Table of ContentsView AllTable of ContentsSignsCausesTypesLocationsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Signs
Causes
Types
Locations
Diagnosis
Treatment
A closed fracture is a broken bone that does not penetrate the skin. This is an important distinction because when abroken bonepenetrates the skin (anopen fracture), urgent treatment is needed, and an operation is often required to clean the area of the fracture.
Closed fractures may still require surgery for proper treatment, but surgery is often not as urgent and can be performed in the days or weeks following the injury. Whether the fracture is closed or open, if you suspect you have a fracture, seek medical care.
This article will explain the signs and symptoms of a closed fracture, describe several types, and address diagnostic and treatment options.
Matt Meadows / Getty Images
Signs of a Closed Fracture
There are several signs and symptoms that you might have a closed fracture.Signs of a fractureinclude:
Generally, there is pain around the injury, and you may be unable to move the affected area. The injury may also appear crooked and out of place. If the skin is broken over the injury, the fracture may be an open fracture, which carries a greater risk of infection.
Closed vs. Open FractureIn an open fracture, the injury breaks the skin. You may or may not be able actually to see the bone. In a closed fracture, the skin remains intact.
Closed vs. Open Fracture
In an open fracture, the injury breaks the skin. You may or may not be able actually to see the bone. In a closed fracture, the skin remains intact.
Causes of Closed Fractures
Closed fractures can occur from a variety of different causes. The main causes are trauma, overuse injuries,osteoporosis, and pathological fractures.
Trauma
Fractures most often occur due to trauma or injury to the bone, such as a fall, motor vehicle collision, orsports injury.
Overuse
Fractures can also occur as a result of overuse. Overuse fractures are also known asstress fracturesand occur due to excessive, repetitive use of the bone. They are common in athletes.
Osteoporosis
Osteoporosis weakens bones. Individuals with osteoporosis are more likely to experience a fragility fracture or an insufficiency fracture. Afragility fractureoccurs with a low-impact activity that would typically not induce a fracture. An insufficiency fracture is a type of stress fracture.
Pathological
Weakening of the bone from various illnesses and disease states can cause fractures. These types of injuries are called pathologic fractures and typically result in a closed fracture pattern. Pathologic fractures occur when a bone weakens, typically from tumors orvarious cancers.
Types of Closed Fractures
There are several different types of fractures that can cause a closed fracture. The type of closed fracture you experience significantly affects how the fracture is treated. The types of closed fractures include:
Fracture types can be mixed. For example, you might have a stable transverse or oblique fracture.
You may also hear your healthcare provider use the terms “displaced” and “non-displaced” fracture. A displaced fracture means the bones are out of alignment. This type of fracture is more likely to require surgery. In a non-displaced fracture, the broken bones remain aligned. This type of injury is more likely torecover with a castand immobilization and less likely to require surgery.
Locations of Closed Fractures
Fractures can happen throughout the body. Common locations of fractures can include bones of the wrist, hips, ankles, spine, and clavicle (collarbone).
Broken Wrist
Awrist fractureis one of the most common fractures in the United States.Closed wrist fractures can often be treated with a cast to hold the healing bones in the proper position. More severe wrist fractures may require surgery, even when the injury is closed. In these cases, pins, plates, and screws are commonly used for treatment.
Hip Fracture
Abroken hipis usually a closed fracture and is common in individuals aged 80 and older.These are often closed fractures, as open hip fractures are exceedingly rare injuries. In older patients, osteoporosis causes hip fractures. Trauma, such as from a car accident, is usually the cause of hip fractures in other populations. Despite being a closed fracture, broken hips almost always require surgical treatment.
Ankle Fracture
Stress fractures are one of the more commonankle fracturetypes. Runners and athletes involved in sports that involve a lot of running (e.g., soccer and basketball) are especially susceptible to stress-related ankle fractures.
Trauma, such as from a car crash or fall, is another cause of ankle fractures. Other causes include twisting orrolling the ankle. Surgery may be needed depending on the type and severity of the injury.
Vertebral Compression Fracture
The spinal column is made of vertebrae stacked up upon each other. Osteoporosis can weaken the bones in the spinal column. Spinal compression fractures are most common in older individuals and often occur with relatively minor injuries or even no known injury at all. They are one of the most common complications of osteoporosis. Healthcare providers typically suggest nonsurgical treatments first before considering surgical intervention.
Clavicle Fracture
Clavicle fracturesare another common fracture type. They occur in all age groups. In kids and adults, clavicle fractures are typically the result of a fall or accident. In babies, clavicle fractures can happen during childbirth. Most clavicle fractures can heal without surgery unless the bones have significantly shifted.
Diagnosing a Closed Fracture
A healthcare provider will do a physical exam and also likely order X-rays to diagnose a fracture. If a healthcare provider suspects a fracture but does not see one on an X-ray, they may order additional imaging, such as anMRI or CT scan.
A CT scan can provide more detailed pictures than an X-ray and may pick up small fractures more easily.
