HealthInfo Waitaha Canterbury
Treating a broken lower leg
Te whakarauora i te waewae kua whati
The way your broken lower leg will be treated depends on many different things, including:
- what type of break it is and whether the bones have moved or are unstable (meaning they could move)
- whether a bone has broken through your skin (an open wound)
- how old you are
- your job, hobbies and activities
- whether you have other injuries as well
- how good your overall health is.
You'll probably need surgery to put the broken bone back into the right place and hold it there until it heals. Occasionally, older people with less complex stable breaks (the bones do not move around) do not have surgery, but the broken bones are held in place in a cast while they heal.
Self-care for a broken lower leg
There are several things you can do to help your broken lower leg bone heal whether or not you're having surgery.
- If you smoke, stop smoking. Continuing to smoke will slow down how quickly you heal.
- Do not do any heavy lifting using your leg as this will increase your pain and slow your recovery. You'll probably need some time off work to let your leg recover.
- Take regular pain relief as recommended by your health professional. Seek advice from your general practice team if you still have pain while taking the recommended pain relief. Do not take extra pain relief that has not been prescribed for you.
- The more swollen your leg is, the more painful it will be. To reduce swelling, keep it raised (elevated) above the level of your heart whenever possible.
- Take care not to get the cast wet.
- Until the bone is fully healed, be very careful not to twist it. Twisting can make the bone rotate and heal incorrectly.
Getting help for a broken lower leg
It's very important to tell your nurse or doctor if your pain is getting worse despite taking pain relief. Increasing pain may be a sign that the swelling in your leg is pressing on nerves and blood vessels, which can cause permanent damage if it isn't treated.
If you are not having surgery
At first, your whole leg will be put into a cast (called a long leg cast) to hold the bones in the right place and stop them moving while they're healing. This cast usually starts at the base of your toes and goes up to the top of your thigh with your knee slightly bent.
You'll have this cast for at least six weeks before it's either removed or changed to a shorter cast or brace that lets you start to move your leg gently.
When you start walking again, you'll need to keep all weight off your leg and use crutches or a walker. It's very important to follow your doctor's instructions, as putting any weight on your leg can mean you do not recover well. You'll still have to take care of your leg once the cast comes off.
Sometimes, a break seems to be stable and is put in a cast, but as the swelling goes down the broken bones move apart and need surgery to put them back into place. For this reason, you'll have regular X-rays while your leg is in a cast to make sure the bones stay in the right place while they're healing.
Surgery for a broken lower leg bone
If you need surgery, it will be done by an orthopaedic (bone) surgeon. Exactly what surgery you have will depend on what type of break you have. Your surgeon will talk to you about exactly what it involves, the risks, benefits and how you're likely to recover.
Your surgery will involve some metal (usually a rod called an intramedullary nail with locking screws, or a plate and screws) to line up your bones properly and support them while they heal. It's possible the screws will be held together with clamps and rods outside your skin to stabilise the break. This is called external fixation, but it's usually a temporary measure until the swelling has gone down enough for surgery.
You'll probably spend two to three nights in hospital. Your leg will be in a cast or backslab (a half-cast that wraps around the back of your leg) for up to six weeks. After that, the cast will either be removed or changed to a shorter cast or a brace so you can start gently moving your leg.
Depending on how unstable your break is, you may need to keep all weight off your leg and use crutches or a walker when you start walking again. It's very important to follow your doctor's instructions, as putting any weight on your leg can mean you do not recover well. You may even need another operation to fix problems caused by putting weight on your leg too soon. You'll still have to take care of your leg once the cast comes off.
Recovery after surgery
You'll most likely need at least two weeks off work after surgery. Exactly how much time you'll need off depends on how bad the break is, what your job involves and whether there are any light duties you can do.
For example, if you're an office worker, you may just need 10 to 14 days off work. But if you're a manual worker, you may need 10 or more weeks off.
As you recover, you'll have regular appointments with your surgeon, and some X-rays to make sure your leg is healing well. You may also need some physiotherapy to strengthen your leg and get it moving again.
If you have external fixation, this will need to be removed once you've healed. If the metal inside you is causing pain or other problems, it will also need to be removed. Exactly when that happens depends on how bad your break was and how quickly your bones heal. Your surgeon will talk to you about this.
If you have any concerns about whether your leg is healing or about the cast, please see your general practice team.
Written by HealthInfo clinical advisers. Last reviewed July 2022.
Sources
Review key: HIHIL-240273
