From car accidents to sports injuries, broken legs are a very common injury. The femur or upper leg bone is very strong and less likely to be fractured than the lower leg bones, the tibia and fibula.
Here are some examples of common leg fractures:
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Tibia fractures are a common injury due to motor vehicle accidents and major trauma. In the past, tibia fractures were treated with a cast. Now most of these fractures are treated surgically with rods. Fractures near the joint, either the ankle or knee joint, are usually treated with plates and screws; sometimes surgeons put bars (external fixators) outside the body, with pins or wires to hold the injured bone in place. With current technology, most fractures will heal appropriately, but severe fractures, especially those that are open or severely comminuted may be delayed in healing even with a rod in place. It is not unusual in these types of fractures to need electrical bone growth stimulation. Unless the tibia fracture is minimally displaced, most surgeons are opting to treat these patients surgically because there is a better more predictable result and the patient can be mobilized more quickly.
As recently as twenty years ago, leg fractures were routinely set into a cast. Treatment has evolved to using rods as described above without destroying the soft tissue which helps to heal the bone. A rod is used to hold the tibia together and prevent rotation and shortening. This approach allows patients to use crutches so the leg can bear weight sooner so a cast may not be necessary. Using current technologies and treatments the overall down time for a patient is reduced. In the long run, surgery is sometimes the more conservative approach.
Leg Nonunions
Most leg fractures will heal normally either with immobilization, internal or external fixators, or surgery. However, depending upon patient condition and other risk factors such as obesity or smoking, a nonunion may occur. Nonunions occur when the healing bone lacks adequate blood supply and/or stability. Nicotine is thought to interfere with bone healing. Diabetes and the use of certain medications such as prednisone, aspirin or ibuprofen can also negatively impact bone healing. Adequate dietary nutrition is also essential.
If a bone has a nonunion, your physician will recommend treatment, either surgical or non-surgical. An external bone growth stimulator is an effective way to help the bone heal. The stimulator produces electrical or ultrasound energy which encourages the natural bone healing process.
If non-surgical treatments are not effective, surgery may be required to repair the nonunion. Bone graft materials, either from the patient or from a cadaver, or enhanced bone graft products such as DBM, can help the body heal by providing fresh bone cells and nutrients needed by the bones. In addition to bone grafts, your surgeon will often place internal screws and plates to hold the bone together.
External fixation may also be used.