Lower limb fractures
Understanding this condition
A fracture is a break in the continuity of a bone. In the lower limb, it can affect the femur (thigh), tibia or fibula (leg), ankle, or foot bones. Severity depends on the location, displacement, whether the fracture is open or closed (skin intact or not), and the patient's general condition.
Causes vary: a fall (particularly in elderly patients for femoral neck fractures), a road traffic accident, a sports injury, or an accident of daily life. In older patients, a simple fall may be sufficient due to bone fragility (osteoporosis).
Symptoms
Intense immediate pain, inability to bear weight on the leg, sometimes visible deformity (displaced or shortened segment), swelling, and bruising appearing within hours.
A fracture is almost always clinically evident. The diagnosis is confirmed by X-rays, sometimes supplemented by CT scan for complex fractures.
How can it progress?
An untreated or poorly managed fracture can heal in a poor position (malunion), cause joint stiffness, a limp, or even non-union (failure to heal). Intra-articular fractures that are not reduced progress to early osteoarthritis.
In elderly patients, an untreated femoral neck fracture is associated with loss of independence and a major vital risk. It is a surgical emergency.
Treatment options
Management depends on the type of fracture. For undisplaced and stable fractures: immobilisation with a cast or splint, rest, and monitoring. For displaced or unstable fractures: surgical fixation (plates and screws, intramedullary nails, or screws according to the case) which allows reduction and stabilisation of the fracture.
Management is urgent. A prompt consultation is necessary for the best guidance. Recovery always includes a rehabilitation phase.