A broken lower leg fracture, also known as a lower leg fracture, is a break in the shin bone (tibia), i.e. a shin fracture, a fracture of the fibula (calf bone), or a fracture of both bones. Lower leg breaks with complicated shin bone fractures or breaks close to the joint are usually treated surgically. Such fractures are fixed with plates, screws or nails, while simple shin or calf bone fractures are treated with a plaster cast.
Overview of lower leg fractures
The lower leg consists of two bones: the thicker of the two is the shin bone (tibia), and the thinner is the calf bone (fibula). A lower leg fracture involves either the tibia, the fibula or both bones. Lower leg fractures often affect children, adolescents and athletes, and are frequently caused by falls, for example, while skiing or playing football. Other common causes include twisting, physical force or traffic accidents. In addition to children, young people and athletes, older people are also often affected by lower leg fractures. An injury or fracture can occur particularly quickly, especially if you have osteoporosis.
Treatment goal
The aim of a lower leg fracture surgery is to restore the bone to its original position. Surgery is performed to create a stable connection, helping the individual fragments to grow together correctly and restore the leg’s functioning. Surgery also aims to avoid any shortening, misalignments or axial deviations.
Surgical procedure
A basic distinction is made between open and closed fractures: in the case of a closed fracture, the skin is not injured and the broken parts of the bone are not visible. In the case of an open fracture, there is an injury to the skin and at least one area in which parts of the bone are directly visible.
For conservative treatment of a broken fibula, tight bandaging is usually sufficient. Only rarely is a cast or even surgery necessary. A broken shin bone, on the other hand, is only treated with a plaster cast or surgery.
A plaster cast is used for simple, uncomplicated shaft fractures. Open fractures and particularly complicated fractures (several fragments, displaced fractures) and periarticular fractures (tibia head fracture) require surgery. Lower leg fracture surgery can be carried out under general anaesthesia or spinal anaesthesia.
With osteosynthesis, the bone fracture is exposed by incisions to the skin and muscle and, depending on the type of fracture, straightened and stabilised using intramedullary rods, metal plates, metal screws or an external frame (external fixation). Injured ligaments, tendons and muscles are also treated and stitched. The surgical wound is then closed. Depending on the procedure selected, the intervention takes between one to two hours.
Preparation and precautions
Before the surgery, an X-ray examination is carried out to determine the extent and scope of the injury. In some more complex cases, computed tomography can also be used to assess the fracture in greater detail. In addition, your doctor will carry out the standard checks before the intervention, including a blood test, blood pressure measurement and an ECG.
Blood-thinning medications must be discontinued in advance in consultation with the attending doctor. In addition, it’s important that the patient has fasted before the intervention – this means that the patient is not allowed to eat for at least six hours before the intervention and cannot drink for two hours before the procedure.
Aftercare and recovery
Aftercare and recovery from a broken shin bone
It takes several weeks to months to heal from a fractured shin. After the fracture is surgically repaired, the leg must be immobilised for some time. Often, the leg is immobilised with the help of a cast or brace to ensure a straightforward healing process and prevent misalignment.
Targeted exercises are used to move the knee and ankle joints while lying down and to stretch the muscles. From the second day after the surgery, partial weight-bearing exercises are practised with walking aids. Full weight-bearing is generally possible after six to eight weeks. Through our regular follow-up examinations, we ensure an optimal healing process.
Aftercare and recovery after a calf bone fracture
A broken fibula usually heals without complications in about six weeks. For simple fractures, six weeks of immobilisation with a plaster cast is sufficient in most cases. Surgery to stabilise the bone is necessary only in severe cases.
While most patients fully recover from a broken fibula after just a few months with accompanying physiotherapy, athletes who place heavy strain on their legs need around six months of healing before full weight-bearing is achieved.
Potential complications
Lower leg fractures generally heal well after surgical stabilisation and fixation of the fractures.
Surgery also enables early mobilisation, which prevents complications such as thrombosis or muscle breakdown. As with all surgeries, however, certain risks cannot be completely excluded: infections, nerve injuries, post-operative bleeding or blood clots can occur in rare cases. In isolated cases, pseudoarthrosis of the knee or ankle may also occur. However, targeted and early physiotherapy exercises can prevent most potential surgery complications.
Questions about the treatment of a lower leg fracture
Does a lower leg fracture always have to be operated on?
No. Although a fracture of the lower leg is usually associated with severe pain, it does not necessarily lead to surgery. A lower leg fracture can often be treated conservatively. Surgery is only required for open fractures, particularly complicated fractures and periarticular fractures (tibia head fracture). In contrast to a shin fracture, a calf fracture can usually be treated conservatively.
How can you tell if your calf bone is broken?
A calf bone break often manifests as severe pain, swelling and problems with bearing weight in the lower leg. Pain when applying pressure to the bone can also indicate a fractured calf bone.
Can you still walk if you have a broken calf bone?
Since the shin bone bears most of the weight, walking is sometimes still possible even with a broken calf. However, this often results in severe lower leg pain.
What causes a lower leg fracture?
Lower leg fractures are often caused by twisting, falling or direct force. Severe strain can cause the bone to eventually break. Osteoporosis can also lead to a fracture of the lower leg.
Healing period for a lower leg fracture: how long does it take to heal?
It takes around six to eight weeks for a calf or shin fracture to heal and return to full weight-bearing. In the case of conservatively treated fractures and complex, surgically treated injuries, full healing tends to take longer than in the case of simple fractures.
