Fracture (broken bone): symptoms, treatment and recovery

A fracture is the medical word for a broken bone. Breaks vary from a small crack to a bone that has come out of position or through the skin. The NHS says treatment depends on the type of break and how bad it is.

Fractures often follow an injury such as a fall or an accident. The NHS says a broken leg often happens after a serious accident like a car crash, and a broken hip usually happens because of a fall or injury and is more common in older people and people who have osteoporosis. A stress fracture is a different kind: pain that has come on over a few weeks from small cracks or breaks, usually caused by a repetitive activity such as running.

The NHS says you may have broken a bone if you have injured the area and it is painful, swollen and bruised, and difficult to move. It may also be shorter, twisted or bent, change colour or shape, feel numb, or make a grating noise as the ends of broken bones rub together. If the break is severe there may be a wound with the bone sticking out.

It can be hard to tell if a bone is broken, dislocated or badly sprained, and you will probably need an X-ray. For a toe, the NHS says do not worry if you are not sure whether it is broken or just bruised, as treatment is usually the same for both.

The NHS pages for broken arm, leg, ankle, collarbone, hip and toe give similar advice about when to call NHS 111, go to A&E or call 999. Do not drive yourself to A&E; ask someone to drive you or call 999.

The NHS suggests the following things while waiting to see a doctor, with variations by body part.

• Support the injured arm, for example with a towel or bandage as a sling, and avoid using it. Avoid moving a suspected broken leg or putting weight on it.

• Hold an ice pack (or a bag of frozen peas) wrapped in a tea towel to the injured area for up to 20 minutes every 2 to 3 hours.

• Stop any bleeding by applying pressure to the wound with a clean pad or dressing, without pressing on a broken bone.

• Remove any jewellery such as rings or watches, because fingers, wrist or hand could swell.

• Use painkillers such as paracetamol, or ibuprofen gel, if a healthcare professional has advised you to.

• Do not eat or drink anything in case you need surgery to fix the bone when you get to hospital.

At hospital, an X-ray is used to see if there is a break and how bad it is. The NHS says the affected arm may be placed in a splint to support it and stop broken bones moving out of position, and you will be given painkillers. A plaster cast can be used to keep the arm in place until it heals, sometimes applied a few days later to let swelling go down first.

A doctor may try to move the broken bones back into place with their hands, with medicine to reduce or stop the pain beforehand. If you have a very bad break, surgery may be needed to fix the bones back into place, using plates, rods or screws for serious leg breaks. A weight and pulley (traction) is often used to treat small children with a broken thigh bone.

For a stress fracture the NHS says treatment is rest, avoiding the activity that caused it and taking weight off using crutches or a padded boot. A broken hip needs treatment in hospital straight away and always needs surgery, usually on the day of arrival or the following day. A very minor ankle break may not need any treatment.

Healing time depends on the bone, how severe the break is, and your age and health. The NHS gives these typical timescales, and says recovery can take longer if a break is severe.

The NHS says to keep a plaster cast dry (waterproof covers are available from pharmacies), not to scratch under it with anything because that could cause infection, not to drive or lift heavy items until told it is safe, and to follow exercise advice from the hospital or fracture clinic. Rest and raise the injured limb whenever possible.

Get help from NHS 111 if you are recovering from a broken bone and the pain gets worse, your temperature is very high or you feel hot, cold or shivery, the cast breaks or feels too tight or too loose, your fingers or toes feel numb or burning, look swollen or turn blue or white, or there is a bad smell or discharge from under the cast.

The NHS says osteoporosis develops slowly over several years and is often only diagnosed when a fall or sudden impact causes a bone to break. The most common fractures in people with osteoporosis are the wrist, the hip and the spinal bones, although breaks can also happen in other bones.

To lower the chance of breaking a leg, the NHS suggests wearing the right shoes and taking enough rest time if you run a lot, eating a healthy diet that includes protein, calcium and vitamin D, and preventing falls by making sure rooms and staircases are well lit, using non-slip mats and doing strength and balance exercises. If you are over 50 and have broken an arm, wrist or hip, ask your GP surgery about a fracture liaison service.

Suspected fractures are assessed on the NHS through NHS 111, urgent treatment centres, minor injury units or A&E, where X-rays, casts and surgery are provided. Follow-up is usually in a fracture clinic, and the NHS says physiotherapy may be needed afterwards.

Some people use a private orthopaedic service or physiotherapist for follow-up or rehabilitation. It helps if any private provider has access to your X-rays and hospital notes and shares their advice with your GP.