Comminuted Fracture

A comminuted (pronounced “kah-MUH-noot-ed”) fracture is a bone that’s broken in at least two places.

These fractures usually affect large or long bones in your body, like your:

• Thigh bone (femur)
• Shin bone (tibia)
• Calf bone (fibula)
• Upper arm bone (humerus)
• Forearm bones (radius and ulna)
• Collarbone (clavicle)
• Skull

Serious traumas, like car accidents or falls from high places, almost always cause comminuted fractures. You’ll probably need surgery to repair your bone. Comminuted fractures that happen in smaller bones may heal without surgery.

How long it takes to recover depends on which bone is fractured and what caused the break. You might need up to a year to recover from a comminuted fracture if it’s in one of the long or larger bones in your body.

Types of comminuted fractures

A healthcare provider will classify the fracture as either open or closed. If you have an open fracture, the pieces of your broken bone break through your skin. Open fractures are sometimes also called compound fractures. Closed fractures are still serious, but your bone doesn’t push through your skin.

“Displaced” or “non-displaced” are more words your provider will use to describe the fracture. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke. Non-displaced means the pieces weren’t moved far enough to be out of alignment during the break. Comminuted fractures are more likely to be displaced than other types of broken bones because they always have multiple broken pieces.

Symptoms of comminuted fractures

The symptoms of a comminuted fracture can include:

• Intense pain
• Not being able to move a part of your body like normal
• A part of your body looking noticeably different or out of its usual place
• Seeing your bone through your skin
• Swelling
• Bruising

If you have a comminuted fracture, you’ll probably experience other serious symptoms of the trauma that caused it. These will depend on the other injuries you have.

Comminuted fracture causes

Traumas that put enough force on your bones to break them into pieces cause comminuted fractures. These are usually serious injuries, like car accidents and falls from great heights, like off a ladder or roof.

Any impact to your bones can cause a comminuted fracture. But slips, falls and other common causes of broken bones aren’t usually strong enough to cause them.

Complications of this condition

Comminuted fracture complications can include:

• Compartment syndrome
• Malunion and nonunion
• Bone infections

Comminuted fractures also have a higher risk of other internal damage. The injuries that cause them, or the broken pieces of your bone, can harm your:

• Muscles
• Nerves
• Blood vessels
• Tendons
• Ligaments

How doctors diagnose comminuted fractures

A healthcare provider will diagnose a comminuted fracture with a physical exam and imaging tests. In some cases, this may be done in the emergency room (ER) if you’re admitted after a trauma.

If you’re taken to an ER, a team of providers will stabilize you and treat your injuries in the order of severity, especially if some are life-threatening. After you’re stabilized, you’ll need imaging tests to confirm the fracture. You might need:

• X-rays
• MRI
• CT scans

Comminuted fracture treatments

You’ll probably need surgery to repair a comminuted fracture. There are a few techniques used to repair comminuted fractures. Which one your surgeon will use depends on a few factors, including:

• Which bone is broken
• Other injuries you have
• Any other complications after the trauma

Your surgeon will realign your bone to its correct position and secure the pieces in place so they can heal together. They usually perform an open reduction and internal fixation.

You might need an external fixation. This is often a temporary solution that stabilizes the fracture while other injuries heal. Your surgeon will put screws on either side of the fracture inside your body, and then connect them to a brace or bracket around the bone outside your body.

Your surgeon may use a bone graft if the fracture is severely displaced or if your bone isn’t healing back together as it should. They’ll 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.

After surgery, your care team will immobilize your bone fracture. Depending on where this is, you’ll need some combination of a brace, splint or cast before you can start putting any weight on it or using it normally.

When should I see my healthcare provider?

Call 911 (or your local emergency services number) or go to the emergency room if you think you have a comminuted fracture. Especially if you experience a severe trauma. Try not to move or use that part of your body.

Comminuted fracture recovery time

Comminuted fractures take longer to heal than other kinds of broken bones. They’re also much more likely to involve complications.

Most comminuted fractures take a year or longer to heal. The exact time it takes you to recover will depend on the severity of the break and if you experience complications.

If you experienced other injuries during the original trauma, your life might be impacted forever. Because the traumas that cause comminuted fractures are often life-threatening accidents, it’s tough to separate one from the other. Talk to your provider about your customized healing plan, and what to expect as you heal.