Fractures are among the most frequent injuries that people experience. However, different types of fractures exist, and the treatment differs for each. What is the difference between an open vs. closed fracture?
What is a fracture?
Fractures are common injuries that can occur for various reasons, such as accidents, sports injuries or underlying medical conditions.
A fractured bone is broadly categorized into two main types: closed fractures and open fractures. Understanding the differences between these types of fractures is crucial for proper diagnosis, treatment and recovery.
If you think you have a bone fracture, whether it’s open or closed, seek medical care right away. You can start with the nearest urgent care for smaller bones in places like your hand, wrist, foot or ankle. However, for major bones and injuries to your face, go straight to the emergency room.
Closed fractures
A closed fracture – or a simple fracture – means the broken bone hasn’t pierced the skin. The break is entirely internal and, while it may cause swelling, bruising or visible deformity, the skin remains intact.
Identifying a closed fracture can be challenging without proper medical evaluation, especially if there are no visible signs of external injury. However, there are common symptoms associated with closed fractures.
These common symptoms include:
- Pain: Pain at the fracture site is the most common symptom of any fracture. This is common with a stress fracture, and the intensity of pain can vary depending on the severity and location of the fracture.
- Swelling: Swelling and bruising may occur around the injured area. This is from damage to the soft tissues as well as inflammation.
- Deformity: In some cases, a closed fracture may cause a visible deformity or abnormal alignment of the affected limb or joint.
- Difficulty moving: Fractures can restrict normal movement, making it difficult to use the injured part of your body.
Diagnosing a closed fracture typically involves a physical exam, medical history review and imaging tests, such as X-rays, CT scans or MRI scans. Once diagnosed, treatment aims to realign and stabilize the fractured bone to promote healing.
Common treatment approaches for closed fractures include:
- Immobilization: Bracing, splinting or casting are ways to immobilize the injured limb and prevent further damage.
- Reduction: In cases of displaced fractures, manual or surgical reduction may be required to realign the bones.
- Pain management: Pain relievers and anti-inflammatory medications are prescribed to manage pain and reduce swelling.
- Physical therapy: Rehabilitation exercises help restore strength, flexibility and function to the injured area once the fracture begins to heal.
Open fractures
Unlike closed fractures, open fractures – or compound fractures – are when the bone breaks through the skin. This leads to part of the bone being directly exposed to the external environment.
Open fractures are considered more severe and carry a higher risk of complications, such as infection. These fractures often result from high-energy trauma, such as severe falls, motor vehicle accidents or gunshot wounds.
Open fractures present with symptoms that include those of closed fractures along with additional signs related to the open wound.
These signs are:
- Visible wound: An open wound or laceration at the fracture site is visible, exposing the broken bone. This is also known as a compound fracture.
- Bleeding: Open fractures may cause significant bleeding, depending on the severity of the injury and involvement of blood vessels.
- Risk of infection: Due to the exposure of bone and surrounding tissues, open fractures are at high risk of developing infections, leading to complications.
Immediate medical attention is crucial for open fractures to potentially avoid infection and promote optimal healing. Diagnosis involves assessing the extent of the injury through a physical exam, imaging and evaluating the risk of related injuries.
As far as treatment options for open fractures, those include:
- Wound cleaning: Thorough irrigation and wound cleaning to remove debris, dirt and bacteria are essential to reduce infection risk.
- Antibiotics: Broad-spectrum antibiotics are often administered intravenously to prevent or treat potential infections.
- Surgical intervention: An open fracture often requires surgery to clean the wound, called debridement. Surgery is also necessary to realign fractured bones and stabilize them using internal fixation devices such as plates, screws or rods.
- Wound closure: Depending on the severity and contamination of the wound, a doctor may need to close the wound.
Why it’s important to understand open vs. closed fractures
Understanding whether a fracture is open or closed isn’t just a medical technicality – it shapes the entire treatment plan. Both closed and open fractures can lead to various complications, including delayed healing, improper bone healing leading to deformity, failure of bone fragments to heal, increased pressure within muscles and post-traumatic arthritis.
Long-term management of any type of fracture involves regular follow-ups with your health care provider. Depending on the location of your fracture, your doctor may refer you to an orthopedic specialist during your recovery.
Adhering to your rehabilitation programs and modifying your lifestyle to support bone health and prevent future injuries is also important.
How we can help
Understanding the differences between an open vs. closed fracture is essential for prompt recognition, appropriate treatment and optimal outcomes. You can go to an urgent care for closed fractures in smaller areas of your body. However, if you’re unsure, it may be best to go straight to an emergency room.
Learn about the orthopedic services as well as the urgent care and emergency services we provide at Mercy Health.
