Fractures

Fractures occur for a variety of reasons including:

• Trauma - such as from a car accident, sports injury or fall
• Underlying illnesses - like osteoporosis or cancer can make your bones weaker and more likely to break (pathological fractures)
• Overuse - repetitive force or overuse can cause tiny breaks in the bone (stress fractures)

There are many types of fractures ranging from mild to severe.

Fractures are named after the type or pattern of break that has occurred, or the bone that is affected.

Fractures can either be simple, compound, displaced or nondisplaced.

Simple (closed) fracture

The bone is broken, but the skin remains intact.

Compound (open) fracture

A compound fracture is when the broken bone pierces the skin. They normally occur due to a traumatic injury such as a car accident. Compound fractures need to be treated as soon as possible to prevent infection and put the bone back into its correct position. They are treated with surgery.

Nondisplaced fracture

If a fracture is nondisplaced it means the bone hasn't moved out of its correct position. Nondisplaced fractures can often be treated without surgery.

Displaced fracture

A displaced fracture is a broken bone that has moved out of its correct position. The bone must be put back into position using a technique called a closed reduction, or with surgery.

Stress (hairline) fracture

This is a thin crack in the bone. It is usually caused by repetitive stress or trauma and is common in athletes, particularly runners. Stress fractures usually affect the shins, heels, feet, hips, and lower back.

Greenstick fracture

This type of fracture describes a partial break on one side of an arm or leg bone. Greenstick fractures are common in children because they have softer bones.

Compression fracture

These usually occur in the spongy bones of the spine when the front part of the vertebra collapse. They are commonly caused by conditions such as osteoporosis.

Pathological fractures

This is a type of fracture caused by an underlying disease that weakens the bones such as osteoporosis or bone cancer.

Longitudinal fracture

Is a fracture that extends along the length of the bone.

Transverse (complete) fracture

A transverse fracture causes a straight, horizontal break of the entire bone. They normally affect the long bones like the arms and legs, or collarbone, and are commonly caused by trauma such as a fall or a car accident. Some transverse fractures heal by themselves with a cast or splint while others need surgery.

Oblique fracture

While a transverse fracture is a break straight across a bone, an oblique fracture is a break at an angle. They are most common in the arms, legs, and collarbone, and are usually caused by trauma. Some oblique fractures may be treated with a cast or splint, while others require surgery.

Intra-articular fracture

An intra-articular fracture is when the fractured bone crosses into the surface of a joint causing damage to the joint cartilage. If damage to the joint is mild, they may be treated without surgery, but in severe cases or where bones, ligaments and tendons are involved surgery is needed to reconstruct and stabilise the joint.

Comminuted fracture

A comminuted fracture is when the bone is broken in at least two places. They are normally caused by severe trauma. Comminuted fractures are usually treated with surgery and may take up to a year to fully heal. They commonly affect the arms, legs, collarbone, or skull.

Segmental fracture

Like comminuted fractures, segmental fractures occur when the bone is broken in at least two places. With segmental fractures, a segment of bone becomes separated from the rest of the bone. Segmental fractures normally affect the arms, legs, or collarbone. They normally require surgery and can take up to a year to heal.

Spiral fracture

A spiral fracture occurs when the bone is broken with a twisting motion creating a corkscrew-like break in the bone. Spiral fractures most commonly affect the arms and legs or the small bones of the hands and fingers. Spiral fractures often require surgery.

Avulsion fracture

This type of fracture occurs when a small piece of bone attached to a ligament or tendon is pulled away from the bone. They are common in young athletes and normally happen during quick movements or when changing direction. Avulsion fractures can affect any bone that is connected to a tendon or ligament such as the elbow, ankle, foot, knee, fingers, wrist, pelvis, or spine. They often heal without surgery, but in severe cases, an operation may be needed.

Buckle (impacted) fracture

Buckle fractures are partial fractures which means that the break doesn't go all the way through the bone. They are a type of compression fracture that occurs when there is sudden pressure on the bone. Buckle fractures are common in children and usually occur when falling onto an outstretched arm. They normally heal without surgery.

Symptoms of a fracture can vary according to the type of fracture you have, how severe it is, and which bones are affected.

Some symptoms of a fracture may resemble other conditions such as sprains or bone bruises. If you have symptoms of a fracture, always see a medical professional to get an accurate diagnosis.

Common symptoms of a fracture include:

• Pain
• Tenderness (pain when you touch the area)
• Bruising
• Swelling
• Deformity - the affected area may be a strange shape
• Severe pain when moving the affected area
• If you have an open fracture, there will be a visible wound and bleeding. In some cases, you may be able to see the bone

At the time of the fracture you may experience:

• Severe pain
• A snapping or cracking sound
• Nausea
• Dizziness
• Faintness or light-headedness

At your first consultation, you will be seen by a consultant orthopaedic surgeon, a doctor specialising in conditions affecting the bones, joints, muscles, ligaments, and tendons.

