Is it Broken or Just Fractured???
As an orthopedic surgeon, I get this question a lot. A patient (and in my case most often with parents) will follow up with me in clinic after they’ve been to the ER or urgent care, had x-rays and are in a splint. We start discussing the injury and depending on the the breeze, I might call their injury a “broken bone” or a “fracture.” I’m often met with responses like “Oh, thank goodness it’s just fractured and not broken” or “so it’s broken? I thought it was just fractured” or vice versa.
In order to set the record straight, a fracture is a broken bone and a broken bone is a fracture. One is no less severe than the other. Fracture is just the fancy doctor word for a broken bone.
Other times when our orthopedic terminology gets confusing for patients is when it comes to “sprains” and “tears.” Ligaments are strong bands of tissue that connect one bone to another bone. Technically speaking, any injury to a ligament is called a sprain. So, why do we call some ligament injuries “tears” and others “sprains?” Honestly, your guess is as good as mine.
If you’re told that you have a “tear,” that sounds bad. And in some cases, it can be. An anterior cruciate ligament (ACL) tear in the knee usually occurs during sports and as most athletes know, it usually means surgery with sometimes a year-long rehab period. We should probably call ACL tears “sprains” more commonly, but we don’t.
Most people have had personal experience with an ankle sprain at some point in their lives. You roll your ankle, it’s painful, swells and might turn black and blue; but with some time, rest, ice, and ideally some rehab exercises, it usually gets better in a week or two without any problems. We typically don’t think of or describe ankle sprains as ligament “tears,” but they are. How bad the sprain is usually depends on how significant the tearing in the fibers of the ligaments is and how many ligaments are injured. Low grade sprains may tear a small percentage of fibers in the ligament while high grade sprains might tear most or all of the fibers in the ligament. Fortunately, ankle ligaments heal better than anterior cruciate ligaments, and surgery is rarely needed following an ankle sprain (even with significantly torn ligaments).
The way that we describe muscle injuries often is no less confusing than with ligament injuries. The hamstrings and gastrocnemius (calf) muscles are two commonly “pulled” muscles that people encounter. The medical word for an injury to a muscle is “strain.” However, these injuries are often called “strains” and “tears” interchangeably. All have some degree of “tearing” of muscle fibers with lower grade strains having less muscle fiber tearing and higher-grade strains having more significant muscle fiber tearing. Fortunately, as with ankle sprains, most muscle strains (or tears) heal on their own without the need for surgical treatment.
So the next time you hear “fracture,” “tear,” or “strain,” just know that while the terminology might vary, the treatment plan is what really matters. If you’re ever unsure, don’t hesitate to ask for clarity. We're here to help you understand your injury and what to expect during recovery.
