During the physical exam, the health care provider will inspect the affected area for tenderness, swelling, deformity or an open wound.
X-rays can usually pinpoint the location of the break and determine the extent of injury to any adjacent joints. Occasionally, computerized tomography (CT) or magnetic resonance imaging (MRI) is needed for more detailed images. For instance, you may need a CT scan or an MRI for a suspected stress fracture, since X-rays often fail to reveal this injury.
Treatment of a broken leg will vary, depending on the type and location of the break. Stress fractures may require only rest and immobilization, while other breaks may need surgery for best healing. Fractures are classified into one or more of the following categories:
- Open fracture. In this type of fracture, the skin is pierced by the broken bone. This is a serious condition that requires immediate treatment to decrease the 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 not separated into two parts.
- Complete fracture. In complete fractures, the bone has broken 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.
- 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. Greenstick fractures are more likely to occur in children because a child's bones are softer and more flexible than those of an adult.
Setting the leg
Treatment for a broken leg usually begins in an emergency room or urgent care clinic. Here, health care providers typically evaluate the injury and immobilize the leg with a splint. If you have a displaced fracture, the care team may need to move the pieces of bone back into their proper positions before applying a splint — a process called reduction. Some fractures are splinted at first to allow swelling to subside. A cast is then used once there is less swelling.
For a broken bone to heal properly, its movement needs to be restricted. A splint or a cast is often used to immobilize the broken bone. You may need to use crutches or a cane to keep weight off the affected leg for at least 6 weeks.
A pain reliever such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others), or a combination of the two, can reduce pain and inflammation. If you're experiencing severe pain, your health care provider might prescribe stronger pain medications.
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.
Surgery and other procedures
Immobilization with a cast or splint heals most broken bones. However, you may need surgery to implant plates, rods or screws to maintain proper position of the bones during healing. This type of surgery is more likely in people who have:
- 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
Some injuries are treated with a metal frame outside the leg attached to the bone with pins. This device provides stability during the healing process and is usually removed after about 6 to 8 weeks. There's a risk of infection around the surgical pins.
Preparing for your appointment
Depending on the severity of the break, your health care provider may recommend examination by an orthopedic surgeon.
What you can do
You may want to write a list that includes:
- Detailed descriptions of the symptoms and what caused the injury
- Information about past medical problems
- All the medications and dietary supplements you or your child takes
- Questions you want to ask the health care provider
For a broken leg, some basic questions to ask your care provider include:
- What kinds of tests are needed?
- What is the best course of action?
- Is surgery necessary?
- What are the alternatives to the primary treatment you're suggesting?
- What restrictions need to be followed?
- Should I see a specialist?
- What pain medications do you recommend?
Don't hesitate to ask any other questions you have.
What to expect from your doctor
Your health care provider is likely to ask you questions, including:
- How and when did your injury occur?
- Were there any other injuries or areas of pain?
- Have you had broken bones in the past or a history of osteoporosis?
- Do you have any numbness, tingling or loss of sensation to the injured area?
- Were you able to get up and stand or walk, bearing weight on your leg, after your injury?
- How severe is the pain from your injury?
- What, if anything, seems to improve the pain?
- What, if anything, appears to worsen the pain?
For injuries to children, the evaluation often includes routine questions to rule out concerns for intentional injury or child abuse.