Your consultant will ask you about what happened at the time of your injury, when it occurred and what symptoms you have.

They will perform a physical examination to check for visible signs of a fracture such as bruising, swelling and deformity. They may press gently with their fingers to check for any tenderness and see how well you can move the affected area. Your consultant may check your pulse and sensation to see whether there is damage to the nerves or blood vessels.

Your consultant will usually order an X-ray to confirm your diagnosis, even if you have already had one elsewhere. This is normal and helps us to understand your injury better, and also allows us to see if there has been healing already. In some cases, they may order other scans such as a CT scan or MRI to examine the bone in more detail or check the soft tissue around the injury.

At Circle Health Group, your first appointment is very important as it's where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important that you are as well-informed and comfortable as possible during your time with us, so please feel free to ask your consultant as many questions as you like during your appointment.

After making a diagnosis, your consultant will discuss possible treatment options with you and decide on the best option based on your symptoms and diagnosis.

Simple, closed fractures can often be treated without surgery. If the fracture is displaced, your consultant will need to put the bones back into their correct position before they can heal. This may be done by manually manipulating the bones using a technique called a closed reduction. In some cases, you may need surgery to realign the bones.

Immobilisation

Immobilising the fractured bone in a cast or splint keeps the bone in the correct position as it heals. You will normally wear your cast or splint for between three and eight weeks. Your consultant will arrange follow-up X -rays to check your bone is healing well.

Medication

Painkillers and non-steroidal anti-inflammatory drugs (NSAIDs) help to relieve pain and reduce inflammation after a fracture. Your consultant can prescribe a suitable pain medication for you.

Traction

Traction is when weights and a pulley mechanism are used to stretch the muscles and tendons around a broken bone and keep the bone in the correct position while it heals.

Physiotherapy

Your physiotherapist will show you exercises to reduce pain and swelling, strengthen your muscles and restore mobility and function to your fractured bone as it heals. Physiotherapy is also used during your recovery from surgery.

Surgical treatment

If your fracture is complex it may need to be fixed in a surgical procedure called an open reduction and internal fixation (ORIF).

An ORIF can also speed healing and reduce the amount of time your fractured bone is in plaster.

During ORIF your surgeon moves the bones back into their correct position and fixes them in place with plates, pins, rods, and screws.

Many fractures cannot be prevented, but there are some things you can do to reduce your risk of fractures including:

• Take in enough calcium and vitamin D to build strong bones
• Take regular weight-bearing exercise
• Have regular bone density scans if you are at risk of osteoporosis
• Stop smoking. Smoking reduces bone strength and delays wound healing
• Always wear a seatbelt when travelling by car
• Use the correct protective equipment when participating in sports
• Keep stairs and corridors free of items like carpets and low tables that could cause you to trip

Long-term recovery and outlook after a fracture depend on many factors like your age, general health, the type of fracture you had and how it was treated.

Most fractures heal without any problems, and you can usually continue with your normal activities after your bone has healed. If the fracture was severe or complex, you experienced multiple injuries, or have other health conditions, a fracture may have a longer-term impact.

Getting expert specialist care and the right treatment is essential for the best possible recovery and long-term outcomes.

Talk to your consultant about your expected recovery and long-term outlook.

We answer some of your most commonly asked questions about fractures.

How do you tell if a bone is fractured or bruised?

A bone bruise or bone contusion is an injury to the soft tissue around the bone. Symptoms of a bruised bone that may be similar to a fracture include discolouration of the skin, swelling, pain and tenderness.

If you have fractured your bone you may also experience:

• A crack or snap when the injury happened
• Deformity
• Severe pain when moving the affected area or difficulty weight bearing

The only way to tell for sure whether you have a fracture is with an X-ray. If you think you may have broken a bone go to a hospital immediately for specialist medical care.

Is a fracture the same as a break?

Yes. A fracture is another word for a break in the bone and the two terms can be used interchangeably.

How long does a fracture take to heal?

Most fractures heal in around six to eight weeks when treated correctly. Some severe or complex fractures can take up to a year to heal fully.

Why is a hip fracture so dangerous?

Hip fractures are more common in older people, who may have other health conditions like diabetes and heart disease putting them at higher risk of complications. Most hip fractures need surgery which carries its own risk of complications like infections and blood clots. Healing from a hip fracture often takes time and requires an extended period of immobility which can lead to complications including chest infections, blood clots, and reduced muscle mass.

At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant best suit your needs
• Personalised, consultant-led treatment plans tailored to you
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard, with a range of delicious healthy meals available
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about fracture treatment, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in January 2023. Next review due January 2026.

1. What is a fracture?, Medical News Today
2. Understanding Bone Fractures: Diagnosis and Treatment, Web MD
3. How do I know if I've broken a bone?, NHS
4. Bone Fractures, Cleveland Clinic