BROKEN LEG

How do you know if a Child Has a Broken Leg?

Fractures occur frequently during childhood. They are the fourth most common injury in children who are below six years old. Most of the broken legs in children within this age group are a result of falls, while the most serious ones occur from car crashes.

A broken leg in a child is different from that of an adult since the bones in children are more flexible with a thicker covering that makes them absorb shocks better. Fractures in children rarely require surgery. In most cases, all they need is a molded cast to stop the broken bones from moving. Parents should check for several signs of a child’s broken leg. Different symptoms can manifest due to the different types of fractures that exist. Some of these symptoms include:

Bruising

The child may have bruises around the break. The bruise may feel tender or may hurt whenever it is touched. Bruising is a common sign of fracture, particularly around the tibia, but bruising occurs with a variety of other injuries.

Inability to hold the leg straight

The child may say that he or she finds it difficult to hold the leg straight at the spot of the injury.

Inability to move the leg normally

The child may find it difficult to move the fractured leg. Sometimes kids will still move a broken leg.

Numbness

The site of the injury sometimes gets numb. This shows that the nerve near the site of the injury is damaged. Parents can easily notice a change in skin color.

Pain

The child will feel pain when he or she tries to move the leg. The child may also find it difficult to walk, hold, or lift objects.

Snapping sound when the injury was sustained

If the child says he or she heard a ‘snap’ when the injury was sustained, it is most likely a broken leg.

Swelling

You may notice that the area around the injury starts swelling. Swelling typically occurs around the fracture site, which can occur near the knee, between the knee and ankle, or at the ankle. Bumps may appear at the injury site. If you notice any of these signs or if a bone pokes out through the skin, ensure you seek medical care as soon as possible.

Causes of a Broken Leg

A child can break his or her leg in different ways, including:

Falls

A fall can cause one or both of the lower legs to break. The thigh bone, on the other hand, is unlikely to break unless a more significant trauma occurs. In particular, a rolled ankle during a fall can result in a tibia fracture, especially when significant weight-bearing forces impact this area.

Trauma

Trauma is one of the most common causes of a broken leg and can occur from falls, vehicle accidents, or impacts while playing sports. These situations often involve sudden and intense forces that exceed what the leg bones can withstand, leading to fractures. For children, this can be particularly concerning as their bones are still developing.

Overuse

Overuse is another significant factor contributing to broken legs, particularly through stress fractures. When repetitive force is applied to the leg over time, such as with increased or high-volume running in sports, the bones can develop tiny cracks. These stress fractures are more common in sports that require running and jumping with frequent changes of direction.

Osteoporosis

Though more common in adults, osteoporosis can affect children with certain medical conditions. It involves the body losing too much bone or making too little, resulting in weak bones that are more likely to break. Understanding this condition helps in recognizing how it can contribute to fractures, even in younger individuals.

Accidents

A major motor vehicle accident can break all the bones in the leg. Such significant trauma can involve the tibia, often leading to severe fractures due to the force of impact.

Sports Injuries

Collisions during contact sports can break a leg. A direct blow from an opponent’s body or a hockey stick can also cause a broken leg. Tibia fractures are sometimes seen in sports that require running and jumping with frequent changes of direction. Moreover, a stress fracture to the tibia may occur from overuse, often linked to a recent increase or high volume of running.

Child Abuse

Child abuse can also result in a broken leg, especially when it occurs before the child starts walking. In such unfortunate cases, multiple bones, including the tibia, can be affected due to intentional harm. By understanding these causes, parents and caregivers can better protect children from situations that increase the risk of leg fractures.

Falls

A fall can cause one or both of the lower legs to break. The thigh bone, on the other hand, is unlikely to break unless a more significant trauma occurs.

Accidents

A major motor vehicle accident can break all the bones in the leg.

Sports injuries

Collisions during contact sports can break a leg. A direct blow from an opponent’s body or a hockey stick can also cause a broken leg.

Child abuse

Child abuse can also result in a broken leg, especially when it occurs before the child starts walking.

Understanding the Difference: Tibia vs. Fibula

When exploring the anatomy of the lower leg, two critical bones come into focus: the tibia and the fibula. Though they work together to support the leg’s structure, they each play distinct roles.

