Knee + Leg

Fractures

Overview

Fractures can vary greatly from a stress fracture to broken bones. Treatment varies from immobilization (such as a cast) to surgery to line-up the bone fragments and hold them in place. Symptoms of a fracture include:

Pain with weight bearing
Swelling and bruising
Tenderness to touch
Deformed or crooked appearance

If your child has a potential fracture, they should be examined by a doctor as quickly as possible. A child's bones heal quickly, and it is important that the bone receives the proper treatment before it begins to heal.

Tibia (Shinbone) Fractures

The tibia, or shinbone, is the most commonly fractured long bone in the body. A tibial shaft fracture occurs along the length of the bone between the knee and ankle. It typically takes a high energy force to cause this type of injury. Motor vehicle collisions, for example, are a common cause of tibial shaft fractures. In many tibia fractures, the smaller bone in the lower leg (fibula) is broken as well.

Learn more about tibia fractures.

Femur (Thighbone) Fractures

Fractures of the thighbone that occur just above the knee joint are called distal femoral fractures. Femur fractures often occur either in people whose bones are weak or people who have high energy injuries such as from a car crash. The breaks may extend into the knee joint and may shatter the bone into many pieces.

Learn more about femur fractures.

Stress Fractures

A stress fracture is a common sports injury caused by overuse. It occurs when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone causing a tiny crack called a stress fracture. More than 50 percent of all stress fractures occur in the lower leg.

Learn more about stress fractures.

Growth Plate Fractures

Because children are still growing, their bones are subject to a unique injury called a growth plate fracture. Growth plates are areas of cartilage located near the ends of bones. They are the last portion of a child's bones to harden and are particularly vulnerable to fracture. Approximately 25% of all childhood fractures are growth plate fractures. Because the growth plate helps determine the future length and shape of the mature bone, this type of fracture requires prompt attention. With proper treatment, most growth plate fractures heal without complications.

Learn more about growth plate fractures.

Diagnosis

X-rays are commonly used to evaluate fractures. Sometimes, stress fractures cannot be seen on regular x-rays or will not show up for several weeks after the pain starts. Occasionally, a computed topography (CT) scan or magnetic resonance imaging (MRI) will be necessary to further evaluate the injury.

Treatment Options

Treatment of fractures vary greatly,depending on the location, number of fragments, and how well the bones line up. The pieces of bone may line up correctly (stable fracture) or be out of alignment (displaced fracture). The skin around the fracture may be intact (closed fracture) or the bone may puncture the skin (open fracture).

Stress fractures are treated with rest and postponing the activity that caused the fracture for 6-8 weeks to allow the fracture to heal. If your fracture is more serious, your doctor may immobilize the fracture with a cast or brace and recommend rest. Surgery may be required for fractures with open wounds, many bone fragments, or a large degree of displacement. Surgery may also be needed for fractures that have not healed properly with nonsurgical treatment. Your doctor will talk with you about the best treatment option for you and your injury.

Physical Therapy

It may be important for you to avoid putting your full weight on your leg while healing. This may involve the use of a walker, crutches, or a wheelchair. You may also need to use a knee immobilizer or brace. Your doctor may recommend physical therapy to help you regain strength and to restore range of motion after immobilization.