Fractures (broken bones)
Your health expert: Henry Maxwell, Consultant Orthopaedic Surgeon
Content editor review by Rachael Mayfield-Blake, September 2021
Next review due September 2024
A fracture is a broken or cracked bone. A fracture can be partial or the bone may completely break. Bone is able to repair itself. But for most fractures, you’ll need treatment to manage your pain and help the bone to stay in the right position while it heals.
About bone fractures
You have over 200 bones in your body that make up your skeleton. Your skeleton supports and protects the soft tissues in your body and allows you to move. Bone is a living tissue; it has a soft centre of bone marrow that produces blood cells, and a hard outer surface called the cortex.
Healthy bones are strong and can bear a lot of weight and force. They do bend a little, so they can bear a certain amount of force without breaking. But a lot of force, like that during an accident or fall, might cause your bone to fracture (break). Your bone can even fracture into many pieces if the force is great enough.
Causes of fractures
Most fractures are caused by one of the following.
- An accident or injury that puts severe force on your bone – for example, a car accident, a sporting injury or a fall.
- A health condition such as osteoporosis, that weakens your bones. This means that even a mild force, which wouldn’t normally cause a fracture, can cause your bone to break. These are called fragility fractures.
- Repeated stress on a particular bone. This can gradually damage your bone, and lead to what’s called a stress fracture. Stress fractures are most common in people who do a lot of high-impact sports such as running, basketball or gymnastics.
In this topic, we describe what to expect if you break a bone as a result of an accident or single injury. The treatment and management of stress fractures and certain other fractures related to osteoporosis can differ.
Types of fracture
Fractures can be open or closed.
- A closed fracture is when your bone breaks or cracks, but your skin isn’t cut.
- An open fracture (also called compound fracture) is when you have an open wound in your skin, which may expose the broken bone. The bone may have punctured your skin or you may have injured your skin at the same time as the fracture. Open fractures are more serious because you might develop an infection in the bone and wound.
A fracture can be displaced or not displaced.
- In a displaced fracture, the fragments of bone have moved out of line. This can make the area of your body (for example, your arm or leg) look misshapen.
- In a non-displaced fracture, the broken parts of the bone haven’t moved out of position, and the area looks normal.
Doctors also name fractures by where the break is. The main types include the following.
- A transverse fracture – the fracture is straight across your bone.
- An oblique fracture – the break is at a diagonal across your bone.
- A spiral fracture – the fracture line twists around your bone.
- An impacted fracture – the bone fragments are driven into each other, which shortens your bone.
- A comminuted fracture – your bone shatters into pieces.
- A greenstick fracture – the bone only has a crack on one side. Children get these fractures because they have softer bones, adults don’t get them.
Fractures are also given names that depend on which bone is affected. For instance, a scaphoid fracture affects a bone in your wrist. A Colles’ fracture is a break in one of the bones in your forearm, near your wrist.
Symptoms of fractures
The main symptom of a broken (fractured) bone caused by an accident or injury is pain. This can be severe and you might not be able to move the injured area. For example, you might not be able to walk on a broken ankle or use your hand if you have a broken wrist.
Other symptoms of a fracture include:
- swelling
- bruising
- the area looking deformed or out of place
If you think you’ve broken a bone, seek medical help as soon as possible. Where you need to go for treatment will depend on where you’ve injured yourself, and how severe it is. You might need to go to a minor injury unit, A&E or call for an ambulance. Contact NHS 111 for advice on what to do or call 999 if your injury is severe.
Diagnosis of fractures
Your doctor will ask about your symptoms and examine you for signs of a fracture. They’ll also ask you about your medical history, and how you injured yourself.
You may have an X-ray to confirm that you have a fracture. Sometimes, you might need another type of scan after your X-ray. This might be an MRI or CT scan, which can produce more detailed images of your bone.
Treatment of fractures
When you first see a doctor, they’ll give you painkillers and apply a splint to the affected area to protect it. This will also stop it from moving. If you have any other injuries, your doctor might need to deal with these first.
The aim of treatment for fractures is first to move your bone back into its original position (reduction), if possible. And then prevent it from moving (immobilisation) until it heals. Sometimes you may need to have an operation.
Reduction
If your bones or pieces of bones are out of place, your doctor will need to move them back into position first. You may have a regional anaesthetic for this to block the pain. Or your doctor may give you painkillers and sometimes sedation, which will make you sleepy.