The Tibia

• Also Known As: Often referred to as the shinbone.
• Size and Strength: It is the larger and stronger of the two, tasked with bearing the majority of the body’s weight.
• Function: The tibia serves as a crucial connector, linking the knee joint to the ankle bones, providing stability and support for movement.

The Fibula

• Location: The fibula runs parallel to the tibia and is situated on the lateral side of the leg.
• Size and Role: While thinner and less robust, the fibula is essential for stabilizing the ankle and supporting muscles of the lower leg.
• Vulnerability: A fracture can occur in various locations—near the knee, mid-shaft, or at the ankle—highlighting its supportive but less weight-bearing nature.

Key Differences

• Purpose: The tibia primarily supports weight. In contrast, the fibula aids in muscle attachment and ankle stability.
• Resilience: Given its structural role, the tibia is the go-to bone for strength. The fibula, while supportive, cannot bear significant weight alone.

In essence, while these bones are adjacent, they have different responsibilities that are vital for the overall function and movement of the leg.

When to See a Doctor

You need to see a doctor right away if your child has any signs of a broken leg. Delaying diagnosis and treatment can lead to complications, such as poor healing. If there is any leg fracture as a result of a high-impact trauma (like a car or motorcycle crash), seek emergency medical care. Fractured thigh bones are severe; they are potentially life-threatening injuries that need emergency medical attention to prevent further damage.

Potential Complications During and After Healing

It’s crucial for parents to watch for complications that may arise during and after the healing process of a broken leg. Here are some potential issues to watch for:

• Osteomyelitis (Bone Infection): An infection in the bone that requires prompt treatment to prevent serious health concerns.
• Nerve Damage: This can occur if the bone injures nearby nerves, potentially leading to long-term numbness or pain.
• Muscle Damage: Damage can happen if the fracture is near adjacent muscles, affecting mobility and strength.
• Joint Pain: Ongoing discomfort in nearby joints can result from the injury or healing process.
• Osteoarthritis: Poor bone alignment during healing can lead to the development of osteoarthritis years later.

By understanding these potential complications, parents can address any issues promptly and ensure optimal recovery for your child.

Finally, we offer personalized treatment and urgent pediatric care services at all of our four locations — Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX.  If you notice any symptoms of a broken leg in your child, don’t hesitate to contact us to avoid complications.

 

Diagnosis

Doctors use a series of diagnostic tests to know if a leg is broken. These tests include:

X-Ray

This is enough to detect the presence of most types of fractures.

Magnetic Resonance Imaging (MRI)

This produces detailed images of organs, ligaments, and tendons.

Computed tomography scans (CT and CAT scans)

These tests provide greater detail of fractures.

Bone scans

These show the inflammation around the bones. They help to see cell activity and bone metabolism.

Treatment for a Broken Leg

The main treatment for a broken leg is to ensure the ends of the broken bones are well aligned and to immobilize the bone to ensure that it heals properly. This healing process starts with setting the leg. If the broken bones are not aligned, the doctor may need to arrange the pieces of the broken bone in the correct position; a process referred to as reduction. After the bones have been well-positioned, the leg is then immobilized with a cast (made of plaster or fiberglass) or splint.

Proper treatment is crucial because it significantly impacts the recovery process and the ability to regain normal function. When treated promptly and effectively, proper alignment and immobilization of the broken leg facilitate optimal healing. This often leads to a return to normal mobility and lifestyle, minimizing long-term complications.

The actual treatment administered for a broken leg depends on different factors such as the location of the fracture and the type of leg fracture the child sustained. However, the outcome of correct treatment is often the same: a successful recovery that allows individuals to return to their daily activities with restored function and confidence. The following can occur:

Open fracture

It is also known as a compound fracture. In this case, the broken bone pierces the skin or emerges through a wound.

Closed fracture

It is a type of fracture whereby the surrounding skin is not broken.

Incomplete fracture

In this case, the bone is cracked but does not separate into two parts.

Complete fracture

The bone breaks into two or more parts.

Displaced fracture

In a displaced fracture, the bone fragments (on each side of the fracture) are not aligned.

Greenstick fracture

This is the type of fracture that is commonly found in children. In this case, the bone is bent; it does not crack all through.