An MRI can show changes to the soft tissues as well as injury within the bone. Sometimes very small fractures do not show up on X-rays until the injury begins to heal. MRIs can show injury to surrounding structures that indicate there’s a fracture, even if it is not easily detectable on an X-ray.
If a healthcare provider is concerned about additional injuries, such as blood vessel or nerve damage or an infection, they may order additional tests.Angiographyis imaging, such as an X-ray or a CT scan, that is done after a contrast dye is injected. Angiography can show damage to blood vessels from a fracture.
A healthcare provider may ordernerve conduction teststo assess for damage to nerves from a fracture.
Treating a Closed Fracture
Fracture treatment is highly dependent on several different factors. Factors such as patient age, patient preference, and surgeon preference play a role. Some of the treatments used for closed fractures include:
How long does a closed fracture take to heal?How long a closed fracture takes to heal depends on several conditions. Recovery can last from just a few weeks to several months, depending on your health, age, and the severity of your injury.
How long does a closed fracture take to heal?
How long a closed fracture takes to heal depends on several conditions. Recovery can last from just a few weeks to several months, depending on your health, age, and the severity of your injury.
Summary
Closed fractures are when a bone breaks, but there is no break in the skin over the injury. There are several causes of closed fractures.
Whether a fracture is treated conservatively or with surgery depends on the injury’s severity, the patient’s health and age, and the provider’s preference. Closed fractures are typically less emergent than open fractures due to the decreased infection risk.
Several treatment options exist, and surgery is not always necessary to align and heal the bones. If you think you might have a closed fracture, seek advice and treatment from a healthcare provider.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hannigan GD, Pulos N, Grice EA, Mehta S.Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections.Adv Wound Care (New Rochelle). 2015;4(1):59–74. doi:10.1089/wound.2014.0531American Academy of Orthopaedic Surgeons.Fractures (Broken bones).MedlinePlus.Fractures.Palmer W, Bancroft L, Bonar F, et al.Glossary of terms for musculoskeletal radiology.Skeletal Radiol. 2020;49(S1):1-33. doi:10.1007/s00256-020-03465-1Bentohami A, van Delft EAK, Vermeulen J, et al.Non- or minimally displaced distal radial fractures in adult patients: three weeks versus five weeks of cast immobilization—a randomized controlled trial.J Wrist Surg. 2019;8(1):43-48.Ye J, Li Q, Nie J.Prevalence, characteristics, and associated risk factors of wrist fractures in Americans above 50: the cross-sectional NHANES study.Front Endocrinol (Lausanne). 2022;13:800129.Zhang YW, Lu PP, Li YJ, et al.Prevalence, characteristics, and associated risk factors of the elderly with hip fractures: a cross-sectional analysis of NHANES 2005–2010.Clin Interv Aging. 2021;16:177-185.American Academy of Orthopaedic Surgeons.Hip fractures.American Academy of Orthopaedic Surgeons.Stress fractures of the foot and ankle.American Academy of Orthopaedic Surgeons.Ankle fractures (Broken ankle).McCARTHY J, Davis A.Diagnosis and management of vertebral compression fractures.American Family Physician. 2016;94(1):44-50.American Academy of Orthopaedic Surgeons.Clavicle fracture (Broken collarbone).Merck Manual Consumer Version.Overview of fractures.Additional ReadingFonseca H, Moreira-Gonçalves D, Coriolano HJ, Duarte JA. “Bone quality: the determinants of bone strength and fragility” Sports Med. 2014 Jan;44(1):37-53.Halawi MJ, Morwood MP. “Acute Management of Open Fractures: An Evidence-Based Review” Orthopedics. 2015 Nov;38(11):e1025-33.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hannigan GD, Pulos N, Grice EA, Mehta S.Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections.Adv Wound Care (New Rochelle). 2015;4(1):59–74. doi:10.1089/wound.2014.0531American Academy of Orthopaedic Surgeons.Fractures (Broken bones).MedlinePlus.Fractures.Palmer W, Bancroft L, Bonar F, et al.Glossary of terms for musculoskeletal radiology.Skeletal Radiol. 2020;49(S1):1-33. doi:10.1007/s00256-020-03465-1Bentohami A, van Delft EAK, Vermeulen J, et al.Non- or minimally displaced distal radial fractures in adult patients: three weeks versus five weeks of cast immobilization—a randomized controlled trial.J Wrist Surg. 2019;8(1):43-48.Ye J, Li Q, Nie J.Prevalence, characteristics, and associated risk factors of wrist fractures in Americans above 50: the cross-sectional NHANES study.Front Endocrinol (Lausanne). 