Cruris fracture

In a cruris fracture, or broken lower leg, both the tibia and the fibula are broken. A break of both bones means there is instability of the lower leg.

In addition to bone injury there is often also damage to the so-called soft tissues in a cruris fracture. These are the tissues that connect, surround and support the bone fragments. Think of damage to the skin and muscles or, in more severe cases, to blood vessels and nerve tissue. Especially in the case of an open fracture, where the broken bone pierces the skin and comes into contact with the outside air, there is always additional soft tissue damage.

How does a cruris fracture occur?

A cruris fracture is thus a combination of a fracture of the tibia and the fibula. This despite the fact that the tibia is a very thick and strong bone. A high-energy trauma is needed to break this bone. Often this involves a fall from height, a traffic accident or a direct blow or kick to the lower leg.

What are the symptoms of a cruris fracture?

A deformity of the ankle, often outwards, with pain or swelling at the fracture site are the most characteristic features of a cruris fracture. Due to the instability of the fracture it will not be possible to stand on the affected leg. In the case of an open fracture there is a visible wound at the fracture site and, due to soft tissue damage, there may be a sensory disturbance in the area below the fracture.

How is a cruris fracture diagnosed?

It is usually not very difficult to diagnose a cruris fracture. However, additional tests in hospital are always necessary to visualise the severity and location of the fracture. That examination also focuses on the presence and severity of soft tissue damage.

First an X-ray will be made to assess the fractures. If necessary, an additional CT scan or MRI scan is made. This gives more insight into soft tissue damage.

What does treatment of a cruris fracture look like?

A cruris fracture is usually unstable. As a result, the broken parts are unlikely to regain the same alignment as before the fracture on their own. In that case, surgery is necessary. To allow the broken bone fragments to heal well, they are often provided with fixation material during the operation.

This fixation material is a metal pin or plate with screws, depending on which bone fragment must be fixed. This method is also called 'internal fixation'. In severe injuries, including soft tissue damage, the surgeon is more likely to fix the bone fragments from the outside. This is called 'external fixation'.

The recovery time after surgery varies according to the fixation technique, the severity of the fracture and the severity of the soft tissue damage. In general, the affected leg may not be loaded in the first 6 to 12 weeks. In the period thereafter it is wise to work towards full load capacity under the guidance of a physiotherapist.