Surgery

Doctors may use Internal fixation devices like rods, screws, or plates to surgically hold the bones in place. This is usually necessary when the child sustains the following injuries:

• Displaced fracture
• Multiple fractures
• A fracture that damages the ligaments around the site of the injury
• A fracture that is caused by a crushing accident
• Fracture in the femur

Medication

The doctor may recommend over-the-counter pain relievers to reduce pain and inflammation. If the pain is severe, the doctor may recommend stronger pain relievers.

Understanding External Fixation Devices

An external fixation device is a medical apparatus employed to stabilize and heal complex fractures. Unlike internal devices, it operates externally, creating a supportive frame around the affected limb.

When Is It Used?

• Severe Fractures: These devices are commonly used for severe fractures that require immediate stabilization to prevent further injury.
• Complex Injuries: When the fracture involves damage to surrounding tissues, such as ligaments or joints, external fixation offers a non-invasive way to secure the bone.
• High-Risk Areas: For fractures in sensitive or high-risk areas (like the femur), external fixation can help due to its minimal interference with internal structures.
• Crushing Accidents: In cases of crushing injuries, where the soft tissue integrity is compromised, an external fixation can help provide the necessary support without an invasive procedure.

Overall, external fixation devices offer a vital solution in orthopedic treatment, facilitating bone healing while ensuring minimal disruption to the body’s natural systems.

What to Consider Before Starting a Rehabilitation Exercise Program for a Tibia Fracture

Embarking on a rehabilitation exercise program after a tibia fracture requires careful planning and consideration. Here are key points to keep in mind:

1. Consultation with a Healthcare Professional

• Always meet with your healthcare provider or physical therapist. Their expertise is crucial for tailoring a program suited to your specific needs and injury severity.

2. Personalized Assessment

• Individual Health Assessment: Ensure you undergo a comprehensive assessment to evaluate your current physical condition, medical history, and specific fracture details.
• Goal Setting: Define clear, achievable recovery goals with your therapist to ensure motivation and progress tracking.

3. Professional Guidance

• Consider consultation with an orthopedic specialist to understand the complexities of your fracture and recommended healing strategies.
• Regularly update your therapist on your progress and any pain or discomfort experienced during exercises.

4. Exercise Program Design

• Your program should include phases tailored to different recovery stages, focusing on pain management, strength building, and flexibility.

5. Lifestyle Adjustments

• Be prepared to adapt daily activities to support your recovery process. This might involve modifications at home or changes in routine to minimize strain.

6. Monitoring and Adjustment

• Consistent monitoring of your recovery progress is vital. Be ready to adjust exercises based on results and feedback from health professionals.
• Regular check-ins can prevent setbacks and adapt the regimen as needed for optimal recovery.

Each step in this process plays a significant role in ensuring a safe and effective recovery journey. Prioritize professional advice and continuously evaluate your progress for the best outcomes.

Tibia Fracture Rehab Program: Key Exercises

Recovering from a tibia fracture involves a structured rehabilitation program. Always consult with a physical therapist before starting any exercises. Here’s an overview of exercises that may be included in such a program:

Initial Phase (1 to 2 Weeks)

• Mobility Support: Use crutches to prevent weight-bearing on the affected leg.
• Early Active Exercises: Focus on gentle movements, especially for the quadriceps and hip muscles, to maintain some level of activity.

Building Strength (2 to 4 Weeks)

• Continued Non-Weight Bearing: Remain on crutches as the healing process continues.

Transition Phase (4 to 6 Weeks)

• Cast Transition: You might switch from a full-leg cast to a below-knee cast.
• Knee Flexibility: Gentle knee bending exercises to start strengthening the quadriceps.
• Gait Training: Begin re-educating your walking pattern.
• Progressive Weight Bearing: Gradually increase weight on the leg, guided by pain tolerance.
• Overall Fitness: Engage in upper body and general fitness activities.

Advanced Stage (6 to 12 Weeks)

• Comprehensive Checkup: Around the 8-week mark, expect more X-rays or a review of any surgical hardware.
• Aim for Full Weight Bearing: Typically between 10 to 12 weeks, aim to fully bear weight on the leg.
• Active Rehabilitation: Encourage active movement and exercises from week eight onward.
• Joint Mobility: Focus on enhancing both knee and ankle flexibility.
• Balance and Tone: Work on improving balance and muscle tone, which are critical for long-term recovery.

