Can time heal a fractured bone?

December 14, 2007 3:45 PM

What would happen if you fractured a bone and never got it treated?

Purely theoretical question ahead, but I can't figure this answer out:

I've been having some weird dreams lately, and one of them was really long. I dreamt I was in high school and fell up a flight of stairs-- causing some pain to my tibias. (Like, I landed on the edge of the stairs--my high school's was metal edged marble steps.) In my dream I was pretty convinced that I had if not broken them totally, done some kind of fracture damage to them. But I kept on dreaming and got to the present date (~10 years later) without ever getting them treated. I remember being able to feel my bones and feel a slight indent, and I'd occasionally feel slight pain if I hit those bones or jumped a lot, but did nothing about it.

Anyway, long story short the end of the dream? I started walking a long distance and eventually both my legs broke. Picture like someone chopping a tree-- timberrrr! It was pretty gruesome and I woke up disturbed about the whole thing. I can still recall the snapping sound. Ick!

So what I was wondering is-- say something like this happened-- like a person got some kind of fracture that was not serious enough to debilitate them (I figure it must happen, people often break toes without realizing it)-- would time heal that wound? I've never broken a bone (to my knowledge anyway) so my knowledge is pretty limited in that way, but I know big fractures need to be set in order to heal-- but if it was something that didn't snap the bone all the way through, maybe it would heal on its own? Or would such a thing heal better if you did better things, like take calcium supplements/drink a lot of milk? And if calcium intake improves it, say you ignored it for several years, could you then take a lot of calcium and heal them okay after the fact? And lastly, could you wear down your bones enough to snap them in a low impact situation? I'm thinking that's more my own dreams acting as fantasy more than anything else.

posted by actionpact to Health & Fitness (15 answers total)

Some bones, like clavicles, often heal well when left alone, that is why most clavicle (collarbone) fractures are treated with little or nothing, as are many rib fractures. The other extreme are open fractures, where the bone breaks the skin. Left untreated those get infected, which can then progress to osteomyelitis or gangrene.

For other fractures, if the bones are held in relative stability at close proximity they may heal, but at an angle; this is a malunion. The geometry of any joints involving that bone may be adversely affected, leading to osteoarthritis in those joints. In the case of weight-bearing joints, the limp caused by malfunction on one side can also cause problems on the other side. This sort of thing can also cause one leg to be shorter than the other. The other possibility is if the bone continues to move after it is broken it will never mend, and instead for a "false joint" or pseudarthrosis. This can lead to problems similar to those from a malunion or worse.
posted by TedW at 3:55 PM on December 14, 2007 [1 favorite]

I fractured my knee cap back in February, and luckily I did not require surgery. The "treatment" was to leave the knee alone, rather to immobilize the leg, preventing the associated muscles from contracting over the knee cap and worsening the fracture.

The knee cap healed, but the bone density was reduced, because bone density is often a function of related muscle activity (of which there was almost none). So the fracture annealed after a couple months, but the bone got spongier (weaker, overall) and my leg muscles atrophied considerably.

Gradual re-use of the leg and good diet helped bring calcium back into the bone, as X-rays showed, but I'm still in rehab to strengthen dramatically weakened leg muscles.

Would a bone heal without immobilizing? Possibly, certainly more slowly, and the fracture may not heal the way you want.

I think you'd be in so much horrific pain in the meantime, that you would find a way to immobilize or reduce usage of the body part in question — I know I would.

If the bone fracture doesn't anneal nicely, doctors can sometimes rebreak the bone so as to get things set properly. You can imagine how little fun that would be.

Best to set the bone as well as you know how, or have a doctor do it (preferably), and add rest and a good diet to let evolution's healing magic take over.
posted by Blazecock Pileon at 4:07 PM on December 14, 2007

For what it's worth ( very litte: IANAD) I fractured my shoulder bone and the only 'treatment' I received from ER and an orthopedic doctor was being told not to move it. I haev health insurance and all that also.

Moving it brought on excruciating pain so the advice was followed and not really necessary. Outcome would have been the same without treatment. Now I have a tiny bump in the bone similar to the indent you describe in paragraph 1.

Former regular lurker, by the way :)
posted by oblio_one at 4:09 PM on December 14, 2007

I broke my arm about three inches above the wrist when I was a kid. Both bones were broken, quite badly, though it was not a compound fracture. My arm was casted for 6+ weeks, but either the bones weren't set quite right, or the cast wasn't made quite right, because when the cast came off, my arm had a noticeable bump in it, and I couldn't fully pronate my forearm. Because the break was near a growth plate, the docs didn't want to just leave it like that - they were afraid my right arm would end up shorter than my left. So they operated, rebroke the bones, pinned the radius (which had healed the worst), and then took the pin out a year later. I have an impressive scar, but can turn my forearm as far as its supposed to go.
posted by rtha at 4:52 PM on December 14, 2007

Depends on the break.

I've cracked ribs on more than one occasion, no displacement. Never got treatment, and they heal fine. (Just how would you set a cracked rib anyhow?) Broke a tarsal (little foot bone), no displacement, never got treatment, so I limped for a couple months, and it did heal -- but I still walked a little funny for years. Broke my navicular (little wrist bone), small displacement, GOT treatment including a thumb spika cast, and it just barely did heal -- I imagine it wouldn't have healed had I not worn a cast for 4 months.

