Dealing With Broken Legs

As someone who has never experienced fractured femurs, I'm a bit of a loss on what to do once you get them.

(Trying to write a badass who can actually deal with it.)

So is it safe to assume that one will not be able stand and walk or can some form of splinting allow walking with broken legs?

Is the pain intense enough to distract or can it be managed and ignored?

Lastly, how long does it take to heal? Not at a hospital and in the wilds, what would the patient's chances of making a full recovery be?

If you're talking specifically about the femur (the single large bone in the thigh) as opposed to one or the other of the tibia and fibula (the two smaller, paired bones in the shin), and a complete break, not just a crack or a fracture) no, he aren't going to be walking on it, no matter how tough the character is.

This is a simple matter of physics: You walk by contracting the muscles attached to the front of the femur to lift the leg, then contracting the muscles attached to the rear of it to extend the leg.

Think of it as working sort of like a lever, only there's a rope attached to the top of one end to pull it up and a rope attached to the other end to pull it down, and those ropes are the only way to move the ends.

Now, break the board that forms the lever. The rope that pulls up will only lift the end it's attached to. The rope that pulls down will do the same thing, on the other end. The whole lever won't change position — only one end of it will. The other end will stay in the same position. Same thing with a broken femur. The muscles will pull on the bone where they're attached, and that end of the bone will move, but the whole bone won't.

Now add in the fact that you aren't dealing with an insensate board, but a system full of nerves that are going to be firing off pain signals, and you've got "Nope, he's not going anywhere until it's (at the very least) splinted solidly. And even that will still hurt like a sonofabitch."

Healing time? Four months of no weight-bearing seems to be about the absolute minimum, from what I can find. The more he moves around, the longer it will take, and the more likely it is that he will acquire a permanent limp, possibly severe.

edited 31st Jul '12 9:55:15 AM by Madrugada

It would all depend on the extent of the injury.

Is it 'just' a hairline crack of the bone? If so, I'd imagine it would be possible though painful to weight bear; depending on the person's pain tolerance and determination to walk. But if the entire bone has been transected (i.e. it's in two pieces), it would be next to impossible since the structural integrity of the limb has been destroyed as the two pieces probably are no longer aligned properly.

Also to consider is if there has been damage to the muscles overlaying the bone. The trauma that broke the bone might also have damaged the muscle; which would affect a person's ability to walk.

As for splints, while they may provide some added weight-bearing support, their main purpose is to immobilise the fracture to prevent misalignment as the bone heals.

Which leads to the final question. Bones can heal over time. The trouble is to ensure that the bone heals up correctly and that is done by ensuring that the bone is aligned correctly with lengthening or shortening of the limb. As for how long, bad breaks tend would be in the order of months and some may never fully recover (especially if there have been the aforementioned misalignment).

Hope this helps.

By the way, this looks like a good overview.

While I unfortunately can't answer the questions about pain levels and mobility, I can give some input on healing time. When I broke my tibia (open fracture), it took roughly two months to heal fully. Granted, this was with medical care (including casts and no less than two surgical operations).

EDIT: Dang, didn't notice you said "femurs" in the OP.

edited 31st Jul '12 11:10:52 AM by DoktorvonEurotrash

• Thank you all for the posts.

Okay, how about just one broken leg?

Would a badass Rambo type be able to perform some sort of gung ho field first aid and/or surgery before he crawls back to base for proper mediacal care?

I'm imagining (for a relativelty simple clean fracture) something like a few hits of morphine, some disassembled rifle barels and a pulley to wrench the leg into positon before strapping the leg still with a dozen belts or so.

Sound plausible or utter bunk?

edited 1st Aug '12 9:13:41 AM by Natasel

Lower leg bone, clean simple break? Yes, he could conceivably splint it and get back to base. He might even be able to walk (well, sort of hop) rather than crawl if he can fashion a sturdy enough crutch-analogue. He'll be in a lot of pain, and it will be slow, but it can (and has) been done in real life.

Hey wait, if there was a wheel chair, would it help?

It rolls so not as much jostling, you can use arms instead of legs, and that's where you'll end up in after the docs fix you anyway.

Sticking wheels to a chair an even better idea than splinting?

Wheelchairs would significantly impede the type of terrain he'd be able to traverse through - hence the big hullabaloo about making public buildings wheelchair accessible in RL.

Instead, I think crutches are your best bet. It's highly improvisable. For instance, one badass thing he could do is fashion a pair of crutches by using two big, bulky anti-tank rifles. And when a bad guy shows up, he just points one of said guns to blow them away.

. .... screw reality. I have got to find a way to work that in somehow.

Yes, wheelchairs are only practical on smooth surfaces.

Anti-tank crutches is my new favorite mental image.

He's a corpse.

Seriously. The femur is full of marrow and right next to a humungous artery. His odds of bleeding to death (assuming a shard of bone doesn't nick the artery and kill him within four minutes or so) or dying of infection if he doesn't get to hospital are very high.

A guy I knew cracked his femur and died of septicaemia two days later.

edited 3rd Aug '12 3:27:09 AM by InverurieJones

Never mind. Idiot post.

edited 3rd Aug '12 7:56:07 AM by Natasel

^^ Indeed. When my father broke his femur in two some 15 years ago (playing local league softball, he slammed into another outfielder) he lost something on the order of 1 full unit of blood and the bone never pierced the skin. He had headaches for almost two months after coming out of the hospital because of it.

So yeah, breaking that bone is a serious blood loss concern.