Fracture Types by Body Region
A comprehensive reference to fracture classification, healing timelines, and treatment approaches across the skeletal system.
Fracture Classification System
Orthopedic fractures are categorized by how the bone breaks. The pattern of the break determines treatment approach, healing time, and whether surgery is required.
Clean break without skin penetration. Bone stays aligned or nearly so.
Lower severityBone pierces through the skin, creating infection risk. Requires urgent care.
High severityBone shatters into three or more fragments. Common in high-energy trauma.
High severityIncomplete break where bone bends. Almost exclusively seen in children.
Lower severityHairline crack from repetitive force. Common in runners and military recruits.
Moderate severityBone is crushed or collapses. Typically occurs in spinal vertebrae from osteoporosis.
Moderate severityFragment pulled away at tendon or ligament attachment. Common in sports injuries.
Moderate severityTwisting force creates a corkscrew-shaped break along the bone shaft.
High severityDiagonal break across the bone at an angle. May shift after initial injury.
Moderate severityStraight horizontal break perpendicular to the bone's long axis.
Moderate severityUpper Extremity Fractures
Shoulder, arm, wrist, and hand fractures account for nearly half of all fractures treated in emergency departments.
Colles Fracture (Distal Radius)
Sometimes surgicalCaused by falling onto an outstretched hand (FOOSH injury). The most common wrist fracture. The broken end of the radius tilts upward, producing a visible "dinner fork" deformity. Especially prevalent in older adults with osteoporosis.
Boxer's Fracture
Rarely surgicalBreak at the neck of the fifth metacarpal, typically from punching a hard surface. Causes swelling and loss of knuckle prominence.
Humeral Shaft Fracture
Sometimes surgicalBreak in the middle portion of the upper arm bone. Often from direct blows, falls, or motor vehicle accidents. Risk of radial nerve injury.
Clavicle Fracture
Rarely surgicalThe collarbone is the most commonly broken bone. Usually from falls onto the shoulder or direct impact. Mid-shaft breaks are the most frequent.
Lower Extremity Fractures
Leg, knee, ankle, and foot fractures often require longer recovery due to weight-bearing demands.
Tibial Plateau Fracture
Usually surgicalFracture of the top of the shinbone at the knee joint. Caused by high-energy falls, vehicle collisions, or sports impacts. Joint surface damage can lead to long-term arthritis if not properly aligned.
Ankle (Malleolar) Fracture
Sometimes surgicalBreak involving one or more of the three malleoli (bony bumps around the ankle). Twisting injuries are the primary cause. Bimalleolar and trimalleolar fractures typically require surgical fixation for joint stability.
Fibula Fracture
Rarely surgicalBreak in the thinner outer bone of the lower leg. Often occurs alongside ankle fractures or from direct impact. Isolated fibula fractures may heal with a walking boot alone.
Metatarsal Stress Fracture
Rarely surgicalHairline cracks in the foot bones from overuse. The second and third metatarsals are most affected. Common in distance runners, dancers, and military recruits during basic training.
Hip and Pelvis Fractures
Among the most serious fractures, especially in older adults. Hip fractures carry significant mortality risk and nearly always require surgical intervention.
Femoral Neck Fracture
Usually surgicalBreak just below the ball of the hip joint. Blood supply disruption can cause the femoral head to die (avascular necrosis). In older patients, total or partial hip replacement is often the best outcome. In younger patients, urgent surgical fixation aims to preserve the joint.
Intertrochanteric Fracture
Usually surgicalBreak between the greater and lesser trochanters of the femur. More common than femoral neck fractures in patients over 70. Blood supply is better preserved than femoral neck fractures, so avascular necrosis is rare.
Pelvic Ring Fracture
Sometimes surgicalDisruption of the bony ring formed by the pelvis. Low-energy fractures (pubic ramus) in osteoporotic patients may heal with rest. High-energy injuries from motor vehicle accidents can be life-threatening due to internal bleeding.
Spine Fractures
Vertebral fractures range from mild compression cracks in osteoporotic bone to devastating high-energy injuries with neurological consequences.
Vertebral Compression Fracture
Sometimes surgicalThe vertebral body collapses, losing height. Most common in the thoracic and lumbar spine. Osteoporosis is the leading cause, and many occur without significant trauma. Multiple compression fractures lead to progressive kyphosis (hunched posture). Vertebroplasty or kyphoplasty may be offered for persistent pain.
Burst Fracture
Usually surgicalVertebral body shatters outward in all directions from axial loading (falling from height, diving into shallow water). Bone fragments may enter the spinal canal and compress the spinal cord.
Chance Fracture
Usually surgicalHorizontal fracture through the vertebral body, pedicles, and posterior elements. Caused by a flexion-distraction mechanism, classically from a lap-only seat belt in a car crash. Associated with abdominal organ injuries.
Hangman's Fracture (C2)
Sometimes surgicalBilateral fracture through the pars interarticularis of the second cervical vertebra (C2). Despite its name, the modern cause is usually hyperextension in motor vehicle accidents. Paradoxically, the spinal canal widens, so neurological injury is uncommon.
Pediatric Fractures
Children's bones are more porous and flexible than adult bone, producing unique fracture patterns. Growth plate injuries require special attention to avoid long-term growth disturbance.
Growth Plate Fracture (Salter-Harris)
Sometimes surgicalInjury to the cartilaginous growth plate (physis) near the ends of long bones. The Salter-Harris classification (Types I through V) describes where the fracture line runs relative to the growth plate. Type I and II fractures generally have excellent outcomes. Types III, IV, and V carry higher risk of growth disturbance and often need surgical alignment.
Torus (Buckle) Fracture
Rarely surgicalThe bone buckles or crumples on one side without breaking through completely. Extremely common in children under 10 who fall on outstretched hands. These are stable injuries that heal reliably with a splint or removable brace.
Greenstick Fracture
Rarely surgicalBone bends and cracks on one side but does not break through completely, like snapping a green twig. The opposite cortex remains intact. Most commonly seen in the forearm bones (radius and ulna) of children under 10. Angulated greenstick fractures may need to be straightened under sedation before casting.
Understanding Your X-Ray
Fracture diagnosis relies on imaging. Your orthopedic team uses X-rays, CT scans, and sometimes MRI to classify the break and plan treatment.
Related Resources Across Our Network
Fracture recovery often overlaps with joint health, soft tissue injuries, and specialist care. Explore these related sites.
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