Leg Fracture

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KEY POINTS

• A leg fracture is a break or crack in the bone of the upper leg or a break in one or both of the bones in the lower leg.
• Treatment may include surgery, a cast or removable boot, and special exercises to help your child’s leg get stronger and more flexible.
• Follow the full course of treatment your child’s healthcare provider prescribes.

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What is a leg fracture?

A leg fracture is a break or crack in the bone of the upper leg or a break in one or both of the bones in the lower leg. The break may be just a bend or small crack in the bone, or the bone may break into pieces or shatter. Some fractures may stick out through the skin.

The bone in the upper leg is called the femur. The bones in the lower leg are called the tibia and fibula.

What is the cause?

A leg fracture is usually caused by a fall or direct hit to the leg. Sometimes it can happen from overuse such as during sports where you run or jump for long periods of time. This type of fracture is called a stress fracture. A fracture may also be the result of a medical condition that causes weak or brittle bones.

What are the symptoms?

Symptoms may include:

• A snapping or popping sound at the time of the injury
• Pain, swelling, bruising, or tenderness that happens right after the injury
• Pain when the injured area is touched or that keeps your child from putting weight on the leg
• An area of the leg or foot that is cold, pale, or numb
• A change in the shape of the leg

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and how the injury happened. Your provider will examine your child. Tests may include:

• X-rays of the leg
• CT scan, which uses X-rays and a computer to show detailed pictures of the bones
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the bones
• Bone scan, which uses a small amount of radioactive chemical injected into the blood to make detailed pictures of the bones

How is it treated?

The treatment depends on the type of fracture.

• If your child has an open wound with the fracture, your child may need treatment to control bleeding or prevent infection.
• If the broken bone is crooked, your healthcare provider will straighten it. Your child will be given medicine first so the straightening is less painful.
• Sometimes surgery is needed to put the bones back into the right position.
• Your child’s provider may put the leg in a splint, cast, or removable boot to keep it from moving while it heals.
  • If your child has a cast, make sure the cast does not get wet. Cover the cast with plastic when your child bathes. Teach your child not to scratch the skin around the cast or poke things down between the cast and the skin. This could cause an infection.
  • Your provider will tell you how much weight your child can put on the leg, if any. Your child may need to use crutches, a knee walker, or a cane as directed by your healthcare provider.

With treatment, the fracture may take up to 4 months to heal. Your child may need to do special exercises to help the leg get stronger and more flexible. Ask your child’s healthcare provider about this.

How can I take care of my child?

Follow the full course of treatment your child’s healthcare provider prescribes. Also:

• To keep swelling down and help relieve pain, your child’s healthcare provider may tell you to:
  • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the injured area every 3 to 4 hours for up to 20 minutes at a time for the first day or two after the injury.
  • Keep the leg up on pillows so that it is above the level of the heart when your child is sitting or lying down.
  • Give your child pain medicine, such as ibuprofen, as directed by your child’s provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. Read the label and give as directed. Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye syndrome.

Ask your child’s healthcare provider:

• How and when you will get your child’s test results
• How long it will take for your child to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent a leg fracture?

Most broken legs are caused by accidents that are not easy to prevent. However, here are some things that can help prevent leg injuries:

• Follow safety rules and use protective equipment recommended for work or sports.
• Wear shoes that fit well and give good support.
• Gently stretch before and after physical activity.