Water-Based Exercises

Aquatic Therapy: Exercising in a pool can lessen gravitational stress while providing resistance.

Workout Suggestions:

• Perform jumping jacks in shoulder-deep water.
• Practice leg kicks while holding the pool’s edge.
• Use a kickboard to swim across the pool.
• Jog in water with a weighted belt, ensuring you remain upright.

Low-Impact Cardio

• Stationary Cycling: This can enhance muscle strength, flexibility, and joint support, while helping to minimize pain. Ensure you consult your therapist to confirm it’s suitable for your recovery stage.

Each phase of this program is designed to carefully reintroduce activity, promote healing, and enhance functional recovery. Always adhere to personalized advice and adjustments provided by your physical therapist based on your individual condition.

Physical therapy

After removing the cast or splint, the child will likely need physical therapy to reduce stiffness and restore movement in the leg. Since the child has not moved the leg for a while, he or she may experience stiffness and weakened muscles in the areas that were not injured. Physical therapy will help in this case, but it can take several months or more before severe injuries are completely healed.

A physical therapist plays a crucial role in this recovery process by designing a personalized exercise program. Initially, they will focus on manual exercises to gently move the ankle, bend and straighten the knee, and stretch the calf and Achilles tendon. These movements are slow and controlled, aiming to gradually improve flexibility and mobility.

As the child’s range of motion improves, the therapist will introduce strengthening exercises like leg lifts, one-legged wall squats, and leg curls. These exercises help rebuild muscle strength and support joint stability. Incorporating aquatic therapy helps. Exercising in a pool reduces the impact of gravity, allowing for movements like jumping jacks, leg kicks, and jogging in water.

This environment provides resistance while minimizing strain on the healing leg. Additionally, using an exercise bike may enhance muscle strength and flexibility, aiding in faster recovery. However, it’s essential to consult the physical therapist to ensure this activity is suitable for the child’s specific condition. Throughout the rehabilitation journey, the therapist’s guidance is indispensable, ensuring exercises are performed safely and effectively, and adjusting the program as needed to match the child’s progress.

Recommended Strengthening Exercises for Tibia Fractures

Recovering from a tibia fracture requires a well-structured exercise program to help rebuild strength and improve mobility. Here are some effective exercises commonly recommended for this purpose:

1. One-Legged Wall Squats

Focus on utilizing your body weight to gently strengthen the leg muscles. Stand a comfortable distance from the wall and slide down into a squat position using only the affected leg for support. Hold the position briefly before returning to a standing position.

2. Leg Lifts

Leg lifts are essential for improving muscle tone and flexibility. Lie on your back with your uninjured leg bent for support. Slowly lift your injured leg, keeping it straight, to engage the thigh muscles. Lower carefully and repeat.

3. Leg Curls

For leg curls, lie face down and bend your injured leg at the knee. This exercise targets the hamstrings, enhancing the back of your leg’s strength. Elevate your leg and then slowly bring it back to the starting position.

Tips for Success:

• Consult a Professional: Always check with a physical therapist or healthcare provider before starting any exercise regimen to ensure it’s appropriate for your condition.
• Start Gradually: Begin with low-intensity exercises and progressively increase the effort as your strength and confidence improve.
• Listen to Your Body: Pay attention to what your body is telling you to avoid overexertion or injury.

Incorporating these exercises into your recovery routine can significantly aid in restoring your leg’s strength and function after a tibia fracture. Remember, patience and consistency are key in the healing process. By blending these exercises with patient guidance, the physical therapist plays a crucial role in restoring the child’s leg functionality. This comprehensive approach ensures that not only is movement restored, but the leg is fortified against future injuries.

Recovery Timeline for a Snapped Tibia or Fibula

Recovering from a fractured tibia or fibula generally requires a dedicated timeline. Here’s what you can expect:

• Standard Healing Period: Typically, it takes about six to eight weeks for these bones to heal. This timeframe allows the bone to mend completely and regain strength.
• Post-Surgery Recovery: If surgery is involved, the recovery might extend up to 12 weeks. This extra time is crucial for allowing the body to adjust and the surgical site to heal.
• Beginning Rehabilitation: Rehabilitation often begins after the initial six to eight weeks or post-surgery healing period. This stage is essential for restoring mobility, flexibility, and overall strength.

