Breaking a bone is a serious and scary situation that can happen to anyone in a number of different ways. The most common way a bone breaks is through a traumatic event like a car accident, a fall, or a sports-related injury; however, a broken bone can even occur through improper overuse. Those diagnosed with Osteoporosis are much more likely to find themselves with a fracture because the ailment itself leads to weakened bones, making them more likely to break.

Bone breaks are categorized into different types of fractures. The most common types are stable fractures, open compound fractures, transverse fractures, oblique fractures, and comminuted fractures. These types of fractures range in severity from a simple bone displacement to a fracture involving the bone breaking through the skin.

Once a doctor diagnoses what kind of fracture you have, they can develop a treatment plan. For some breaks, your doctor might elect to treat it with a cast, sling, or boot; for a more severe break, the patient may require surgery. Treatment options depend on where the fracture is located, the patient's age and health, and the break's severity. 

Dr. Michael Hawks, a board-certified orthopedic surgeon specializing in Orthopaedic Trauma and Fracture Care, held an open Q&A segment with our followers on Instagram to answer some of the most common questions about fractures. Keep reading to get a first-hand account of treatment options, their differences, recovery success rates, and more.

What is the most painful fracture?

Dr Hawks: I might not be an expert on this topic since —fun fact — I’ve never broken a bone myself! But after treating tens of thousands of injured patients over the years, I’d probably guess that the top three would be fractures of the ribs, hips, and spine.

That said, any broken bone hurts, and not a week goes by that I don't hear, “Doc, this is the worst pain I’ve ever felt, and I’ve had ‘insert any other painful condition here!’”

What are some signs of a definite fracture vs. a bruise or sprain?

Dr. Hawks: Sometimes, it’s very difficult to distinguish between a soft tissue injury, bruise or sprain, and a true fracture without taking x-rays and/or other imaging. Both types of injuries occur after similar mechanisms, like twisting your ankle or bracing a fall with your hand. If you suspect you have had a serious enough injury to possibly have caused a broken bone, an x-ray of the area will help lead to the proper diagnosis and guide treatment.

If a bone breaks, do I have to get surgery?

Dr. Hawks: Great question! Actually, many broken bones can heal properly without surgery. How a break is treated depends on the location of the break -involvement of a moving joint usually requires surgery- the distance it’s moved, and the age of the patient - most fractures in kids can be treated with casts/splints- and other factors.

If a bone heals in a cast, will it break again more easily? Would surgery prevent this?

Dr. Hawks: Whether an injury is treated with casting or surgery, the goal is for complete healing and return to full function. Sometimes your doctor may need to perform surgery to realign fractures that would be unstable with casting alone or are too displaced to imagine casting would work. But to answer your question, we would not expect a bone to break more easily if treated to complete healing in a cast.

Is a boot the same as a cast?

Dr. Hawks: If your doctor has recommended a cast, he or she believes that completely immobilizing the break will lead to better results. A boot is used when less protection is needed and when some time out of the boot to work on your flexibility is desired.