Bone Fractures

What a fracture means

A fracture is a break in a bone, including what people often call a crack. The location, alignment and stability of the break matter, as does injury to surrounding tissue. A fracture that communicates with a wound is an open fracture and needs urgent hospital care. AAOS fracture overview.

This page is a guide to the decisions around fracture care, not a method for diagnosing an injury at home. If a limb looks deformed, there is a wound over a suspected break or the hand or foot has lost feeling, seek emergency assessment. Do not wait to see whether bruising appears or whether an online appointment becomes available.

Causes and symptoms

Falls, collisions and other injuries can break a bone. Pain, swelling, bruising and difficulty using the limb are possible symptoms. Appearance alone does not describe the full injury, and being able to move part of the limb does not settle the diagnosis. AAOS symptoms and causes.

Repeated loading can also produce a stress fracture, particularly when activity increases faster than bone can adapt. Reduced bone strength may allow a fracture during ordinary activity. Persistent focal pain with exercise deserves assessment rather than repeated attempts to train through it. AAOS stress-fracture information.

Describe exactly what happened, where the pain began and whether there was a wound. Mention medicines, previous fractures and any bone-health diagnosis. If the injury occurred at work or during travel, record the date and location for your own records, but do not let administrative details delay medical care. Bring an accompanying person if you need help remembering the history.

Assessment and imaging

The team examines the injury, checks circulation and sensation and usually uses X-rays to assess the break. Additional imaging may be needed for a specific fracture or an injury not fully explained by the first study. Treatment aims to place and hold the bone in a suitable position while it heals. AAOS evaluation and treatment.

Ask for the name of the bone and the location of the break in everyday terms. Clarify whether a joint is involved and whether the fracture is stable. If a temporary splint is used, ask what the next appointment is intended to decide. A temporary treatment does not mean the assessment was incomplete; it may be one stage in a plan that needs follow-up.

Before leaving, confirm the permitted level of use, the follow-up date and a contact route for problems. “Take it easy” is not enough if you need to know whether you may stand, lift or use stairs. Request written weight-bearing or lifting instructions that can be shared with a family member, employer or physiotherapist.

Treatment without surgery

A cast, splint or other protective device can hold selected fractures while healing occurs. Some displaced fractures are first moved into better alignment by a clinician. The appropriate treatment depends on the injury rather than the patient’s preference for a smaller device. AAOS treatment overview.

Keep the device dry unless the team has specifically confirmed otherwise. Do not insert objects under a cast or alter it yourself. Ask how to protect it during washing and which exposed joints you should move. AAOS cast-care guidance.

Discuss practical arrangements before returning home. You may need help with meals, transport, bathing or caring for someone else. Ask whether your usual chair, bed and staircase can be managed with the equipment supplied. If you cannot follow the plan safely at home, say so; the team needs that information to consider appropriate support.

When an operation is discussed

Some fractures need surgery to restore alignment or provide stability. Plates, screws, rods or an external frame may be used, depending on the injury. Open fractures can require surgical cleaning as well as stabilisation. AAOS fixation options.

Ask why the proposed method fits the break, what non-surgical alternatives exist and whether more than one procedure might be necessary. Discuss infection, stiffness, healing problems and risks to nearby structures with the surgeon. Clarify which implant information should be kept and whether any future removal is expected or only considered if there is a problem. Avoid assuming that metalwork must always be removed.

Healing and recovery

Bone healing requires adequate stability and blood supply. Smoking, infection and some health problems can interfere with healing; occasionally a fracture takes longer than expected or does not unite. Persistent pain or lack of progress may lead to further assessment. AAOS nonunion information.

Follow-up is important even when pain improves. Return to loading, work and sport depends on the bone, injury and treatment. Ask what evidence the team will use to change restrictions rather than relying only on a date. Keep previous X-rays and discharge records available when attending a different facility.

If the break followed a minor fall, ask whether bone health needs assessment. If it followed an increase in training, discuss the training history before planning a return. At each review, mention difficulties with the equipment and any new symptoms rather than reporting only whether you can tolerate pain.

Warning signs during treatment

Increasing pain or cast tightness, numbness, burning, excessive swelling beyond the cast or inability to move exposed fingers or toes needs urgent review. AAOS cast warning signs. A visibly deformed limb, exposed bone or loss of feeling after injury needs emergency care. NHS fracture guidance.

Use urgent medical services for these concerns. Do not cut off or modify a cast yourself while waiting for routine advice, and do not use a website message as the only route to report worsening symptoms.

Keeping follow-up organised

Record the appointment date and the location of the fracture clinic before leaving hospital. Ask whether you need to bring images or whether the team already has access. If another clinician changes your instructions, request a written update so that your household and therapist can follow the same plan.