What's the Difference Between a Fracture and a Break?

Do you know the difference between a fracture and a break? This terminology ranks in the top 10 of misunderstood medical jargon, right behind the difference between a heart attack and cardiac arrest. For something that happens in sports quite a bit, it's too bad that coaches and players will often ask whether a bone is broken or just fractured.

Hand in bandage
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So What's the Difference?

There's no difference.

A fracture is any loss of continuity of the bone. Anytime the bone loses integrity—whether it's a hairline crack barely recognizable on an x-ray or the shattering of bone into a dozen pieces—it's considered a fracture.

A broken bone is a fractured bone and vice versa.

If you had a crack in your car windshield and someone asked how long it had been broken, would you correct them? Would you say it's not broken, it's just a fracture? Probably not. In fact, you'd probably talk about the rock that did the deed on the freeway. We all regularly use the terms fracture and break interchangeably. It's not any different in the medical field.

It's All in the Presentation

Watch patients interact with physicians, even on television or in the movies. When a tiny little break is barely discernible on an x-ray, the doc will point it out—usually with a ball-point pen—and say, "here's the fracture."

Why not say "Here's the break?" Probably because it doesn't sound doctorly.

The same physician is going to walk out of the room and tell her colleague that the patient broke his whatever. Docs like to sound educated, but they let their guard down with peers. To be fair, while you can use both break and fracture as either nouns or verbs, break sounds more like an action and fracture sounds more like a thing.

How About a Sprain?

We've established that there isn't a lick of difference between breaking a bone or fracturing it, but there is a big difference between a sprain and a fracture. Not that you could tell without an x-ray.

Fractures and breaks are bone problems. Sprains are joint problems. You can break a bone, but you can't break a joint.

Here's an example using the ankle.

Your ankle is made of three bones: tibia, fibula, and talus. You can break any of them. If you do, technically you have a broken tibia (or talus or fibula). You can also stretch or tear the ligaments and tissues holding all three bones together; that's called a sprain.

They both hurt really, really badly. Without an x-ray, we can't tell whether it's a broken bone or a sprained ankle. As far as first aid goes, it doesn't matter. We treat them both the same.

We also say it wrong all the time. We meaning healthcare professionals. We say broken ankle when we are talking about a broken bone near the ankle joint. It's a shortcut, but if it confused you, we take the blame.

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