from very severe pain with a lower leg fracture. These can be so strong that the person concerned loses consciousness and may injure himself again if he falls again. Furthermore, the pain often spreads to the neighboring regions of the body.

There are significant restrictions in movement, so that the person concerned is usually always dependent on the help of other people in his everyday life. In most cases, the fracture of the lower leg is an open fracture, so that infections or inflammations can also occur. The affected regions are severely swollen and there is significant reddening and bruising.

In most cases, complications with a fracture of the lower leg only occur if the fracture is not treated. This can lead to the bone growing together incorrectly. There are no complications with the treatment itself. The discomfort is alleviated by resting the region. This leads to a positive course of the disease. The life expectancy of the patient is usually not negatively affected by the fracture of the lower leg.

When should you go to the doctor?

If severe pain occurs in the leg area after a fall, violence or an accident, this should be monitored further. If the pain increases in intensity and extent or if it remains unchanged over a longer period of time, a visit to a doctor is advisable. If the foot can no longer be placed on the floor without symptoms after the triggering event, this is unusual. The person concerned should be examined and treated. Disorders of locomotion, restricted freedom of movement and a sudden decrease in physical performance are signs of an existing illness.

A doctor is required because a fracture of the lower leg does not lead to spontaneous healing. If there are visual changes in the bones in the area of ​​the lower leg or if there are abnormalities in the skin, this is a sign of a health irregularity. If bruises or tenderness develop, further tests are necessary to clarify the cause and make the diagnosis.

If the person concerned can no longer shift his own weight onto one of his legs without symptoms, he needs help. If the physical activities can no longer be carried out as usual and sensory disorders of the leg or feet appear, a doctor should be consulted. Circulatory problems and a tingling sensation on the skin are further signs of an existing irregularity.

Treatment & Therapy

Treating a Lower leg fracture depends on the severity of the injury and the other accompanying injuries to tendons, ligaments or vessels. All open fractures are treated surgically. This also applies to displaced fractures in the area of ​​the tibia and to fractures with additional injuries to the ankle.

The broken bone can be stabilized with an intramedullary nail. The use of plates and screws is also possible. An external fixator, the so-called external fixator, ensures the stability of the fracture site by means of externally attached screws and rods. If the muscles and connective tissue are injured, several operations are necessary to reconstruct the damaged soft tissue covering.

Open fractures often require the patient to take an antibiotic. To restore the mobility of the broken lower leg, physiotherapeutic exercises must be started after healing.Simpler fractures of the tibia, the bone ends of which have not shifted against each other, as well as fractures of the fibula can be treated with a plaster cast, in which the fracture of the lower leg can heal in four to six weeks without any further consequences for the patient.

prevention

There a Fracture of the lower leg usually occurs as a result of an external force, there are no direct measures to prevent this injury. By choosing the right sports equipment for skiing and appropriate motorcycle clothing, injuries associated with the lower leg fracture such as involvement of the ankle joint or injuries to tendons and ligaments can at best be reduced.

Aftercare

Regular x-ray examinations of the lower leg are an essential measure to assess bone healing. Complications such as misalignments or delays in fracture healing can thus be recognized at an early stage. Otherwise, the follow-up care of the patient depends on whether the lower leg fracture was treated conservatively (without surgery) or surgically.

In the conservative procedure, a plaster cast usually has to be worn for four to six weeks. Anticoagulant medication is given during immobilization to prevent thrombosis (blood clots from becoming blocked). Physiotherapy can only begin after the cast has been removed.

If the fracture was surgically treated with nails, screws or plates, physiotherapeutic measures can begin a few days after the operation. In a second operation, the introduced materials must be surgically removed after 12 to 18 months. Another hospital stay is required for this. In the case of complicated fractures, additional surgical interventions may be necessary due to malpositions or joint instabilities.

The basis for an effective restoration of health is rehabilitation (rehab). After the bone has healed, the leg's load-bearing capacity is continuously increased through physiotherapy. Systematic gait training aims to avoid incorrect positions when walking. Further goals of rehab are to strengthen the muscles of the lower leg and to promote mobility.

You can do that yourself

An uncomplicated thigh fracture usually heals quickly. The patient must take it easy and perform the physiotherapy according to the doctor's instructions. An active lifestyle is optimal, whereby the injured limb must be excluded from exercise and stretching measures. Smokers stop using cigarettes, and it is also important to avoid luxury foods such as alcohol or caffeine.

A change in diet is recommended after a fracture. A complete diet rich in vitamins and fiber is important. Calcium and vitamin D supplements as well as omega-3 fatty acids and curcumin also contribute to the healing of the fracture. Tried and tested products are flaxseed oil, krill oil as well as various types of fish, eggs and gently prepared fruit and vegetables. The blood circulation in the fracture zone and thus the recovery is stimulated by shock wave therapy, magnetic field therapy and laser radiation. If these measures are followed, the lower leg fracture should heal quickly. The doctor must be informed about the state of health and any complaints so that the therapy can be adapted and the healing process can be optimally supported.

If complications such as pain or numbness occur, the responsible doctor should be informed. Taking the prescribed pain relievers and anti-inflammatory drugs properly is also part of self-help. Certain drugs such as diclofenac or ibuprofen intervene in the bone metabolism and should only be taken after consulting a doctor.