What is a bone fracture?
A bone fracture is the medical definition for a broken bone.
Fractures are usually caused by traumas like falls, car accidents or sports injuries. But some medical conditions and repetitive forces (like running) can increase your risk for experiencing certain types of fractures.
If you break a bone, you might need surgery to repair it. Some people only need a splint, cast, brace or sling for their bone to heal. How long it takes to recover fully depends on which of your bones are fractured, where the fracture is and what caused it.
What are the symptoms of a bone fracture?
Symptoms of bone fractures include:
- Pain.
- Swelling.
- Tenderness.
- Inability to move a part of your body like you usually can.
- Bruising or discoloration.
- A deformity or bump that’s not usually on your body.
What causes bone fractures?
Bone fractures are almost always caused by traumas. Anything that hits one of your bones with enough force can break it. Some of the most common causes include:
- Car accidents.
- Falls.
- Sports injuries.
Sometimes you can fracture a bone without experiencing a trauma. Repetitive forces — like running or practicing a sport — can cause stress fractures. Similarly, repeating one movement or motion constantly over a long period of time can lead to overuse syndrome in your hands and arms. If you play an instrument or use your hands in the same way every day at work you’re more likely to develop a stress fracture.
Your risk of experiencing a fracture is greatly increased if you have osteoporosis. Osteoporosis causes more than one million fractures each year.
How are bone fractures treated?
How your fracture is treated depends on which type it is, what caused it and how damaged your bones are.
Immobilization
If your fracture is mild and your bones did not move far out of place (if it’s non-displaced), you might only need a splint or cast. Splinting usually lasts for three to five weeks. If you need a cast, it will likely be for longer, typically six to eight weeks. In both cases you’ll likely need follow up X-rays to make sure your bones are healing correctly.
Closed reduction
More severe breaks require a closed reduction to set (realign) your bones. During this non-surgical procedure, your provider will physically push and pull your body on the outside to line up your broken bones inside you. To prevent you from feeling pain during the procedure you’ll receive one of the following:
- Local anesthetic to numb the area around your fracture.
- Sedatives to relax your whole body.
- General anesthesia to make you sleep through the procedure.
After the closed reduction, your provider will put you in a splint or cast.
Bone fracture surgery
Some bone fractures require surgery. Depending on which type of fracture you have — and how badly your bones are damaged — there are few techniques your surgeon might use.
Internal fixation
Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. They usually perform what’s called an internal fixation, which means your surgeon inserts pieces of metal into your bone to hold it in place while it heals. You’ll need to limit how much you use that part of your body to make sure your bone can fully heal.
Internal fixation techniques include:
- Rods: A rod inserted through the center of your bone that runs from top-to-bottom.
- Plates and screws: Metal plates screwed into your bone to hold the pieces together in place.
- Pins and wires: Pins and wires hold pieces of bone in place that are too small for other fasteners. They’re typically used at the same time as either rods or plates.
Some people live with these pieces inserted in them forever. You might need follow-up surgeries to remove them.
External fixation
You might need an external fixation. Your surgeon will put screws in your bone on either side of the fracture inside your body then connect them to a brace or bracket around the bone outside your body. This is usually a temporary way to stabilize your fracture and give it time to begin healing before you have an internal fixation.
Arthroplasty
If you fracture a joint (like your shoulder, elbow or knee) you might need an arthroplasty (joint replacement). Your surgeon will remove the damaged joint and replace it with an artificial joint. The artificial joint (prosthesis) can be metal, ceramic or heavy-duty plastic. The new joint will look like your natural joint and move in a similar way.
Bone grafting
You might need bone grafting if your fracture is severely displaced or if your bone isn’t healing back together as well as it should. Your surgeon will insert additional bone tissue to rejoin your fractured bone. After that, they’ll usually perform an internal fixation to hold the pieces together while your bone regrows. Bone grafts can come from a few sources:
- Internally from somewhere else in your body — usually the top of your hip bone.
- An external donor.
- An artificial replacement piece.
After your surgery, your bone will be immobilized. You’ll need some combination of a splint, cast, brace or sling before you can start using it like you did before your fracture.
Complications of bone fracture treatment
Fracture surgery complications include:
- Acute compartment syndrome (ACS): A build-up of pressure in your muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage.
- Malunion: This happens when your broken bones don’t line up correctly while they heal.
- Nonunion: Your bones may not grow back together fully or at all.
- Bone infection (osteomyelitis): If you have an open fracture (the bone breaks through your skin) you have an increased risk of bacterial infection.
- Other internal damage: Fractures can damage the area around the injury including your muscles, nerves, blood vessels, tendons and ligaments.
What medications are used to treat bone fractures?
Over-the-counter NSAIDs like aspirin or ibuprofen can lead to bleeding and other complications after a surgery. Your surgeon will talk to you about the medications you can take to reduce pain after your surgery.
NSAID side effects
Side effects of NSAIDs include:
- Bleeding.
- Ulcers.
- Stomach pain.
- Bowel complications.
How long does it take bone fractures to heal?
How long it takes a bone fracture to heal depends on a few factors, including:
- What caused it.
- Which bone is broken.
- Which type of fracture it is.
- Which treatment(s) you need.
- Any other injuries you experienced.
Depending on which type of immobilization or surgery you needed to repair your fracture, you should be able to start moving again in a few weeks. More severe fractures can take a year or more to heal.
Talk to your provider or surgeon about what to expect while you’re recovering.
Contact your provider right away if you experience intense pain that doesn’t get better.
How are bone fractures diagnosed?
Your provider will diagnose a bone fracture with a physical exam and imaging tests. In some cases, this may be done in the emergency room if you’re admitted after a trauma.
If you’re taken to the ER, a team of providers stabilize you and treat your injuries in the order of severity, especially if some are life-threatening. After you’re stabilized, you will need imaging tests to confirm any fractures.
What tests are done to diagnose bone fractures?
You’ll need at least one of a few imaging tests to take pictures of your fracture:
- X-rays: An X-ray will confirm any fractures, and show how damaged your bones are.
- Magnetic Resonance Imaging (MRI): Your provider might use an MRI to get a complete picture of the damage to your bones and the area around them. An MRI will show tissue like cartilage and ligaments around your bones too.
- CT scan: A CT scan will give your provider or surgeon a more detailed picture of your bones and the surrounding tissue than an X-ray.
- Bone scan: Healthcare providers use a bone scan to find fractures that don’t show up on an X-ray. This scan takes longer — usually two visits four hours apart — but it can help find some fractures.
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