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
mediaphotos / Getty Images

Fracture vs. Break

There's no difference between a fracture and a break. 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.

How Your Healthcare Provider Uses Each Word

Watch patients interact with healthcare providers, even on television or in the movies. When a tiny little break is barely discernible on an X-ray, the healthcare provider 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 healthcare provider is going to walk out of the room and tell their colleague that the patient broke their whatever. Healthcare providers 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.

Fracture vs. 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 injuries to the ligaments, which are the thick bands of cartilage that attach bone to bone (often at a joint). You can break a bone, but you can't break a ligament. However, you can tear a ligament.

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—a lot. 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. Both are treated the same.

Healthcare professionals also say it wrong all the time. They say broken ankle when they are talking about a broken bone near the ankle joint. It's a shortcut. If you are confused by anything your healthcare provider says, ask for clarification.

By Rod Brouhard, EMT-P
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.