What are the most common type of fractures in the hip, knee, ankle, and foot that require physical therapy as part of the healing process?
Common Fractures of the Leg, Ankle, and Foot
A broken leg can be a painful and scary injury. It can lead to significant loss of function and may interrupt normal work and recreational activity. A leg fracture, if not properly cared for, may cause long-lasting impairments such as loss of range of motion (ROM) or decreased strength. Therefore, physical therapy after a fracture is often very important.
Many people wonder if a broken leg and a fractured leg mean the same thing. They do. If your doctor tells you that you have fractured your thigh bone, it means that your thigh has been broken.1
Leg fractures are almost always caused by trauma to the body. Falling, athletic injuries or motor vehicle accidents can all cause a bone in your leg to break.
Symptoms include, but are not limited to, pain, difficulty walking, bruising, discoloration and swelling, or an obvious deformity in the leg.2 If you suspect you have a broken leg, knee, ankle or foot, you must seek medical attention right away. Call your doctor or go to your local emergency department to get an accurate diagnosis of your problem and receive proper treatment. Failure to do so can lead to long-term disability and loss of function.
Initial treatment for a leg fracture includes reduction of the fracture and immobilization.2
Reduction is the process where the broken bones are put back into their correct position. This is often done manually, but a surgical procedure called an open reduction internal fixation (ORIF) may be necessary for severe fractures. Immobilization is the process of keeping the bones in place with the use of a cast or brace to ensure that proper healing takes place.
Once your fracture has sufficiently healed, you may be referred to a physical therapist to help improve your mobility and function. Your physical therapist can help you choose the right assistive device to help with walking during the early stages of healing if needed, and can guide you in the proper exercises to help improve strength and range of motion after a fracture.
Below is a list of common fractures that can happen in your lower body that often require physical therapy to restore functional mobility.
A hip fracture is the most common broken bone that requires hospitalization.3
Hip fractures usually occur in older adults and may be due to trauma like a fall. Occasionally, pathologic fractures (fractures that occur in a bone that is affected by cancer or bone metastases) or fractures that occur as the result of bone weakening (such as in osteoporosis), may occur.
Surgery is almost always necessary for treatment of a hip fracture, and the type of surgery depends mostly on the location and displacement of the fracture.
About half of hip fractures are treated with ORIF, and the other half are treated with an arthroplasty procedure.
Physical therapy involves improving hip range of motion and strength in order to improve walking and mobility.
A femur fracture usually requires a significant force or fall. The femur, or thigh bone, is the longest bone in the body and is very strong. It helps you walk, run and stand upright.
Trauma to the shaft of your femur may cause it to break, leading to significant pain and functional loss. Greater force is usually needed to break the femur than other bones in the leg.
Pain, loss of range of motion, and reduced strength after a femur fracture may affect the hip and knee, further compromising your mobility. Physical therapy is often needed after healing to restore full function.4
Tibial Plateau Fracture
A tibial plateau fracture occurs when the knee is subjected to forceful twisting during a trauma. The tibial plateau is the place where your shin bone and your thigh bone come together in your knee.
Occasionally, tibial plateau fractures require surgery.5
Since the tibial plateau is in the knee joint, significant loss of knee range of motion and strength often result from a fracture here. Physical therapy is usually needed to restore as much function as possible after the fracture has healed.
A tibia/fibula (tib/fib) fracture is a common fracture of the ankle bones.
The tibia (shin bone) and fibula (bone on the outside part of your ankle) are located in the lower leg and help form part of your ankle joint. Occasionally, just one of the bones, either the tibia or fibula, is broken.
If you have suffered a tib/fib fracture, you may require surgery.3
Physical therapy after an ankle fracture can often restore your strength, range of motion, and functional mobility to the level is was prior to your fracture.
A Jones fracture is a break in the fifth metatarsal of the foot.6 The fifth metatarsal is the long bone in your foot that connects to your pinky toe.
Usually, minor trauma such as running or jumping causes a Jones fracture. A Jones fracture is often considered a stress fracture, a type of fracture which is usually caused by repeated stress on a bone rather than a single traumatic injury.
After healing, your range of motion may be reduced and your gait may be affected. Commonly, physical therapy after a Jones fracture is helpful in restoring functional mobility especially with stress fractures, which tend to have a poorer prognosis than acute Jones fractures.
A Lisfranc fracture is a fracture and dislocation of the midfoot.7 The midfoot is the part of your foot between your ankle and your toes. Here, many of your foot bones come together to help your foot move properly.
A Lisfranc fracture can happen when you twist your foot during sports, especially when moving on uneven ground, or in a motor vehicle accident.
Minor Lisfranc fractures are treated with immobilization in a cast or walking boot, but many Lisfranc injuries require surgery.
A Lisfranc fracture is usually a painful injury that can result in substantial limitations in mobility and walking. Physical therapy after a Lisfranc fracture and dislocation is important to improve the strength and range of motion of your foot and ankle in order to restore you to your previous level of walking ability.
A Word From Verywell on Common Leg Fractures and Healing
Leg fractures are common, and many of these can result in long-term reductions in strength and mobility without physical therapy. Often times, however, working with a physical therapist allows people to return to their previous level of functional ability in time.