What is bone a fracture and how long does it take to heal?

A bone fracture occurs when there is a break or a crack in the continuity of a bone, disrupting its normal structure and function. This can result from trauma, such as a fall or impact, or from conditions that weaken the bone, like osteoporosis. Fractures vary in severity, ranging from hairline cracks to complete breaks that may cause displacement of bone fragments. Common symptoms include pain, swelling, and difficulty using the affected limb.

How long does a bone fracture take to heal?

Broadly speaking all bones would have healed after 6 to 12 weeks from a fracture. This can vary depending on multiple factors. Children’s bones heal much faster than adults. Smoking or certain medication will have a detrimental effect on bone healing. Lastly, the type of treatment provided will also play a role.

If a fracture takes twice as long to heal than expected for a specific bone and patient age,  we talk about “delayed union”. When a fracture does not heal even past that delayed time and after 6 or 9 months, the term used is “non-union” or “pseudo-arthrosis”.

As early as 3 weeks from the fracture, there is a bridging callus made of calcified cartilage which represents a degree of healing that stabilises the bone. The secondary callus which is stronger than the bridging one and of a similar consistency of mature bone will appear between 4 and 8 weeks in most cases. However, a radiological callus which is clearly visible on an X-ray is not present at least until 12 weeks from the fracture. This is why a fracture line will still show on x-rays for the first 3 months without this necessarily representing any abnormality or delay in the healing process.

What can cause delays in the healing?

Delay in bone healing can be caused by many factors but the most notorious one is smoking. The detrimental effects of smoking have been well described and these not only involve delayed healing but also increased risk of developing other types of complications. Smoking reduces blood flow to the fracture site and impairs the healing process. Even though smoking cessation strategies are not easy to implement I always warn my patients that they must try hard given the clear benefits towards an uneventful recovery from a foot or ankle fracture. Some adverse effects persist for a prolonged period of time but it is never too late to quit smoking!

Is there anything I can do to make a bone heal more quickly?

There are some strategies to enhance bone healing when it is not following its usual course. An innovative bone healing stimulator that uses low intensity pulsed ultrasound waves is available through our clinic and has shown excellent results. It is a device that can be taken home and applied on a daily basis with a risk- and pain- free profile. It is approved by the National Institute for Clinical Excellence (NICE) which is the public body of the Department of Health in the UK that publishes guidelines on healthcare topics.

Increasing numbers of stress fractures

After the pandemic, I have seen an increasingly high number of foot stress fractures in my clinics. My assumption is that due to lockdowns and other limitations a good number of people suddenly decided to become active (mainly in the form of jogging) or increase their previous level of activity. This is per se a good thing but doing it too abruptly or without the necessary preparation can be damaging and lead to stress fractures.

Stress fractures are a very different type of fracture than those sustained after a high impact when the bone breaks and separates. They occur during low energy activities that repeatedly cause stress in the bone. This is due to microtrauma more than a high-energy trauma.

The foot and ankle are the most common areas of stress fractures in the body. Many foot bones are susceptible to stress fractures but the most frequently affected are the metatarsals.

A stress fracture in the metatarsal is also called a “march fracture” as they were initially described in soldiers who were accustomed to long marches, but in my practice the vast majority are seen in athletes, particularly runners. They would present with pain and swelling on the top of the foot, walking may be difficult but generally possible.

Once the necessary tests have been done to confirm the diagnosis, metatarsal stress fractures will be treated with a period of rest from sporting activities, offloading in a boot or orthopaedic shoe and physiotherapy.

Recognising the signs and symptoms of these conditions is crucial for seeking timely medical attention. Mr Francesc Malagelada is dedicated to diagnosing and treating various foot and ankle conditions, providing personalised treatment plans to address your specific needs and help you get back on your feet comfortably. Contact us and book an appointment today!

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This article is for information purposes only and is not a substitute for professional medical advice. Consult your physician for personalised guidance. In case of a medical emergency, contact your doctor or emergency services.