Bone Fracture vs. Break: Is There a Difference?

There is no difference between a bone fracture vs. a break; they mean the same thing. Whether a bone has a hairline crack or is completely broken in two, an orthopedist or orthopedic surgeon will commonly refer to the injury as a break or fracture.

With that said, bone fractures can differ by their type, severity, location, and whether they are open or closed. These features can direct the appropriate course of treatment and predict how long the fracture will take to heal.

Types of Bone Fractures

Bone fractures can range in severity from mild to permanently debilitating. As part of the workup, the healthcare provider will first assess whether a fracture is closed or open. By definition:

• Closed fractures are those in which the bone is broken but the skin is intact. These often improve with immobilization or casting.
• Open fractures, also known as compound fractures, are those in which the broken bone breaks through the skin. These are more likely to require surgery.

A bone fracture can also be described by the position of the broken ends. This is referred to as displacement or non-displacement. By definition:

• Displaced fractures are those in which there is a physical gap between the broken ends. These are more likely to require surgery.
•  Non-displaced fractures are those in which the broken ends are not separated and are in more or less the correct alignment. These often improve with immobilization or casting.

Location of Bone Fractures

The location of a bone fracture may be obvious, particularly when there is a compound fracture, but others may require an X-ray to find where the break (or multiple breaks) are.

In total, there are 206 bones in the adult body. These include long bones of the limbs, short bones like those of the wrist and ankles, flat bones like the skull and shoulder blades, and sesamoid bones like the kneecap that is embedded.

Bone fractures are commonly seen in these five parts of the body:

Chest and Torso

• Sternum (breast bone)
• Ribs
• Clavicle (collarbone)
• Scapula (shoulder blade)

Spinal Column

• Cervical vertebrae (upper spine)
• Thoracic vertebrae (middle spine)
• Lumbar vertebrae (lower spine)
• Sacrum (base of the spine)
• Coccyx (tailbone)

Head and Face

• Cranial bones (skull)
• Facial bones
• Nasal bones
• Maxilla (upper jaw)
• Mandible (lower jaw)
  

Arms and Hand

• Humerus (upper arm bone)
• Radius (larger forearm bone)
• Ulna (smaller forearm bone)
• Carpals (wrist bones)
  
• Metacarpals (hand bones)
• Phlanages (fingers)

Lower Body

• Pelvis girdle (pelvic bones)
• Femur (thigh bone)
• Tibia (larger calf bone)
• Fibula (smaller calf bone)
• Patella (kneecap)
• Tarsals (ankle bones)
• Metatarsals (foot bones)
• Phalanges (toes)
  

Pattern of Bone Fractures

After the initial physical examination, an orthopedist or orthopedic surgeon will want to classify the fracture by the pattern of the break. As this may not be visible to the naked eye, an X-ray may be needed.

There are seven main break patterns:

• Longitudinal fractures occur when a bone breaks in a straight line along its length.
• Transverse fractures occur when a bone is broken straight across perpendicular to its length.
• Oblique fractures, also known as angulated fractures, occur when a bone is broken at an angle.
• Comminuted fractures occur when a bone breaks into more than three separate pieces.
• Segmental fractures occur when a bone breaks in at least two places, leaving a segment of bone separated by the breaks.
  
• Spiral fractures, also known as torsion fractures, occur when a twisting injury causes the bone to break in a corkscrew pattern.
• Greenstick fractures occur when a bone bends enough to crack one side without snapping into pieces.
  

Bone Fracture Types by Cause

Based on these initial assessments, the orthopedist or orthopedic surgeon should be able to establish the cause of the fracture and determine the treatment plan.

Among some of the more common diagnoses:

• Stress fractures, also known as hairline fractures, are those that cause a small crack or fissure in the bone, but the bone remains largely intact. These are often caused by an overuse (repetitive stress) injury, such as can occur with sports.
• Avulsion fractures occur when a sudden forceful pull on a tendon while the bone is moving in the opposite direction. This can occur with things like a twisted ankle.
• Buckle fractures, also known as torus or impacted fractures, are most common in kids in whom a fall can cause bones to buckle, bulge, and shorten rather than outright break. Children under 12 are most commonly affected.
• Pathologic fractures occur as a result of a medical condition affecting the bone, such as bone cancer. Changes in the bone make it vulnerable to fracture by things that normally wouldn't cause a break.
• Compression fractures affect the spine. Common in people with osteoarthritis, they are characterized by the collapse of spinal bones (vertebrae), either on their own or due to an accident (such as falling from a height onto your feet).

How to Tell if You've Broken a Bone

Some bone fractures are obvious, while others may be subtle and easily confused with a sprain or strain. Some of the more common symptoms of a bone fracture include:

• Deep swelling and bruising around the injury site
• Intense pain
• Numbness or tingling
• Pain that worsens with physical activity
• Inability to bear weight on or move a limb
• A visibly misshapen limb or joint
• A bone that is visibly out of place
• A bone protruding out of broken skin

If you are unsure whether you have broken something or not, err on the side of caution and see a healthcare provider as soon as possible. Leaving a fracture untreated can cause far more serious problems in later life.

How a Fracture Is Diagnosed and Treated

A bone fracture can be diagnosed by an orthopedist or orthopedic surgeon. Although it may be easy to tell that a bone is broken by looking at it, imaging tests are typically used to characterize the break and ensure no other injury is involved.

X-rays are usually sufficient for uncomplicated fractures. Complex breaks may require a computed tomography (CT) scan, which composites multiple X-ray images to generate a three-dimensional visualization of the break.

The treatment of a broken bone depends on which bone is fractured, how bad the injury is, and what your bone health and overall health are like.

Treatment of a fracture can involve:

• Immobilization, using walking boots, slings, or simple taping rather than a fixed cast
• Casts, including those made of fiberglass or plaster
• Traction, using devices to realign bones back into their correct position
• Internal fixation, using pins, rods, and screws to hold bone fragments together
• Open reduction internal fixation (ORIF), using an external framework connected to the bone through the skin to help complex fractures heal correctly
• Physical therapy to aid with recovery
  

How to Prevent Fractures

If you take part in sports or other activities that put you at risk for broken bones, the best way to prevent fractures is to use the right protective gear. Examples include putting on shin guards when you play soccer and wearing a helmet when biking or horseback riding.

If you’re at a high risk for a broken bone because of your health—for example, because you have weak bones from osteoporosis—you may need to take proactive steps to prevent falls. For instance, you may need to be extra careful when taking the stairs, remove throw rugs from your bedroom to prevent tripping, and sand or salt your driveway in icy weather to reduce your risk of slipping.

Summary

A broken bone and a fracture are the same; the words are just used interchangeably. Whether your provider says you have a broken bone or a fracture, the treatment for the injury will be the same. However, the course of treatment will depend on how bad the break is, what type of fracture it is, and your overall health. 

You can prevent fractures by knowing the risks of your hobbies or sports activities and taking steps to prevent injuries. Also consider making changes in your home to protect against falls, and go about your day-to-day life with a mindset to guard against possible accidents (like wearing your seatbelt in the car).