So, in my experience, a break can heal fine if it's A. not displaced, so that the broken ends can grow back together, and B. not subjected to stress that'll move it around and prevent it from healing.
posted by LordSludge at 5:14 PM on December 14, 2007

TedW has it exactly right.
posted by Slarty Bartfast at 5:21 PM on December 14, 2007

I've had multiple fractures in my hands and fingers that went untreated and are totally fine. Both hands look and function normally.
In my feet however- I completely broke the cuboid (I think) in my left foot, which now has a noticeable bump and while standing and walking are fine, sitting cross legged or anything else that puts firm pressure against that spot is rather painful. As for healing it, it swelled up in just a few minutes after it happened, and my whole foot turned black later that night, and stayed black/blue/green/more bruised for a week or so. I had trouble walking for a few weeks.
On my right foot I broke my big toe and it's now, about a year later, still a little fatter than my other big toe, and it doesn't bend. Trying to bend it is rather painful, but it doesn't hurt just from walking or anything.
posted by gally99 at 5:23 PM on December 14, 2007

It depends on the break. I've broken my middle finger and little toe. Neither was treated. My mother had her broken finger treated and all that consisted of was wearing a splint, so I figured why bother with the doctors, especially since I was uninsured at the time. I sort of made my own pseudo splint with the finger taped to clean popsicle sticks for a couple of weeks before removing it when I went on vacation.

It healed fine after a month or two, just a slight bit crooked. Funny thing is my other middle finger is also slightly crooked and has never been broken. The toe is pretty much the same as it was before. Healed up in a couple of weeks. I also taped it.
posted by cmgonzalez at 5:34 PM on December 14, 2007

This happens all the time in poorer countries, the animal world, and all through human history except for the recent parts. Eventually it'll heal in some fashion and provide a weak solution that will have all sorts of negative consequences like pain, irregularities, chance for reoccurance, limited movement, etc.
posted by damn dirty ape at 6:32 PM on December 14, 2007

Not to mention the lack of physical therapy after the healing can be just as bad, depending on the break.
posted by damn dirty ape at 6:33 PM on December 14, 2007

Archaeologists encounter healed fractures all the time. Without wanting to imply that aboriginal people had no ability to treat broken bones, it is clear that on occasion the treatment was suboptimal or nonexistent. Also, animal bones are commonly found with healed fractures. So far as I can tell, all of the following are from "prehistoric" context, certainly pre-modern, and all indviduals survived their injuries..

healed ulna fracture - decent outcome
very poor result on displaced fracture of femur - individual would have had severely shortened leg, limp, probably considerable pain and restricted mobility
another poor displaced femur (indistinct, see arrow)
poorly set severe ankle (distal tibia-fibula) fracture
non-unioned forearm fracture where the fractured ends did not heal together (the false joint referred to above)
various healed ulnae
depressed skull fracture (non lethal)
fractured proximal femur, x-ray of same
severe non-fatal skull fracture
another severe femur fracture with displacement, victim survived at least four months; x-ray
healed depressed skull fracture; victim was scalped later in life.
healed nasal fracture
healed fracture of cheekbone (zygomatic arch)
posted by Rumple at 6:33 PM on December 14, 2007 [2 favorites]

There is a species of primate (baboons maybe?) of which some ridiculous percentage has at least one healed fracture. They fall out of trees.
posted by fshgrl at 6:37 PM on December 14, 2007

Wikipedia as usual has a reasonably comprehensive exposition on bone fractures
posted by Neiltupper at 6:54 PM on December 14, 2007

In case someone stumbles on this thread after breaking a finger or toe, wondering if it's worth spending the money to go to a doctor -- it is absolutely worthwhile to go to a doctor after an injury like this. It is possible that they will just pull on it, buddy-tape it, and let it heal with a splint on, but it's also very possible that the appropriate treatment is more complex, and that if you don't get appropriate treatment for the break you will never have the same hand or foot function again. You don't have a home xray machine (I hope), and so you don't know.

I say this because I have seen people who did not get appropriate treatment for big toe injuries then have ankle problems, knee problems, back problems, because their toe injury messed up their gait pattern.

There's no such thing as "just a finger" or "just a toe."
posted by jennyjenny at 12:05 PM on December 15, 2007

This happened to my mother.

She was in a severe car accident over 20 years ago. Her pelvis was fractured in twelve places and she broke one leg. She was in traction for weeks and wore a steel brace to hold her pelvic bones in place (it looked like an Erector set sticking out of her stomach) for longer.

She also fractured a lower arm bone near the elbow. At the time of her accident, her surgeon let it go, because of her far more serious injuries. It was never set and healed in a floating position. Every so often, especially during unaccustomed physical activity (once as a result of a fall), this bone dislocates slightly and pinches a nerve and causes her severe pain. It slips back into place and the pain goes away.

After the falling incident, which was this year, she saw an orthopedic surgeon (a different guy) and he said that it would probably be more painful to open up the elbw joint and reset the bone.
posted by bad grammar at 8:04 PM on December 15, 2007