Fracture Management
Diagnosis and treatment of all types of bone fractures, from fine hairline cracks to complex, multi-fragment breaks.
A fracture is a break in the continuity of a bone, ranging from a fine hairline crack to a bone shattered into several pieces. The way a bone breaks depends on the type, direction, and speed of the force involved, and on how strong or weakened the bone already was before the injury. Getting the classification right matters, because it directly decides whether a fracture can be treated with rest and a cast, or needs surgical fixation to heal correctly.
Types
Closed (Simple) Fracture
The bone breaks but the skin above it stays intact. Most fractures are closed.
Open (Compound) Fracture
The broken bone pierces through the skin, or the injury exposes the fracture to the outside. These carry a higher risk of infection and usually need urgent surgical care.
Hairline (Stress) Fracture
A thin crack that develops from repeated, low-level stress on a bone rather than a single injury - common in the shin and foot bones of runners and athletes.
Transverse Fracture
A straight break running horizontally across the bone, usually caused by a direct blow.
Oblique Fracture
A diagonal break across the bone, typically from a bending force applied at an angle.
Spiral Fracture
A break that winds around the bone in a spiral pattern, caused by a twisting force — common in falls during sport.
Comminuted Fracture
The bone shatters into three or more pieces, usually from high-impact trauma such as a road traffic accident.
Segmental Fracture
Two separate fracture lines in the same bone, leaving a free-floating segment of bone between them.
Greenstick Fracture
An incomplete break where the bone bends and cracks on one side without breaking all the way through — seen almost exclusively in children, whose bones are more flexible.
Compression (Crush) Fracture
The bone is crushed or collapses under load, most often affecting the vertebrae of the spine, particularly in patients with osteoporosis.
Avulsion Fracture
A small fragment of bone is pulled away by the sudden, forceful pull of an attached tendon or ligament, often during sport.
Impacted Fracture
The broken ends of the bone are driven firmly into each other - commonly seen in falls onto an outstretched hand, or in hip fractures in older adults.
Intra-articular Fracture
A fracture line that extends into the surface of a joint, which can affect long-term joint movement if not treated precisely.
Pathological Fracture
A break occurring in a bone already weakened by a disease process such as osteoporosis, a bone tumour, or infection — sometimes from a force too minor to break a healthy bone.
Common Causes
A fracture happens when the force placed on a bone is greater than the bone can withstand. That force can arrive in very different ways, and the pattern of the break often points to how the injury happened.
- Direct trauma - a fall, road traffic accident, sports collision, or a direct blow to a limb.
- Indirect force - twisting or bending injuries where the force travels along the bone and the break occurs some distance from the point of impact, such as a twisted ankle causing a fracture higher up the leg.
- Repetitive stress - ongoing, lower level loading from running, marching, or high-volume training that gradually cracks a bone without any single traumatic event.
- Weakened bone - osteoporosis, long-standing infections, tumours, or certain metabolic conditions can weaken bone enough that it fractures under everyday loads, sometimes from a minor stumble or even a routine movement.
- Age related patterns - children's more flexible bones tend to bend and crack (greenstick fractures) rather than break cleanly, while older adults with reduced bone density are more prone to fragility fractures from relatively low energy falls.
Signs and Symptoms
- Pain that worsens with movement or weight-bearing
- Swelling, bruising, or visible deformity around the injured area
- Inability to move or bear weight on the affected limb
- A grinding or grating sensation, or an audible snap at the time of injury
- Numbness or tingling, if nearby nerves are affected
Diagnosis
Diagnosis usually starts with a clinical examination followed by an X-ray, which is enough to confirm most fractures and their pattern. For fractures involving a joint surface, or when more detail is needed for surgical planning, a CT scan may be used. On-site digital X-ray is available at our clinic at Rajarajeshwari Nagar(RR Nagar), so imaging and consultation can usually be completed in the same visit.
Treatment Approach
Treatment depends entirely on the type, location, and stability of the fracture. Many closed, stable fractures heal well with casting, splinting, or bracing alone. Fractures that are displaced, unstable, involve a joint surface, or are open generally need surgical fixation - using plates, screws, rods, or wires - to hold the bone in the correct position while it heals. Dr. K. G. Gopalakrishna assesses each fracture individually before recommending surgical or non-surgical treatment, and explains the reasoning behind the choice.
Experiencing something urgent? If there is visible deformity, an open wound, sudden severe pain, or the limb cannot be moved or weight-bearing at all, call us right away. Call +91 72595 84549 If you cannot reach us immediately, please go to your nearest emergency department without delay.
Please note: This page is for general information only and does not replace a proper medical evaluation. Every case is different, and the underlying cause of your symptoms may not match what is described here. Please do not use this page to self-diagnose - consult Dr. K. G. Gopalakrishna or another qualified orthopaedic specialist for an accurate diagnosis specific to you.
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Last reviewed: August 2026