Oblique Fracture

What is an oblique fracture?

Oblique fractures are a type of broken bone. They happen when one of your bones is broken at an angle. You might see oblique fractures referred to as complete fractures. This means the line of the break goes all the way through your bone.

Oblique fractures usually affect long bones in your body. Some of the most common include:

• Femur (thigh).
• Tibia (shin).
• Fibula (calf).
• Humerus (upper arm).
• Radius and ulna (forearm).
• Clavicle (collarbone).

Oblique fractures are almost always caused by falls or other traumas. You might need surgery to repair your bone. Some people only need a splint or cast for the bone to heal. How long it takes to recover fully depends on which of your bones are fractured — and what caused the breaks. Most people need a few months to recover from an oblique fracture.

Oblique fractures vs. spiral fractures

Oblique fractures and spiral fractures are different types of bone fractures. They are different terms that tell your healthcare provider specific details about how your bones are broken and the shape of the fracture.

Oblique fractures occur when your bone is broken at an angle. The fracture is a straight line that’s angled across the width of your bone. They’re usually caused by landing on your bone at an angle after a fall, or when your bone is hit suddenly from an angle (like in a car accident).

Spiral fractures happen when a fracture winds around the length of your bone — like a spiral staircase. They’re common in sports injuries when people’s bones are twisted with great force (like getting tackled in football).

Oblique fractures vs. transverse fractures

Oblique fractures and transverse fractures both mean the break goes across your bone’s width in a straight line.

Oblique fractures are angled across your bone. Transverse fractures run horizontally perpendicular to your bone (opposite the direction of your bone).

No matter which names and terms end up applied to your fracture, the most important first step is getting your injury examined by your healthcare provider as soon as possible.

How common are oblique fractures?

Oblique fractures are one of the most common kinds of broken bones, especially in long bones.

Who gets oblique fractures?

Oblique fractures — like all bone fractures — can affect anyone. This is especially true because they’re caused by falls or traumas. If you’re at risk for falls, you might be more likely to experience an oblique fracture. People with osteoporosis (weakened bones) have an increased risk for all types of broken bones, including oblique fractures.

What are the symptoms of an oblique fracture?

Symptoms of an oblique fracture include:

• Pain.
• Swelling.
• Tenderness.
• Inability to move a part of your body that you usually can.
• Bruising or discoloration.
• A deformity or bump that’s not usually on your body.

Open vs. closed fractures

Your healthcare provider will classify your fracture as either open or closed. If you have an open fracture, your bone breaks through your skin. Open fractures usually take longer to heal and have an increased risk of infections and other complications. Closed fractures are still serious, but your bone doesn’t push through your skin.

Displaced oblique fractures

Displaced or non-displaced are more terms your healthcare provider will use to describe your fracture. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture. Non-displaced fractures are still broken bones, but the pieces weren’t moved far enough to be out of alignment during the break. Displaced fractures are much more likely to require surgery to repair.

What causes oblique fractures?

Any impact to your bones can cause oblique fractures. They’re usually caused by something hitting your body at an angle. Some of the most common causes are falls, car accidents and sports injuries.

How are oblique fractures diagnosed?

Your healthcare provider will diagnose an oblique fracture with a physical exam and imaging tests.

What tests are done to diagnose an oblique fracture?

After a physical exam, you’ll likely need at least one of a few imaging tests:

• X-rays: An X-ray will confirm any oblique or other fractures and show how damaged your bones are.
• Magnetic resonance imaging (MRI): Your healthcare provider might use an MRI to get a complete picture of the damage to your bones and the area around them. This will show them tissue around your bones, too. This is especially important to determine if your muscles, connective tissue and organs were injured.
• CT scan: If you need surgery, your healthcare provider or surgeon needs to know exactly how damaged your bones are. A CT scan will give them a more detailed picture of your bones and the surrounding tissue than an X-ray. You might need a CT scan if your X-rays were inconclusive or to help your surgeon plan your surgery.

How are oblique fractures treated?

How your oblique fracture is treated depends on the severity of your original break. Your broken bones need to heal back together. Depending on how damaged they are and what caused their break, there are a few treatments your healthcare provider might use.

Immobilization

If your break is mild and your bones didn’t move far out of place (if it’s non-displaced), you might only need a splint or cast. Splinting usually lasts three to five weeks. If you need a cast, it will likely be for longer, typically six to eight weeks. In both cases, you’ll likely need follow-up X-rays to make sure your bones are healing correctly.

Closed reduction

More severe breaks require a closed reduction to set (realign) your bones. During this nonsurgical procedure, your healthcare provider will physically push and pull your body on the outside to line up your broken bones on the inside. To prevent you from feeling pain during the procedure, you’ll receive one of the following:

• Local anesthetic to numb the area around your fracture.
• Sedatives to relax your whole body.
• General anesthesia to make you sleep through the procedure.

After the closed reduction, your healthcare provider will put you in a splint or cast.

Oblique fracture surgery

Internal fixation

The most serious fractures require surgery. Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. They usually perform what’s called an internal fixation, which means your surgeon inserts pieces of metal into your bone to hold it in place while it heals. You’ll probably need to limit how much you use the surgically repaired part of your body to make sure your bone can fully heal.

Internal fixation techniques include:

• Rods: A rod inserted through the center of your bone that runs from top to bottom.
• Plates and screws: Metal plates screwed into your bone to hold the pieces together in place.
• Pins and wires: Pins and wires hold pieces of your bone in place that are too small for other fasteners. They’ll typically be used at the same time as either rods or plates.

