Fractures (broken bones)
Your health expert: Brad Green, MSK Physiotherapist, Bupa
Content editor review by Liz Woolf, November 2023
Next review due November 2026
A fracture is a broken or cracked bone. A fracture can be a partial or complete break. Bone is able to repair itself, but for most fractures you’ll need treatment to help the bone stay in the right position while it heals.
About bone fractures
You have over 200 bones in your body – these 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 an extreme amount of force such as an accident or fall might cause your bone to fracture (break). Your bone can 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. This could be running, basketball or gymnastics, for example.
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 fractures related to osteoporosis may be different.
Types of fracture
Fractures can be open or closed.
- A closed fracture is when your bone breaks or cracks, but your skin isn’t broken.
- An open fracture (also called compound fracture). This means you have an open wound, which may expose the broken bone.
With an open fracture, the bone may have punctured your skin when it broke. Or the injury to your skin may have happened 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 how the bone has broken. Fractures can be:
- transverse – the fracture is straight across your bone
- oblique – the break is diagonally across your bone
- spiral – the fracture line twists around your bone
- impacted – the bone fragments drive into each other, which shortens your bone
- comminuted – the bone shatters into pieces
- greenstick – the bone only cracks on one side
Greenstick fractures only happen in children because they have softer bones than adults.
Fractures are also given names to reflect 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
Pain is the main symptom of a broken (fractured) bone caused by an accident or injury. The pain 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 or 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 – either produces 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 fracture treatment is to move your bone back into its original position. Doctors call this ‘reduction’. Then the doctor must stop your bone from moving until it heals (immobilisation). Sometimes you’ll need to have an operation to help with this.
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 hear the doctor talk about traction. This is when they slowly and gently pull on a broken bone to guide it back into place.
You may have a regional anaesthetic for this to block the pain. Or you may have painkillers, and sometimes sedation to make you sleepy.
Immobilisation
To hold your bone in place while it heals, you may have one of the following.
- A splint protects and supports the affected area but doesn’t completely surround an arm, leg or finger. Some movement is possible. You may have a splint until any swelling goes down. Then, depending on the fracture, your doctor may replace it with a cast or brace.
- A cast is a hard and rigid protective covering of plaster or fibreglass. It’s designed to surround the affected area and stop it from moving. You may have a cast if you need immobilisation for several weeks.
- 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. You can wear a brace for longer than a splint.
- A sling (or collar and cuff) is material that you wear over your shoulder. It supports your arm and limits 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 at home. You may need to keep a fractured limb raised for the first day or two, to help reduce any swelling.
If you do have a cast, it’s important to look after it. You can’t get it wet, so you may need to strip wash if you can’t cover it with a plastic bag. Check that your cast isn’t digging in anywhere. You can tape gauze or cotton wool in place for extra padding if you need it.
Casts can be itchy, but never put anything down the cast to scratch – you could break the skin and get an infection. If you have any concerns, ring your fracture clinic.
Some fractures, such as broken ribs, can’t be treated with a brace because of where they are. Your doctor will make sure you have some painkillers. These are important because they’ll help you to do regular deep breathing and coughing.
Although you’ll need rest until the fracture heals, it’s important to be up and moving regularly. This will help to prevent lung complications, including a chest infection. You may also have physiotherapy exercises to help with your breathing.
Surgery
Depending on the type of fracture you have and how severe it is, you might need surgery. In an operation, the surgeon will move your bones back into position and fix them there. To do this they may use metal plates, rods, screws, wires or pins. After 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 after your cast or brace comes off. You may have exercises to reduce stiffness, build up strength and regain mobility. Your physio will aim to help you get your full range of movement back.
Physiotherapy services
Our evidence-based physiotherapy services are designed to address a wide range of musculoskeletal conditions, promote recovery, and enhance overall quality of life. Our physiotherapists are specialised in treating orthopaedic, rheumatological, musculoskeletal conditions and sports-related injury by using tools including education and advice, pain management strategies, exercise therapy and manual therapy techniques.
To book or to make an enquiry, call us on 0330 127 7805
Complications of fractures
Most fractures heal without any further problems. But sometimes complications can happen as a result of 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 need an operation to repair the damage.
- Compartment syndrome – a build-up of pressure in the tissues surrounding your broken bone. This means 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 if 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 (for example, 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. A fractured bone in a joint can cause weakness, stiffness, and reduced movement in that joint.
- Osteoarthritis. If you break a bone that’s part of a joint, it can put you at greater risk of developing osteoarthritis.
A sprain is an injury to your ligaments – the strong fibres that hold your joints together. The pain can be similar to a broken bone, particularly if it’s severe. It can be difficult to tell a fracture from a sprain, so it's important to see a doctor if you’re not sure.
For more information, see our section: Symptoms of fractures.
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 into your cast, to scratch an itch, for example. If it feels uncomfortable, don’t trim it – talk to your doctor.
For more information, see our section: Treatment of fractures.
This varies depending on your age, which bone you’ve broken and the type of fracture you have. In adults, healing can take anything from several weeks to months. Children’s bones heal more quickly.
For more information, see our section: Treatment of fractures.
Fractures can be:
- open (when a broken bone comes through your skin) or closed (when your skin isn’t cut)
- displaced (when the bone has moved out of place) or not displaced
- named after the bone that’s affected
For more information, see our section: Types of fracture.
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