What Kind of Break?

Doctors talk about broken bones, also called fractures, with a few basic terms:

• Open or closed? Closed, or simple, fractures don’t break through the skin. Open, or compound, ones do.
• Partial or complete? Partial breaks don’t go all the way through the bone. Complete breaks mean the bone is in two or more pieces.
• Displaced or non-displaced? If the broken pieces still line up, it’s a non-displaced break. If they don’t, it’s displaced.

Types of Fractures

Common types of breaks include:

• Transverse: breaks straight across the bone
• Stress fracture: a very thin crack, also called a hairline fracture
• Oblique: breaks at an angle
• Greenstick: breaks on one side, but bends on the other–like a fresh stick from a tree
• Comminuted: bone breaks into three or more pieces

Other types include compression fractures, which often happen in the spine, spiral fractures, and avulsion fractures, when a tendon or ligament pulls off a piece of bone.

What It Feels Like: Pain

Sometimes, kids get small fractures and don’t even know it. Other times, your body may be in shock so you don’t feel anything at all–at first. But usually a broken bone means a deep, intense ache. And depending on the break, you may feel sharp pain, too.

What It Feels Like: Other Symptoms

Aside from pain, your body sets off all kinds of alarms to tell you something’s really wrong. You might feel chilly, dizzy, or woozy. You might even pass out.  Around the break itself, you might notice:

• Bruising
• Stiffness
• Swelling
• Warmth
• Weakness

You may also have trouble using that body part or see that the bone doesn’t look right — like it’s bent at an odd angle.

Bone Repair: Step 1

Bone repair begins within just a few hours of the injury. You get a healthy swelling around the break as a blood clot starts to form. Your immune system sends in cells that act like trash collectors — they get rid of small bone pieces and kill any germs. Also, you grow blood vessels into the area to help the healing process. This step may last a week or two.

Bone Repair: Step 2

Over the next 4-21 days, you get a soft callus around the broken bone. This is when a substance called collagen moves in and slowly replaces the blood clot. The callus is stiffer than a clot, but not as strong as bone. That’s part of the reason you get a cast — it holds the healing bone in place. If it moved, the soft callus could break and set back your recovery.

Bone Repair: Step 3

About 2 weeks after the break, cells called osteoblasts move in and get to work. They form new bone, adding minerals to the mix to make the bone hard and strong as it bridges the broken pieces. This stage is called the hard callus. It usually ends 6-12 weeks after the break.

Bone Repair: Step 4

Now you’re in the homestretch: bone remodeling. Here, cells called osteoclasts do some fine-tuning. They break down any extra bone that formed during healing so your bones get back to their regular shape. When you reach this stage, returning to your normal activities actually helps you heal. This step may continue long after you feel better, sometimes lasting up to 9 years.

Treatment for Basic Breaks

Treatment for any break comes down to three basic steps:

• Get the bone lined up in the right place.
• Keep it from moving until it’s healed.
• Manage the pain.

For a basic break, your doctor may have to set the bone back in place. Then, you’ll probably get a splint, brace, or cast to support your bone and keep you from moving it. Your doctor may also give you medicine for the pain.

Treatment for Complex Breaks

For more severe breaks, you may need surgery. Doctors might put in screws, pins, rods, or plates to hold bones in place so they can heal correctly. Those parts may stay in place after you’ve healed, or in some cases, your doctor will take them out.

In rare cases, you may need traction, a system of pulleys and weights around your hospital bed that hold your bones in the right position.