We welcome you to Excelsior Physiotherapy’s information resource page on lower leg fractures.  

What Is Lower Leg Fracture?

This guide will help you understand the lower leg fractures that occur between your ankle and knee. The fracture of the lower end of two different bones fibula and tibia belongs to the ankle fracture category, while the tibia’s upper end causes knee fracture. As the tibia bone is the largest one, it is prone to injuries like fractures when it gets bent or twisted with force. So, this type of long bone fracture is commonly found in adults. It also has several complications like nonunion of bones, not healing well, and more, which indicates you need perfect care from reputed orthopaedic surgeons. Sometimes, the fibula, the tiny bone close to the tibia gets broken too, which acts like the muscle’s anchor point and doesn’t bear body weight. 

This informative guide will focus on:

• Parts of the lower leg 
• Symptoms to look out
• Causes of fractures
• Diagnosis of fractures by professionals 
• Treatment options 
• Excelsior Physiotherapy Rehabilitation Approach  

Anatomy 

Commonly Injured Structures 

Tibia looks like a trumpet that is inverted with a shaft shaped like a triangle with its inner part on the front covered by skin. Tibia is surrounded by muscles and the jagged end of it is prone to open fractures, as it doesn’t have many muscles to cushion it. The nerves and blood vessels lie close to this bone, which means the blood supply and nerve supply might get damaged during the open fractures. 

Causes of Lower Leg Fractures

• Tibia and fibula can break due to forceful leg impact, twisting or bending with force or compression.
• When the outer leg side experiences a direct blow, fibula breakage is possible, without hurting the tibia, which is rare. 
• Tibia’s isolated fracture is a common fracture that causes both bones to break. 
• Bone fractures also cause damage to your skin, nerves, ligament, tendon, and muscles surrounding it. 
• Though the damage to soft tissues might not be visible on X-rays, it can cause severe swelling and pain at the site of injury and delay the healing process. 

Types of Lower Leg Fractures

• Various fracture patterns related to the fibula and tibia are based on varied types of injury. A direct impact or bending force might cause oblique fractures. 
• Spiral fractures and compression due to twisting with force might lead to transverse fractures. 
• If your lower leg undergoes tremendous force, then it causes multiple fragments called comminution or comminuted fracture.
• Displacement of bone fragments during a fracture might push one or two out of the skin leading to an open fracture.  
• Tibia fractures can also be caused during MVAs or road collisions with high force.
• The leg might get fractured when working with heavy machinery, which might cause major injury to arteries, nerves, tendons and muscles. 
• Sports injuries during tobogganing, contact sports, and skiing might also cause lower leg fractures. 
• Elderly people might fall due to old age, which might cause shin bone fractures, as their bones will be fragile. 
• On rare occasions, pathological fractures are induced by the accumulation of deposits in the bone. 

Symptoms of Lower Leg Fractures

• The feeling of intense pain immediately at the fracture site, which gets worse with slight movement. 
• The leg is bent or twisted causing deformity and wound when bone pierces through skin. 
• Leg gets swelled up quickly and a significant amount of bruising occurs as soon as the fracture occurs.
• Feeling cold or numb in the feet due to injury to the arteries or nerves. 
• Feeling weakness and stiffness when trying to move ankle joints and knee due to soft tissue injury. 
• If metal implants are used for treating fractures, you might feel cold intolerance, aches, and tenderness until it is removed. 

Evaluation of Lower Leg Fractures

• Giving first aid treatment at the accident site includes keeping the injured warm, splinting the fractured leg, and transporting them to a nearby hospital. 

• Assessment must be made to check for dressing wounds, and feet numb feet and straighten the leg if injured badly. 
• In the emergency room, the focus must be on relieving the patient from shock through treatment, checking for other injuries, and getting x-rays of the knee and ankle for fracture evaluation.
• When the isolated shaft fracture is diagnosed, it can be treated by an emergency doctor and later on by a family physician. 
• Tibia shaft fracture will be usually dealt with by an orthopaedic surgeon.  
• An orthopaedic assessment will help evaluate the patient’s medical status, and anaesthesia risks, if any. 
• Assessment of patient medical history and general health parameters is essential. 
• Careful limb examination for vascular loss, neurological issues, skin issues, blisters and wounds is performed. 
• X-ray review for treatment module determination. 
• The treatment plan for lower leg fractures will be determined based on the patient’s health, mobility range, activity level, occupation and fracture level. 
• An unstable fracture will rotate, angulate, or shorten, demanding the need for surgery and treatment. 

Excelsior Physiotherapy’s Treatment for Lower Leg Fractures

Which Treatments Can Be Considered?

Fibula’s isolated fracture might be treated using protection cast to heal the bone without any disturbing factors. Some might be recommended to use crutches for a couple of weeks. 

Though your orthopaedic surgeon would tell you that such lower leg fractures should be treated with surgical options, studies reveal that healing fracture is possible with alignment. If there is no clarity about the outcome of surgery, it is better to avoid it. 

The treatment for lower leg fractures differs based on the pattern of injury, expectations, and the patient’s medical condition.   

