What is a bone fracture?

A bone fracture is a crack or break in a bone. A bone can be completely or partially fractured. Fractures are especially common in children.

A fracture can be:

• closed — where the bone breaks but doesn't go through the skin
• open — where the bone breaks through the skin

Types of bone fractures include:

• hairline or stress fracture — a small crack in a bone from repeated movement or stress
• simple fracture — one fracture line in the bone
• comminuted fracture — the bone breaks into several pieces
• greenstick fracture — the bone breaks on one side and bends on the other
• displaced fracture — the broken bone moves out of its usual position

What are the symptoms of a fracture?

There may be one or more symptoms at the site of a bone fracture. Symptoms may include:

• pain
• swelling
• an unusual shape of the limb
• bruising or discolouration
• difficulty moving the limb

Babies and young children might cry and refuse to move the injured area.

When should I call for an ambulance or go to the emergency department?

You should seek medical attention if you think you have a fracture. Do not move a person if you think they may have a spinal injury, unless they are in danger. Movement can cause more injury.

Go to the emergency department or call an ambulance immediately if:

• your arm or leg has been injured and has an unusual colour or shape
• you have severe pain
• the injured area is bleeding heavily
• you can see bone coming through your skin

What should I do while waiting for the ambulance?

Follow these steps while waiting for the ambulance:

1. Keep the injured person as still as possible.
2. Stop any bleeding, cover wounds and check for other fractures.
3. Put a splint on the fractured limb so it can't move.
4. Bandage the limb to hold the splint in place and prevent movement of the joints above and below the fracture.
5. Check every 15 minutes that the bandages aren't too tight — the hand or foot shouldn't feel cold or look discoloured.

Never try to push the bone into place by yourself.

What causes bone fractures?

Bone fractures are often caused by trauma, such as sports injuries, motor vehicle accidents or falls.

Other causes include:

• overuse and repetitive movements — this can place stress on a bone over time
• health conditions that weaken your bones, such as osteoporosis and certain types of cancer
• assault — physical injury from violence

How is a fracture diagnosed?

A doctor will examine the injured area and may use scans to confirm a fracture. These scans can include:

• x-ray
• CT
• MRI

How is a fracture treated?

Treatment depends on the type and location of your fracture.

First aid

Before you see your doctor:

• use a splint or sling to stop the injured area from moving
• put ice on the injured area
• elevate the injured area
• take pain-relief medicine, such as paracetamol or ibuprofen

Medical treatment

You will probably need to wear a cast, splint or brace to keep the injured area still, so your bone can heal. You might have a full cast that goes all the way around your limb, or a partial cast (or backslab) secured with a bandage. Some fractures need a special sling rather than a cast. Your doctor will tell you how long you need to wear it for.

If the broken bone has moved out of position, you will need to have a procedure called reduction to put it back in place. Sometimes a doctor can do this in the emergency department by carefully moving your limb. You can have a local anaesthetic, so that you don't feel any pain.

Some fractures need surgery to put the bone back in place. Surgery may also include cleaning the wound and putting metal screws into the bone to hold it in place.

Care for the fracture while the bone heals

While your bone is healing, it's important to:

• rest
• keep the injured area elevated
• avoid sport or physical activities
• look after your cast

You may need to have another x-ray to check how your fracture is healing.

What are the complications of a fracture?

Complications from a fracture can happen if the broken bone moves out of place. It may damage a nerve or blood vessel.

Fractures at joints can lead to osteoarthritis.

In children, a fracture can sometimes injure the growth plate. This is the area of the bone that is responsible for growth. This is usually not a problem if the fracture is treated early.

Other possible complications include:

• sores or ulcers under your cast
• pulmonary embolism
• compartment syndrome
• incomplete bone healing or misalignment
• destruction of part of the bone
• infection of an open fracture

Can fractures be prevented?

Some fractures can be prevented by taking measures to avoid falls. Here are other ways to prevent fractures:

• Improve your balance and muscle strength.
• Include calcium and vitamin D in your diet.
• If you are at risk of osteoporosis, get tested so you can have treatment if you need it.
• Use assistive devices or remove hazards at home.

Resources and support

• Visit Kidsafe Australia for advice on preventing accidents that could cause fractures in children.
• Older people are more prone to fractures from falls — learn about things you can do to prevent falls.
• You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Do you prefer to read in languages other than English?

NSW Government has information on bone health in several languages.