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Fractures & Broken Bones

Orthopedic & Fracture Clinic

Dr. Pamela Mehta, MD
Orthopedist, San Jose

Table of Contents

All About Fractures

Did you know that, on average, each person is expected to experience two occurrences of fracture in their lifetime?

So says the American Academy of Orthopedic Surgeons in a 2002 study. It is, therefore, essential to understand more about bone structure and treatments that can improve bone stability. By improving stability, we can contribute to the overall healing process.

In this article, we’ll discuss:

  • What fractures are
  • The many different types of fracture
  • How and why fractures happen
  • How we treat fractures

Read on to find out more!

What is a Fracture?

Bone fractures, commonly known as broken bones, can occur due to many reasons. This can include accidents such as:

  • Sports injuries
  • Falls and tumbles
  • Car crashes

Fractures can also happen due to medical conditions like osteoporosis and certain cancers that make bones weaker. Despite the strength and resilience of bones to considerable impact, they have their limitations as well.

The severity of a fracture typically depends on how much force caused it. If the force only goes a little beyond what the bone can handle, it might crack instead of breaking all the way through. 

However, if the force is strong, caused by an intense trauma, it can cause the bone to break or shatter. If strong enough, this can even lead to “open fractures” where your broken bone breaks through your skin.

There’s a common misconception that a bone “fracture” is different from a “broken” bone.In reality, both terms have the same meaning and refer to the same thing.

“Fracture” is just the medical term for a broken bone, so your doctor may use these words interchangeably. Fractured bones can be painful. Swelling from the break irritates nerve fibres around the bone, causing pain.

Muscles near the broken bone may spasm in an attempt to stabilise it, also contributing to the pain and affecting the total range of motion of the joint. Pain is an important factor in how we treat you at our fracture clinic in San Jose. We aim to reduce pain as much as we can, to make you as comfortable as possible.

Next, let’s go through the different types of fractures and their differences.

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Types of Fracture

Bones can break for different reasons, and we have a range of different ways to classify them. 

Common types of fractures include:

Bone fractures can range from minor to severe, depending upon various factors. These may include the extent of the damage incurred, your age, or underlying medical conditions.

The most serious types of fractures, which are more likely to undergo surgery, include:

Open (Compound) Fractures

These fractures involve the bone breaking through the skin, often requiring surgery to clean the wound and secure the bone. This is serious because once the skin is broken, there’s a risk of infection in both the wound and the bone.

Fractures can be either open or closed, and will also have one or more other classifications like those below.

Closed (Simple) Fracture​s

This is a closed fracture, also referred to as a simple fracture. It involves a broken bone where the skin remains intact. 

Most fractures are “closed” and will have one or more other classifications such as the ones below.

Open vs closed fractures
Adapted image - original from Laboratoires Servier, CC BY-SA 3.0 , via Wikimedia Commons

Common Fracture Types

Different types of fracture animated image
Adapted image - original from Laboratoires Servier, CC BY-SA 3.0 , via Wikimedia Commons

Other Types of Fracture

Displaced Fractures

In these fractures, the bone breaks into multiple pieces. Realignment through surgery is often necessary to ensure proper alignment.

Fractures with Joint Involvement

These fractures occur near or within a joint. Surgery may be required to realign the bone and restore joint function.

Spinal fractures

Fractures in the vertebrae of the spine may require surgery to stabilize the spine and prevent further damage.

Malunion Fractures

When fractures fail to heal correctly on their own, surgery may be needed to realign the bone and facilitate proper healing.


A bone fracture can be caused by many things, and often involve an accident. Accidents involving major trauma or high-force are most likely to cause fractures.

This isn’t always the case. Pathological fractures occur when your bone has been weakened by a bone condition.

Common causes of bone fractures include:


The most common presentation of a fracture is when you experience sudden pain, difficulty moving, and abnormal appearance of a limb during an accident.

