What Is It?
Whenever a bone breaks or cracks, the injury is called a fracture. The leg has three bones that can fracture — the femur (the thighbone) and the tibia and fibula in the lower leg. When a fracture involves the knobby end portions of bones that are part of the hip, knee and ankle joints, the fracture is more complicated. This article describes only fractures of the straight shafts of the three long leg bones.
Femur fractures have the potential to cause dangerous, sometimes life-threatening complications, such as significant bleeding inside the thigh, with blood loss of one quart or more. A femur fracture also may cause blood clots to form within the large veins of the thigh. If these clots break free and travel through the bloodstream, they may eventually lodge in the lungs, creating a life-threatening condition called a pulmonary embolism.
Among children, femur fractures tend to happen because of a fall from a high place, such as a tree or the top of a slide. In adults, these injuries usually are related to motor vehicle accidents (either as a passenger or pedestrian) or to on-the-job trauma. The number of femur fractures caused by gunshot wounds has risen significantly in recent years.
Of all the body's long bones, the tibia is the most likely to be fractured and the most likely to break through the skin when it fractures. This greatly increases the risk of bacterial contamination and infection at the fracture site. It also may prevent normal healing. The sharp ends of a broken tibia can cut into nearby nerves and blood vessels and cause serious damage to soft tissues inside the lower leg.
In 75% to 85% of patients with tibia fractures, the fibula (the thin bone at the outer side of the lower leg) is fractured as well.
When only a fibula fractures, it usually does not cause long-term complications. Rarely, when the segments of broken bone are separated significantly by the injury, one of the nerves to the foot may be injured, causing foot drop, a condition in which the foot hangs limp at the ankle and drags on the ground during walking.
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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.
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