Compound Fracture (Open Fracture)

A compound fracture is when a broken bone breaks through your skin and is visible outside your body. Healthcare providers also call this an open fracture.

When a bone breaks, the pieces usually don’t move very far out of place. But breaks caused by more severe traumas, like a car accident or falling off a ladder, can push the broken pieces of bone through your skin.

Any bone can break and cause a compound fracture. But arm and leg bones are most commonly affected.

You’ll need surgery to repair your broken bone. You may need a cast to hold it in place after that. You’ll also need to take medications to help prevent infections.

Compound fractures can be extremely painful. And they have a higher risk of complications than other types of bone fractures. Go to the emergency room or call 911 (or your local emergency services number) if you can see bone poking through your skin.

Symptoms of open fractures

Seeing bone through your skin is the most obvious compound fracture symptom.

Other symptoms can include:

• Severe, sharp pain
• Tenderness to touch
• Swelling
• Bruising
• Bleeding

Some compound fractures damage nerves around them. That might make pain less severe than you’d expect. But any open fracture is an emergency that needs to be diagnosed and treated right away.

Compound fracture causes

Any injury that breaks one of your bones and pushes the pieces through your skin can cause an open fracture. This takes a lot of force. So, most open fractures are caused by severe traumas, like:

• Car accidents
• Falling from a high place, like a roof or ladder
• Serious sports injuries

Complications of this condition

Compound fractures are more likely to cause complications than most other types of broken bones.

You’ll have a much higher risk of infections because the bone is exposed outside your skin. This will make it easier for bacteria and other germs to get into your body.

As they’re pushed out of place, the sharp pieces of bone can damage your: .

• Skin
• Nerves
• Muscles
• Blood vessels
• Connective tissue, like tendons and ligaments

Infections and other damage can lead to severe complications, including:

• Shock
• Blood clots
• Bone death
• Compartment syndrome
• Uneven limb length after healing

Open fractures can be more likely to lead to nonunion or malunion as they heal.

How doctors diagnose compound fractures

A healthcare provider will be able to see the bone poking through your skin or see bleeding to diagnose an open fracture. They’ll do a physical exam to check for injuries around the fracture. Providers in the emergency room may do this if you’re taken there after a trauma.

After you’re stable and any potentially life-threatening injuries are treated, you’ll need some imaging tests to take pictures of your bone and the area around it. You may need:

• X-rays
• CT scan
• MRI

Compound fracture treatments

You’ll need surgery to put the pieces of your bone back in place. Your surgeon will also clean the wound and your bone. They’ll repair any damage inside your body. They may use tools to realign your bone and secure the pieces together with fasteners.

After surgery, you may need a hard splint or cast. This will hold your bone in place and protect it while it heals.

You’ll need to take antibiotics to prevent bacterial infections. You’ll also need a tetanus shot if you haven’t had one in the last five years.

When should I see my doctor?

Open fractures are medical emergencies. Call 911 (or your local emergency services number) or go to the emergency room right away if you can see bone through your skin.

Cover the open fracture with a clean, wet towel to protect it as well as you can. Don’t move or use that part of your body.

How long does it take a compound fracture to heal?

It can take several months for a compound fracture to heal. Your exact recovery timeline will depend on a few factors, including:

• Your age
• Which bone is fractured
• Any other injuries you experienced
• Any complications that develop

Your healthcare provider and/or surgical care team will tell you what to expect.

You’ll need physical therapy (PT) to regain your strength and ability to move. Your provider may suggest starting PT while you’re still wearing your cast. It depends on which bone is broken.