However, fractures can appear in many other ways. It’s important you get this checked in a fracture clinic.

Common fracture symptoms include:


Your doctor might assess your range of motion by either moving the injured area or instructing you to do so. Additionally, they may inquire about specific details regarding when and how the injury occurred.

To confirm a fracture diagnosis, your doctor may suggest one or more non-invasive imaging tests:

Treatment Options

Treatment for fractures depends on a few factors, such as:

  • Force of injury
  • Your medical history
  • Age and mobility status
  • Affected bones
  • Whether the fracture is open or closed
  • Type of fracture

Treatment will generally take the form of either surgical or non-surgical intervention. Surgery is sometimes necessary to fix the position of the bones and joint for healing. Other times, we can use casts or splints to help your bones to heal.

We also have to fix other problems that might have occurred at the same time as the fracture, such as a shoulder dislocation.

The timescale for these treatments also depends on a few factors:

Emergent Treatment

Emergent means that your treatment will take place as soon as possible. This is treated as an emergency and will be dealt with quickly.

This is often required for serious fractures where the bone breaks through the skin (open fractures).

Urgent Treatment

Urgent treatment will still most likely be treated in the Emergency Room, but with less urgency than in emergent cases.

This is necessary for displaced, unstable, or joint-involved fractures. 

Elective Treatment

Elective means that you can receive treatment as an outpatient. These cases sometimes need surgery, but are often treated conservatively.

Immobilisation is achieved through splints, casts, or bone alignment (reduction).

Conservative Treatment

Conservative treatment aims to treat your condition without major interventions such as surgery or injections.

Orthopedic specialists will collaborate with you to create a treatment strategy that considers all aspects of your injury and overall well-being. They manage some minor arm and leg fractures using non-surgical approaches, which may include:


Pain and swelling near the injury site can be reduced with medications like ibuprofen. If over-the-counter options are insufficient, your doctor may prescribe stronger pain relievers.

Casting or splinting

Depending on where the bone is broken, your doctor might suggest wearing a splint, boot, or plaster cast for a few weeks. This keeps the broken bones still so they can heal safely and prevents more damage.

doctor holding package of medication
man getting physical therapy on his arm

Walking aids

If you have a broken leg, your doctor may suggest minimising weight on it. 

Your doctor will assist you in finding aids such as crutches or a wheelchair to keep you mobile during the healing process.

Physical therapy

Specific exercises and stretches can strengthen muscles and improve your range of motion. Physical therapy is designed to make movement easier in the affected area after a long bone fracture has healed.

The timing and frequency of physical therapy recommendations depend on your injury. 

Rehabilitation specialists collaborate with you to create a personalised plan for you, depending upon your lifestyle and goals

Closed reduction

Sometimes, your doctor may gently move the bones back into place without surgery. They use this method when the bones have only shifted a little. Afterward, the injured bones are usually kept in place with a cast or brace.


In some cases, doctors use weights and pulleys attached to a bed to stretch the muscles and tendons around a fracture. This pulling force helps put the bones back in their natural position. They usually do this shortly after the injury happens.

man in hospital having traction therapy

Fracture Surgery

Long bone fractures, like those in the femur (thighbone), often require fracture surgery to fix damaged tissues.

Your surgeon may use pins or plates to offer extra support, ensuring bones stay in place during the healing process.

Orthopaedic surgeons are skilled in both minimally invasive and traditional techniques, always opting for the least invasive approach. This includes arm and leg fractures that haven’t healed properly (known as non-unions or malunions) when seen in the fracture clinic.

x-ray of ankle fracture with plate and screws

Depending on the damage, you may have to have a procedure on your muscles, ligament, and cartilage. You can read more about these procedures on our pages for:

Types of Surgery

The type of surgery required will depend on the location, the type of fracture, and your medical background. Sometimes this will be a small operation to ensure your bones are stable while healing. Other times this can be a major procedure that will take months to recover from.

