Did I Break the Bone or Just Fracture It?

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Picture of Broken Arm in a CastYadier Molina broke his wrist in May 2007 while catching for the St. Louis Cardinals, and some may be surprised that he may not have been casted for a few days. And while I don't understand the rules for baseball's injury reserve list (why was he put on the 15 day disabled list, when the team knows he will be out for four to six weeks?), I do however, know what's going on with fracture care.

First a few quick definitions.

  • Broken, cracked, or fractured all mean the same thing, that the integrity of the bone is no longer intact. One term is not worse than another. How many times have people thanked me that their ankle wasn't broken, just fractured! I have to remind myself to do the definition list at the bedside as well.

  • Fractures can be displaced or non-displaced, and this attempts to explain whether the bones are aligned properly. Some amount of displacement is allowed depending on which bone is broken and where in the bone the break occurs. The body can remodel bones as they heal, so displaced does not automatically equal having to "set" the bones.

  • Setting means reducing or realigning the bones so they look and function better. The vast majority of fractures that have to be reduced will have that procedure done under anesthesia. And sometimes, bones that appear well aligned right after the injury may move and then require reduction later on.

  • Finally, if the skin over the fracture is lacerated or torn, this is considered an open fracture and will need to be cleaned out, because outside world has invaded the break and the risk of infection is high.

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