Managing Recovery Expectations

During the recovery period, pain is likely to diminish before the fracture is solid enough to handle normal activities. It’s important to follow your healthcare provider’s advice on movement restrictions, even after your cast or brace is removed.

Additional Recovery Considerations

• Mobility Aids: If you have a splint or cast, crutches or a cane might help keep weight off the affected leg for six to eight weeks or more.
• External Fixation Devices: In some cases, doctors may use an external fixation device for about six to eight weeks.

Factors Affecting Recovery Time

Recovery can vary based on several factors, including:

• Severity of the Fracture: More severe breaks may require longer healing times.
• Age and Health: Younger individuals and those in good health may recover faster.
• Complications: Infection or additional injuries could extend recovery periods.
• Underlying Conditions: Conditions such as diabetes, obesity, or smoking can influence healing.

Consult your healthcare provider for a recovery plan tailored to your specific needs and circumstances. However, several other elements can also impact how quickly you heal from a broken leg:

• Age: Younger individuals often heal faster than older adults.
• Additional Injuries: If other injuries occurred at the same time, they could complicate your recovery process.
• Infection: An infection can delay healing and may require additional treatment.
• Underlying Health Conditions: Conditions not directly related to your broken leg can also play a role. These include:
  • Obesity: Excess weight can put additional stress on your healing leg.
  • Heavy Alcohol Use: This can impair bone healing.
  • Diabetes: It might slow down recovery due to circulation issues.
  • Smoking: Smoking is known to significantly hinder the healing process.
  • Malnutrition: Proper nutrition is crucial for bone repair and overall recovery.

Understanding these factors can help you manage expectations and collaborate effectively with your healthcare provider to optimize your recovery plan. Always consult healthcare providers for personalized recovery plans.

How to Reduce a Child’s Risk of Sustaining a Broken Leg

Here are some tips that you can use to reduce your child’s risk of having a broken leg:

• Discourage your child from participating in very risky activities that put him or her at risk of a serious fall or accident.
• Ensure the child has a good balance before riding a bike or scooter. The equipment must also be in good condition and must be the right size for the child. Ensure the child wears a helmet whenever he or she rides a bike or scooter.
• Don’t encourage the child to spend too much time watching TV, playing computer games, or engaging in sedentary activities.
• Ensure the child eats a healthy diet that is low in fat, and high in protein, fiber, calcium, and vitamin D.
• The child must wear the right safety gear while participating in organized sports.
• Encourage your child to participate in weight-bearing physical exercises like walking, dancing, and running.
• Encourage the child to cross-train and also take time off to recover; this reduces the child’s risk of a stress fracture.

How Medical City Children’s Orthopedic and Spine Specialists Care For Broken Legs

The board-certified pediatric orthopedic surgeons and fellowship-trained physicians at Medical City Children’s Orthopedic and Spine Specialists treat children, adolescents, and young adults who have fractures of all complexities. Our expertise gives room for the accurate diagnosis of problems that relate to the growing musculoskeletal system. We will develop optimal care plans that will ensure that your child’s specific condition is catered for.

A broken leg can significantly affect both your mobility and daily lifestyle. Initially, you’ll experience a substantial decrease in your ability to move around, which may require reliance on crutches, a wheelchair, or a walker. This alteration in mobility can disrupt everyday tasks, making activities like walking, driving, or even climbing stairs more challenging. Beyond physical constraints, there’s an emotional dimension to consider. The sudden loss of independence can impact your mental well-being, leading to frustration or even feelings of isolation, especially if social activities are limited.

However, with prompt and proper treatment, including physical therapy and consistent rehabilitation exercises, many individuals can regain full function. Recovery may take weeks to months, but the goal is often to return to your normal lifestyle and physical capabilities. During this period, adapting your home environment to make it more accessible and engaging in low-impact activities can help maintain a sense of normalcy.

Finally, we offer personalized treatment and urgent pediatric care services at all of our four locations — Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX. If you notice any symptoms of a broken leg in your child, don’t hesitate to contact us to avoid complications.

____________________

Footnote:

Healthline: Broken Leg