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REHAB

Broken Leg Explained

A broken leg is most commonly due to a motorcycle accident although, because of the nature of the sport, a broken leg can occur in football (soccer) and other contact sports. In the case of football-related injuries, the fractures are caused either by a twisting force when the foot is fixed or by a direct blow from an opponent. Depending on the mechanism of injury, the fracture pattern may be different.

Often confused, the Tibia is the shin bone that bears most of the weight and the Fibula is the splint bone located on the outside of the lower leg. Tibial fractures are also classified into closed fractures (where the skin is not broken by the fracture fragments) and open fractures (where the fracture fragments break through the skin). All Tibial fractures are medical emergencies and prompt hospital treatment is always required.

Broken Leg Signs & Symptoms

Obviously there will be a great deal of pain with a broken leg and the person will be unable to move their leg. There may be deformity at the site of the fracture, and an open fracture is obvious. In the case of a closed fracture there may be swelling and discolouration due to the large amounts of blood that emanate from a fractured bone. A fracture to the Fibula bone may be less painful and present like a sprained ankle at first as the bone bears less weight than the Tibia, however, weight-bearing will become increasingly difficult and an X-ray should be performed to correctly diagnose the injury.

Broken Leg Treatment

What you can do

Consult a sports injury expert
Wear a removable light-weight plastic walker instead of a plaster cast to protect the bone as some weight is put through the leg, maintaining a degree of function and less muscle wastage.
Use a buoyancy aid for pool fitness exercises
Use a bone healing system to speed up broken bone healing

Treatment decisions are largely dependent upon the type of fracture. If the fracture is closed, and the evidence from x-ray films show the two fragments to be in close proximity, then the orthopaedic consultant will bring fragments as close together as is possible (usually under anesthetic) and fit a plaster cast to immobilise the injury site. The patient may be admitted to hospital in order that the medical team can observe the tightness of the cast and the pressure on the leg.

The usual healing time for a mid-shaft Tibia and Fibula fracture treated with cast immobilisation is 12 to 16 weeks. This is followed by rehabilitation with a Chartered Physiotherapist to restore the range of ankle and knee movement, and to restore the muscle strength that is lost during the immobilisation period. Depending on the fracture type and its location the orthopaedic doctor may allow the use of a Removable Plastic Cast Walker instead of a plaster cast.

Plastic Cast Walkers have several advantages over a conventional plaster cast. They are removable which means that regular exercises can be done under the supervision of a physiotherapist. It also allows regular washing of the affected leg and foot, for much better hygiene than a conventional plaster cast. Plastic cast walkers are also much lighter than conventional plaster casts, making them much more comfortable to wear. They also have a rocker sole which means that once your doctor indicates that it is safe to dos so, you can begin walking in the cast. Early controlled weight bearing has been shown to aid fracture healing.

Where the injury is caused by a greater force there is more chance of the fragments being splintered and displaced, and of the fracture being open. In these circumstances the orthopaedic consultant may choose to fix the fracture surgically. This can be done using a plate and screw method, a large nail down the centre of the bone, or what is known as an external fixator - a frame around the leg that is screwed into the bone. These methods allow earlier and more active rehabilitation, and there is less of a problem with joint stiffness and muscle wastage that are associated with immobilisation.

Once full fracture healing is confirmed by the doctor, rehabilitation can continue with a physiotherapist. Hydrotherapy exercises are very helpful in regaining ankle range of movement. Non weight bearing exercises, such as pool running using a Buoyancy Belt, also allow the user to regain fitness without the impact of the ground. Manual therapy with the physio can help to restore normal ankle movement if there is any stiffness.

Broken Leg Prevention

What you can do

Wear shin guards when playing football

Unfortunately there is not much that can be done to prevent this injury. In football it is important to wear shin guards or shin pads at all time in order to reduce the risk of a broken leg from contact.




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