Leg Injury

Symptoms

DEFINITION

• Injuries to leg
• Injuries to a bone, muscle, joint or ligament

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Types of Leg Injuries

• Fractures (broken bones)
• Dislocations (bone out of joint)
• Sprains - stretches and tears of ligaments
• Strains - stretches and tears of muscles (e.g., pulled muscle)
• Muscle overuse injuries from sports or exercise (e.g., shin splints of lower leg)
• Muscle bruise from a direct blow (e.g., thigh muscles)
• Bone bruise from a direct blow (e.g., hip)

Pain Severity Scale

• MILD: doesn't interfere with normal activities
• MODERATE: interferes with normal activities or awakens from sleep
• SEVERE: excruciating pain, unable to do any normal activities, incapacitated by pain

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See More Appropriate Topic (instead of this one) If

• Involves toe, see FINGER OR TOE INJURY
• Only has cuts, scrapes, or bruises, see SKIN INJURY

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If

• Serious injury with multiple fractures
• Major bleeding that can't be stopped

Call Your Doctor Now (night or day) If

• You think your child has a serious injury
• Looks like a broken bone or dislocated joint
• Large swelling
• Skin beyond the injury is pale or blue
• Skin is split open or gaping and may need stitches
• Age under 1 year old
• Bicycle spoke or washing machine wringer injury
• Pain is SEVERE (and not improved after 2 hours of pain medicine)
• Won't stand or walk
• Has a limp when walking
• Unable to move leg normally
• Joint nearest the injury can't be moved fully (opened and closed)
• Knee injury with a "snap" or "pop" felt at the time of impact

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think your child needs to be seen
• Pain not improved after 3 days

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• No tetanus shot in over 5 years for DIRTY cuts (over 10 years for CLEAN cuts)
• Pain lasts over 2 weeks

Parent Care at Home If

• Bruised muscle or bone from direct blow
• Pain in muscle (probably from mild pulled muscle)
• Pain around joint (probably from mild stretched ligament)

Care at Home

HOME CARE ADVICE FOR MINOR LEG INJURIES

1. Treatment of Pulled Muscle, Bruised Muscle or Bruised Bone:
   • Reassurance: Bruised muscles or bones can be treated at home.
   • Pain: For pain relief, give acetaminophen every 4 hours OR ibuprofen every 6 hours as needed. (See Dosage Table). Ibuprofen is more effective for this type of pain.
   • Local Cold: For bruises or swelling, apply a cold pack or ice bag wrapped in a wet cloth to the area for 20 minutes per hour. Repeat for 4 consecutive hours. (Reason: reduce the bleeding and pain)
   • Local Heat: After 48 hours apply a warm wet washcloth or heating pad for 10 minutes three times per day to help absorb the blood.
   • Rest: Rest the injured part as much as possible for 48 hours.
   • For pulled muscles, teach your youngster about stretching exercises and strength training.
2. Treatment of Mild Sprains (stretched ligaments) of Ankle or Knee:
   • First aid: immediate compression and ice to reduce bleeding, swelling, and pain.
   • Treat with R.I.C.E. (rest, ice, compression, and elevation) for the first 24 to 48 hours.
   • Apply compression with a snug, elastic bandage for 48 hours. Numbness, tingling, or increased pain means the bandage is too tight.
   • Apply a cold pack or ice bag wrapped in a wet cloth to the area for 20 minutes per hour. Repeat for 4 consecutive hours.
   • Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief. Continue for at least 48 hours.
   • Keep injured ankle or knee elevated and at rest for 24 hours.
   • After 24 hours, allow any activity that doesn't cause pain.
3. Expected Course: Pain and swelling usually peak on day 2 or 3. Swelling is usually gone by 7 days. Pain may take 2 weeks to completely resolve.
4. Call Your Doctor If:
   • Pain becomes severe
   • Pain is not improving after 3 days
   • Pain lasts over 2 weeks
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Photo Example

Ankle Sprain

This ankle sprain occurred while playing basketball. There is visible swelling of the outside (lateral aspect) of the left ankle.

First Aid Care Advice for Ankle Sprain:

• Wrap with a snug elastic bandage.
• Apply an ice pack (crushed ice in a plastic bag covered with a towel) to reduce swelling and pain.

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First Aid - Splint for Ankle Injury

• Wrap a large soft pillow around ankle and foot (Reason: to support ankle and foot and keep bones from moving around).
• Use tape to hold the pillow in place.

First Aid - Bleeding Leg

• Apply direct pressure to the entire wound with a sterile gauze dressing or a clean cloth.

First Aid - R.I.C.E.

RICE is an acronym for how to take care of a sprain, strain, or bruise. There are four things you should do:

• REST the injured part of your body for 24 hours. Can return to normal activity after 24 hours of rest if the activity does not cause severe pain.
• Continue to apply crushed ICE packs for 10-20 minutes every hour for the first 4 hours. Then apply ice for 10-20 minutes 4 times a day for the first two days.
• Apply COMPRESSION by wrapping the injured part with a snug, elastic bandage for 48 hours. If numbness, tingling, or increased pain occurs in the injured part, the bandage may be too tight. Loosen the bandage wrap.
• Keep the injured part of the body ELEVATED and at rest for 24 hours. For example, for an injured ankle, place that leg up on a pillow and stay off the feet as much as possible.