Surgical options for fracture healing include:

Internal Fixation

Your surgeon would carefully reposition bones, often using metal tools like nails, pins, or plates to hold broken long bone fragments together during healing.

internal fixation of the wrist xray with plate and screws
Adapted from MustafaSalahalden, CC BY-SA 4.0, via Wikimedia Commons

External Fixation

This involves surgeons securing severely fractured bones to metal rods or pins outside the body. The external frame connects to metal pieces attached to the bones, offering additional support to keep the injured bones in place.

Ortopedikus, CC BY-SA 4.0, via Wikimedia Commons

Bone Grafting

When some bone pieces are broken or crushed beyond repair, surgeons may reconstruct the fractured bone(s) using healthy bone tissue from another part of your body or a donor.

AP and lateral of bone graft surgery
Adapted from Gianluca Cernicchiaro, CC BY-SA 4.0, via Wikimedia Commons

Arthroplasty (joint replacement)

If you break a joint, like your shoulder or knee, you may need joint replacement surgery. The damaged joint is replaced with an artificial one, made of metal, ceramic, or plastic, resembling and moving like a natural joint.

Knee Arthroplasty
Jmarchn, CC BY-SA 3.0, via Wikimedia Commons

Risks and Complications

Inappropriate treatment may lead to complications. Some of the complications from fracture surgery can include:

Common pain relievers available without a prescription, such as aspirin or ibuprofen, may cause bleeding and other issues post-surgery. Your surgeon will discuss suitable pain relief options with you.

Possible side effects of these pain relievers include:

  • Bleeding
  • Ulcers
  • Stomach pain
  • Bowel complications

Fracture Healing

Bones naturally heal after a break caused by injury. Treatments for fracture usually aim to help this healing process. By keeping your bones set in place, they will heal stronger and be properly aligned for the future.

The fracture healing process has three stages:

  1. Inflammation
  2. Repair
  3. Remodelling

Treatment options, like immobilisation, help support this process. Adult bones typically take 3-12 weeks to heal depending on the fracture site and severity of the fracture.

According to the Radiopaedia, typical healing durations for common fractures are:

woman with leg in cast having physical therapy

Upper Limb

  • Finger bones (phalanges): 3 weeks
  • Hand bones (metacarpals): 4-6 weeks
  • Wrist (distal radius): 4-6 weeks
  • Upper arm (humerus): 6-8 weeks
  • Forearm (lower arm): 8-10 weeks

Lower Limb

  • Foot bones (metatarsals): 6+ weeks
  • Shinbone (tibia): 10 weeks
  • Hip joint (femoral neck): 12 weeks
  • Thigh bone (femoral shaft): 12 weeks

After immobilisation or surgery for your fracture, you may resume movement in a few weeks, depending on the treatment. Severe fractures might take a year or longer to fully heal.

If you have persistent intense pain, contact your doctor immediately.

Prevention Tips

Although you can’t entirely avoid fractures, you can take steps to keep your bones healthy.

Frequently Asked Questions

  • How are bone fractures diagnosed?

    Diagnosis often involves imaging tests like X-rays, MRIs, CT scans, or bone scans to assess the extent and location of the fracture.

  • What factors affect the severity of a fracture?

    The force causing the fracture, the bone involved, and the individual's overall health can determine the severity.

  • How are bone fractures treated?

    Treatment varies based on the severity. Options include immobilisation (casts, splints), reduction (realigning bones), and in some cases, surgery.

  • What is the typical healing time for a fracture?

    Healing time depends on the type and severity of the fracture but may range from a few weeks to several months.

  • Are there complications associated with fracture surgery?

    Yes, complications may include acute compartment syndrome, malunion, nonunion, bone infection, and damage to surrounding tissues.

  • When should I seek medical attention for a suspected fracture?

    If you experience severe pain, swelling, or suspect a fracture, seek medical attention immediately for accurate diagnosis and appropriate treatment.