Immobilisation
After reduction, your doctor will use one of the following devices or techniques to hold your bone in place while it heals.
- A cast is a hard and rigid protective covering that’s made of plaster or fibreglass. It’s designed to fit the affected area and stop it from moving. Casts are used if you need immobilisation for several weeks.
- A splint is a device that can protect and support the affected area but doesn’t completely cover it, so some movement is possible. You may need to wear a splint until any swelling goes down, and then your doctor will replace it with a cast or brace.
- A brace is similar to a splint. It doesn’t go all the way around your arm or leg, so it allows for some limited movement. Braces are designed to be worn for longer than a splint.
- A sling is some material that you wear over your shoulder to support your arm and limit its movement.
You may need to wear your cast for several weeks or months until your fracture fully heals. Your doctor will give you some advice about how to manage with your cast or splint at home. For example, you may need to keep your leg raised on something like a cushion for the first day or two, to help any swelling go down.
Some fractures such as broken ribs cannot be treated with a cast or traction because of where they are. Traction is when doctors slowly and gently pull on a broken bone to guide it back into place. Your doctor may advise you to take painkillers and to either rest or do some physiotherapy exercises until the fracture heals.
Surgery
Depending on the type of fracture you have and how severe it is, you might need an operation to move your bones back into position and keep them there. They will be fixed into place using metal plates, rods, screws, wires or pins. Once your bone has healed, these may be left in place or your surgeon may remove them.
Physical therapies
You might see a physiotherapist as part of your treatment. They can give you advice on how to keep mobile while your broken bone is in a cast or splint. They may show you how to use crutches, for example. Your physio can also help you reduce stiffness and build up strength and mobility in your bones and muscles after your cast or splint is removed. Your physio might give you an exercise programme to follow, which will help you to get back to your full range of movement.
Complications of fractures
Most fractures heal without any further problems but sometimes complications can happen from the injury that caused your fracture. Problems that can happen straight away include the following.
- Damage from your broken bone to surrounding nerves or a blood vessel. Minor injuries might heal by themselves over time, but sometimes you may need an operation to repair the damage.
- Compartment syndrome. This is when pressure builds up in the tissues that surround your broken bone, so blood can’t flow into the area properly. It can be extremely painful and can lead to serious problems in the affected arm or leg is not treated quickly. You might need to have an operation to release the pressure on your tissues.
If you have any problems with your fracture (such as an increase in pain, swelling or numbness), contact your hospital.
As time goes on, it’s possible to develop other complications such as the following.
- Healing in the wrong position. A fracture might heal in an abnormal position, so your arm or leg might look bent or twisted. This is called malunion. If the bone doesn’t heal at all it’s called non-union.
- Joint problems. If you fracture a bone in a joint (for example, in your knee, elbow or shoulder) it can cause problems such as weakness, stiffness and reduced movement in your joint.
- Osteoarthritis. If you break a bone that’s part of a joint, it can put you at greater risk of developing osteoarthritis.
Looking for physiotherapy?
You can access a range of treatments on a pay as you go basis, including physiotherapy.
To book or to make an enquiry, call us on 0370 218 6528∧
A sprain is an injury to your ligaments – the strong fibres that hold your joints together. If you tear a ligament, the pain can sometimes be similar to that from a broken bone, particularly if it’s severe. It can be difficult to tell, so it's important to get medical advice. For more information, see our section: Symptoms of fractures above.
It’s important to look after your cast. Don’t get it wet – put plastic bags over it when you shower or buy waterproof shields. Don’t put anything up into your cast, to scratch an itch, for example. And don’t pull any padding out of your cast or trim it – talk to your doctor if it feels uncomfortable.
This varies depending on your age, which bone you’ve broken and the type of fracture you have. In adults, it can take anything from several weeks to months to heal fully. Children’s bones heal faster – a two-year-old’s shinbone, for example, will take around three weeks to heal.
Fractures can be open (when a broken bone comes through your skin) or closed (when your skin isn’t cut). A fracture can also be displaced (when the bone has moved out of place) or not displaced. You can tell the difference by how your arm or leg, for example, looks. A fracture can also be named depending on where it is and which bone is affected. For more information, see our section: Types of fractures above.
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