Non-surgical Treatment Options for Lower Leg Fractures 

• Cast treatment will prove useful if you have a stable spiral fracture pattern and no other serious injuries while the patient is strong enough to withstand the weight of the cast. 
• These casts are later removed and changed once in six weeks based on the x-ray study. Sometimes, a brace or shorter cast will be used if the healing is quick. 
• Open fractures demand you to clean and irrigate the wound every day to speed up healing and prevent infection. 
• If you have an open fracture and an internal fracture, then a compromise approach will be followed to wait until the open fracture gets healed well. It might also demand surgery for correction. 
• Surgical treatment options will include plate fixation internally or open reduction or fixing intramedullary rods based on the type of fracture. 

Rehabilitation After Lower Leg Fractures 

If you are facing immobility due to a lower leg fracture, our physiotherapists at Excelsior Physiotherapy will help you soon after your cast or brace is removed. Whatever type of fracture you had or whichever cast or brace you have worn, it is essential to go through an extensive rehabilitation program after a lower leg fracture to maintain a good range of motion and support knee strength to bear body weight in the long run. 

Customized Rehabilitation Program

If you underwent surgery to correct the lower leg fracture, then avail of physiotherapy treatment in Sherwood Park by Excelsior Physiotherapy to begin your customized rehabilitation program right away. We recommend using an upper-body bike if your knees are ready to bear body weight. If you are wearing partial braces and can bear partial body weight, then we will suggest you use the stationary bike with braces on. At Excelsior Physiotherapy, we also suggest you use weights during exercise for strengthening your other legs and upper body.  Our physiotherapists in Edmonton will also design a specialized treatment plan for maintaining general fitness while helping you recover quickly from fractures. 

Gait Stabilizing Treatment

If using crutches, our physiotherapist in Sherwood Park would help you use them with ease and confidence while catering to your weight-bearing ability. We also train you to use it effectively even when climbing stairs. Our physiotherapy treatment for lower leg fractures will also include gait re-education to walk without any limp. We also help you walk using a walking stick, cane or a single crutch if needed to correct your walking style and treat improper gait. If experiencing pain after the removal of the brace or cast, our physiotherapists will help ease the pain arising out of the joints that remained immobile due to the cast. 

Our Treatment Modalities

Excelsior Physiotherapy’s physiotherapy treatment in Sherwood Park will include the usage of treatment modalities like an electrical current, ultrasound, ice, and heat for assisting with lowering swelling and pain in the fracture area. We also offer massage treatments for lower leg fractures in Edmonton to enhance blood circulation and relieve pain. 

Regain Range of Motion    

The next treatment of Excelsior Physiotherapy will be improving your range of motion and enhancing the stability of your lower limb, foot, and ankle, as it will be extremely atrophied and weak due to immobility. Our physiotherapists will teach a series of strengthening and stretching workouts to practice both at our Edmonton clinic and at home. It includes using theraband and stationary cycle to give your lower leg a good amount of resistance. We will also teach you back and hip exercises to enhance the weight-bearing ability of your joints. 

Hands-On Physiotherapy Techniques

We will also utilize hands-on techniques to take care of the stiff joints in the lower leg, foot, and ankle while gradually improving their motion range. With just a couple of our physiotherapy treatment sessions in Edmonton you will be able to find visible differences while moving your knee or limb. Our physiotherapy treatment in Edmonton for lower leg fractures focuses on increasing muscle strength and promoting motion range to make sure that the rehabilitation program advances quickly while improving your body’s overall efficiency. 

Comprehensive Physiotherapy Treatments 

Generally, the stiffness and lack of strength that one experiences after a lower leg fracture will be healed with regular physiotherapy treatment offered by Excelsior Physiotherapy. Our one-on-one physiotherapy treatment in North Edmonton includes specific exercises for home, motion range enhancing activities and proprioception that will bring you close to complete recovery within a time frame of 3 to 6 months, even when the bone healing might take place for another 6 to 12 months, If you are still facing pain and swelling even after physiotherapy treatment, then get back to your surgeon to check whether the fracture site is healing well or any complications have developed.

Excelsior Physiotherapy offers physiotherapy services in Edmonton.

Complications of Lower Leg Fractures

You might face none or some of the complications mentioned below after a lower leg fracture. 

• Ankle or knee stiffness 
• FES or Fat Embolism Syndrome
• Infections at the surgical site or fractured site 
• Compartment Syndrome, which causes internal bleeding 
• Nonunion or non-healing of the bone 
• Malunion or bone healing in the wrong way like rotated, angulated or shortened 

All these complications might require surgery for correcting the misaligned bones or to correct their position to improve weight bearing, maintain balance while walking and have stable agility when performing regular activities. Some of these issues don’t require correction surgery but might need skin grafting or an internal frame to hold the bones together to heal well. Apart from such treatments, the surgeon might also recommend you continue physiotherapy treatments for the lower leg to quicken the healing process and get relief from pain. If the lower leg fracture is complicated and severe, it might take more than a year to heal, but you can stay assured of complete recovery at the end of the treatment. 

Summary 

The lower leg fracture generally affects your shin bones, fibula, and tibia, which might take several months to heal completely. Whether it is a simple fracture, an open fracture or a complicated one inflicting damage to blood vessels, tissues and nerves, timely treatment is important to save the life and limb of the patient. With Excelsior Physiotherapy’s physiotherapy treatment plans, bearing your body weight, weakness in knees and other joints, and range of motion can be improved gradually while helping you regain your confidence and mobility to return to normal life. When coupled with regular treatment and physiotherapy, recovering from a lower leg fracture quickly is possible.