2022;13:800129.Zhang YW, Lu PP, Li YJ, et al.Prevalence, characteristics, and associated risk factors of the elderly with hip fractures: a cross-sectional analysis of NHANES 2005–2010.Clin Interv Aging. 2021;16:177-185.American Academy of Orthopaedic Surgeons.Hip fractures.American Academy of Orthopaedic Surgeons.Stress fractures of the foot and ankle.American Academy of Orthopaedic Surgeons.Ankle fractures (Broken ankle).McCARTHY J, Davis A.Diagnosis and management of vertebral compression fractures.American Family Physician. 2016;94(1):44-50.American Academy of Orthopaedic Surgeons.Clavicle fracture (Broken collarbone).Merck Manual Consumer Version.Overview of fractures.Additional ReadingFonseca H, Moreira-Gonçalves D, Coriolano HJ, Duarte JA. “Bone quality: the determinants of bone strength and fragility” Sports Med. 2014 Jan;44(1):37-53.Halawi MJ, Morwood MP. “Acute Management of Open Fractures: An Evidence-Based Review” Orthopedics. 2015 Nov;38(11):e1025-33.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Hannigan GD, Pulos N, Grice EA, Mehta S.Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections.Adv Wound Care (New Rochelle). 2015;4(1):59–74. doi:10.1089/wound.2014.0531American Academy of Orthopaedic Surgeons.Fractures (Broken bones).MedlinePlus.Fractures.Palmer W, Bancroft L, Bonar F, et al.Glossary of terms for musculoskeletal radiology.Skeletal Radiol. 2020;49(S1):1-33. doi:10.1007/s00256-020-03465-1Bentohami A, van Delft EAK, Vermeulen J, et al.Non- or minimally displaced distal radial fractures in adult patients: three weeks versus five weeks of cast immobilization—a randomized controlled trial.J Wrist Surg. 2019;8(1):43-48.Ye J, Li Q, Nie J.Prevalence, characteristics, and associated risk factors of wrist fractures in Americans above 50: the cross-sectional NHANES study.Front Endocrinol (Lausanne). 2022;13:800129.Zhang YW, Lu PP, Li YJ, et al.Prevalence, characteristics, and associated risk factors of the elderly with hip fractures: a cross-sectional analysis of NHANES 2005–2010.Clin Interv Aging. 2021;16:177-185.American Academy of Orthopaedic Surgeons.Hip fractures.American Academy of Orthopaedic Surgeons.Stress fractures of the foot and ankle.American Academy of Orthopaedic Surgeons.Ankle fractures (Broken ankle).McCARTHY J, Davis A.Diagnosis and management of vertebral compression fractures.American Family Physician. 2016;94(1):44-50.American Academy of Orthopaedic Surgeons.Clavicle fracture (Broken collarbone).Merck Manual Consumer Version.Overview of fractures.
Hannigan GD, Pulos N, Grice EA, Mehta S.Current Concepts and Ongoing Research in the Prevention and Treatment of Open Fracture Infections.Adv Wound Care (New Rochelle). 2015;4(1):59–74. doi:10.1089/wound.2014.0531
American Academy of Orthopaedic Surgeons.Fractures (Broken bones).
MedlinePlus.Fractures.
Palmer W, Bancroft L, Bonar F, et al.Glossary of terms for musculoskeletal radiology.Skeletal Radiol. 2020;49(S1):1-33. doi:10.1007/s00256-020-03465-1
Bentohami A, van Delft EAK, Vermeulen J, et al.Non- or minimally displaced distal radial fractures in adult patients: three weeks versus five weeks of cast immobilization—a randomized controlled trial.J Wrist Surg. 2019;8(1):43-48.
Ye J, Li Q, Nie J.Prevalence, characteristics, and associated risk factors of wrist fractures in Americans above 50: the cross-sectional NHANES study.Front Endocrinol (Lausanne). 2022;13:800129.
Zhang YW, Lu PP, Li YJ, et al.Prevalence, characteristics, and associated risk factors of the elderly with hip fractures: a cross-sectional analysis of NHANES 2005–2010.Clin Interv Aging. 2021;16:177-185.
American Academy of Orthopaedic Surgeons.Hip fractures.
American Academy of Orthopaedic Surgeons.Stress fractures of the foot and ankle.
American Academy of Orthopaedic Surgeons.Ankle fractures (Broken ankle).
McCARTHY J, Davis A.Diagnosis and management of vertebral compression fractures.American Family Physician. 2016;94(1):44-50.
American Academy of Orthopaedic Surgeons.Clavicle fracture (Broken collarbone).
Merck Manual Consumer Version.Overview of fractures.
Fonseca H, Moreira-Gonçalves D, Coriolano HJ, Duarte JA. “Bone quality: the determinants of bone strength and fragility” Sports Med. 2014 Jan;44(1):37-53.Halawi MJ, Morwood MP. “Acute Management of Open Fractures: An Evidence-Based Review” Orthopedics. 2015 Nov;38(11):e1025-33.
Fonseca H, Moreira-Gonçalves D, Coriolano HJ, Duarte JA. “Bone quality: the determinants of bone strength and fragility” Sports Med. 2014 Jan;44(1):37-53.
Halawi MJ, Morwood MP. “Acute Management of Open Fractures: An Evidence-Based Review” Orthopedics. 2015 Nov;38(11):e1025-33.
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