Some people live with these pieces inserted in them forever. You might need follow-up surgeries to remove them.

External fixation

You might need an external fixation. Your surgeon will put screws in your bone on either side of the fracture inside your body, then connect them to a brace or bracket around the bone outside of your body. This is usually a temporary way to stabilize your fracture and give it time to begin healing before you have an internal fixation.

Arthroplasty

If you fracture a joint — like your hip, knee or shoulder — you might need an arthroplasty (joint replacement). Your surgeon will remove your damaged joint and replace it with an artificial joint. The artificial joint (prosthesis) can be metal, ceramic or heavy-duty plastic. Your new joint will look like your natural joint and move in a similar way.

Bone grafting

You might need bone grafting if your oblique fracture is severely displaced or if your bone isn’t healing back together as well as it should. Your surgeon will insert additional bone tissue to rejoin your fractured bone. After that, they’ll usually perform an internal fixation to hold the pieces together while your bone regrows. Bone grafts can come from a few sources:

• Internally from somewhere else in your body — usually the top of your hip bone.
• An external donor.
• An artificial replacement piece.

Oblique fracture surgeries are usually outpatient procedures, and you should be able to go home the same day. You might need to stay in the hospital after surgery on a larger bone (like your femur).

After your surgery, the part of your body with the fractured bone in it will be immobilized. You’ll need some combination of a brace, splint or cast before you can start putting any weight on it again or using it as you did before your fracture.

What medications are used to treat oblique fractures?

Over-the-counter NSAIDs like aspirin or ibuprofen can lead to bleeding and other complications after surgery. Your surgeon will talk to you about the medications you can take to reduce pain after your surgery.

NSAID side effects

Side effects of NSAIDs include:

• Bleeding.
• Ulcers.
• Stomach pain.
• Bowel complications.

Complications of oblique fracture treatment

Oblique fracture surgery complications include:

• Acute compartment syndrome (ACS): A build-up of pressure in your muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage.
• Malunion: This happens when your broken bones don't line up correctly while they heal.
• Nonunion: Your bones may not grow back together fully or at all.
• Bone infection (osteomyelitis): If you have an open fracture (the bone breaks through your skin) you have an increased risk of bacterial infection.
• Other internal damage: Fractures can damage the area around your injury, including your muscles, nerves, blood vessels, tendons and ligaments.

How soon after treatment will I feel better?

It might take a few weeks for your symptoms to improve. Depending on which type of surgery you had to repair your oblique fracture — and which bones were broken — you should be able to start moving again in a few weeks.

Contact your healthcare provider right away if you experience intense pain that doesn’t get better.

How can I reduce my risk for oblique fractures?

Follow these general safety tips to reduce your risk of injury:

• Always wear your seatbelt.
• Wear the right protective equipment for all activities and sports.
• Make sure your home and workspace are free from clutter that could trip you or others.
• Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
• Follow a diet and exercise plan that will help you maintain good bone health.
• Talk to your healthcare provider about a bone density test if you’re older than 50 or if you have a family history of osteoporosis.
• Use your cane or walker if you have difficulty walking or have an increased risk for falls.

How can I prevent an oblique fracture?

Oblique fractures are usually caused by falls or other accidents, so there’s not much you can do to prevent them. Use can use a cane or walker to increase your stability and try to prevent falls, though.

Also, if you have osteoporosis, treating it will prevent future bone density loss.

What can I expect if I have an oblique fracture?

If you have an oblique fracture, you should expect to make a full recovery.

You’ll need physical therapy to regain strength and range of motion in the part of your body that was injured.

How long does it take an oblique fracture to heal?

How long it takes you to heal depends on the severity of your fracture and which treatments you needed. Most people need a few months to recover from an oblique fracture.

There are lots of factors that can affect how long it takes your body to heal, though. Talk to your healthcare provider or surgeon about a timeline that fits your specific situation.

Will I need to miss work or school?

Your specific injuries and which bones are fractured will impact how long you’ll need to miss work, school and other activities.

Talk to your surgeon or healthcare provider before resuming any physical activities while you’re recovering.

Outlook for an oblique fracture

The outlook for most oblique fractures is positive. Even if you need surgery, you should make a full recovery.

When should I go to the emergency room?

If you think you have an oblique fracture — or any other broken bone — you need to see a healthcare provider as soon as possible. Go to the emergency room if you experience any of the following:

• Intense pain.
• You can’t move a part of your body that you normally can.
• A part of your body is noticeably different looking or out of its usual place.
• You can see your bone through your skin.
• Swelling.
• New bruising that appears at the same time as any of these other symptoms.

Go to the emergency room right away if you’ve experienced a trauma.

What questions should I ask my doctor?

• Which bones are fractured?
• Do I have an oblique fracture or another type of break?
• Will I need surgery?
• How long will it take to recover?
• When can I resume physical activities?

A note from Cleveland Clinic

An oblique fracture isn’t usually a life-changing event, even though it’s scary to find out you’ve broken a bone. Oblique fractures respond well to treatment, and there are lots of options to make sure your bones and body heal properly. Make sure you talk to your healthcare provider about how you can keep your bones strong and healthy, and get regular bone density screenings if you’re older than 50 or have a family history of osteoporosis.