Fracture Healing – How Does it Occur

How Does a Fracture Heal?

Fracture healing in a broken bone is quite a complex process.

To understand the process better we need to have an idea about the anatomy of the bone.

Bone is surrounded by a thin membranous layer of tissue called periosteum. ( See adjoining figure – The figure represents a cut section through a bone. Normally the bone is like a cylinder. Imagine cylinder cut into halves along its longitudinal axis and you would get a similar picture. )

When bone breaks, it bleeds from its torn ends due to disruption of its supplying vessels.


Quite naturally the periosteum also is torn as shown in the figure. This periosteum may be completely torn or partially damaged depending upon the force of injury.

The collected blood is called fracture hematoma.

Due to loss of vascularity or blood supply adjacent portion of broken ends die. Inflammation changes occur in the hematoma over next few hours ( A reaction by the body which occurs whenever there is an insult to a part or structure. The basic purpose of the inflammation is to contain the damage and facilitate the healing and regeneration. Inflammation is responsible for redness, pain, warmth and tenderness of the wounds and abscesses) .

This inflammation brings in many cells that would help in regeneration of the broken bone.

Periosteum plays a vital role in fracture healing. The periosteum is the primary source of precursor cells which develop into chondroblasts( cartilage cells) and osteoblasts ( bone cells) that are essential to the healing of bone.

As the time progresses, the fibroblasts ( A kind of cells which produce fibrous tissue in the body) get interspersed with small vessels and form a loose mesh like structure uniting the broken ends of the bone and on which the future layers of bone tissue would be added. this structure is called granulation tissue.

Over the next few days, the cells of the periosteum replicate and transform. The periosteal cells proximal to the fracture gap develop into chondroblasts and form hyaline cartilage. The periosteal cells distal to the fracture gap develop into osteoblasts and form woven bone a kind of bone which is structurally different from the lamellar bone found in the body.

These two new tissues grow until they unite with their counterparts from other pieces of the fracture. This process forms the fracture callus. The callus is the first sign of union visible in x-ray and generally appears around two weeks after fracture. Eventually, the fracture gap is bridged by the cartilage and woven bone, restoring some of its original strength. A picture like this is produced.


From here on slowly and steadily bone is restructured by a process called remodeling.

This was summary of bone healing in simple language. Those who wish to read more detailed process may want to go further.

Phases of Fracture Healing

Fracture healing  begins with hemorrhage phase and progresses through repair and remodeling

It must be understood that actual fracture healing is continuous process and the events of different phases may overlap with respect to their occurrence.

That means events of preceding phase may continue into next phase and events of subsequent phases may begin in an earlier phase

 Inflammatory Phase

As a result of fracture, the soft tissue envelope [periosteum and surrounding muscles] is also torn along with break in the bone, leading to rupture of blood vessels crossing the fracture line. A hematoma is formed within the medullary canal, between the fracture ends, and beneath any elevated periosteum. Due to loss of blood supply, immediate ends of fracture fragments undergo necrosis

Necrotic material leads to an immediate and intense acute inflammatory response which leads to dilation of vessels and exudation of plasma.

This brings acute inflammatory cells – macrophages, neutrophils and platelets which release several factors such as plasma derived growth factor [PDGF], tumor necrosis factor –alpha, transforming growth factor-beta, IL-1,6, 10,12 etc. These factors are detected as early as 24 hours after injury.

Lack of TNF-Alpha has been found to be associated with delay of both ossification [e.g. in HIV infection]

Fibroblasts and mesenchymal cells migrate to fracture site and granulation tissue forms around fracture ends followed by proliferation of osteoblasts and fibroblasts.

NSAIDs are known to repress runx-2/osterix which is critical for differentiation of osteoblastic cells.

Reparative Phase

The repair cells are of mesenchymal origin and are pluripotent cells [ stem cells] probably of common origin of bone, cartilage and collagen.

The tissue formed eventually is determined by the microenvironment. High oxygen concentration and mechanical stability favors bone formation whereas low oxygen and instability leads to formation of cartilage.

It is notable that blood supply of the extremity is increased as a whole after the fracture but the osteogenic response is limited largely to the zones surrounding the fracture.

The repair cells produce the tissue known as callus, which is made up of fibrous tissue, cartilage, and young, immature bone. This quickly envelopes the bone ends and leads to a gradual increase in stability of the fracture fragments.

Primary callus forms within two weeks. If the bone ends are not touching, then bridging soft callus forms.

Enchondral ossification converts soft callus to hard callus, a type of woven bone. Medullary callus also supplements the bridging soft callus

Amount of callus is dependent on extent of immobilization.

As this phase of repair takes place, the bone ends gradually become enveloped in a fusiform mass of callus as noted in picture above. Immobilization of the fragments occurs due to callus and is considered as on of the clinical signs of  union.

Remodeling Phase

Remodeling about a fracture takes place for a prolonged period of time. In remodeling, osteoclasts resorb the woven bone trabeculae and new struts of bone are laid down that correspond to lines of force. Remodeling is thought to be modulated by electrical signals. When a bone is subjected to stress, electro-positivity occurs on the convex surface and electro-negativity on the concave, a current produced by a piezoelectric effect. Regions of electropositivity are thought to be associated with osteoclastic activity and regions of electronegativity with osteoblastic activity.

The cellular module that controls remodeling is the resorption unit, consisting of osteoclasts, which first resorb bone, followed by osteoblasts, which lay down new haversian systems.

Fracture Healing Time Period

Depending on the fracture site, normal healing may take from 3-12 weeks.

  • Phalanges: 3 weeks
  • Metacarpals: 4-6 weeks
  • Distal radius: 4-6 weeks
  • Distal Humerus: 8-10 weeks
  • Humerus: 6-8 weeks
  • Femoral neck: 12 weeks
  • Femoral shaft: 12 weeks
  • Tibia: 10 weeks

Types of Fracture Healing

For normal fracture healing to occur a number of requirements must be met:

  • Viability of fragments (i.e. intact blood supply)
  • Mechanical rest – Immobilization by cast or fixation
  • Absence of infection

Primary bone fracture healing and secondary bone healing are two different types of healing in fractures depending on the rigidity of fixation of the fracture.

Fracture stability dictates the type of healing that will occur

When mechanical strain is less than 2%, primary bone healing will occur. When the strain is between 2% and 10%, secondary bone healing will occur.

Primary Bone Healing

In this kind of fracture healing callus is not formed at all and  it occurs with rigid stabilization with or without compression of the bone ends. For example,  in a fracture fixed by plating,  primary bone fracture healing occurs. It occurs when mechanical strain on the fracture is < 2%. It is also called intramembranous healing and occurs via Haversian remodeling.

Rigid stabilization suppresses the formation of a callus in either cancellous or cortical bone .

Primary healing per se is rare and most of the fractures heal by secondary healing. This is so because management of most of the fractures allow some degree of movement.

Primary bone fracture healing can be divided into gap healing and contact healing. Union occurs in both types.

Operated and United Radius and Ulna Fractures Healed By Primary Bone Healing

Operated and United Radius and Ulna Fractures Healed By Primary Bone Healing

Rigid stabilization suppresses the formation of a callus in either cancellous or cortical bone .

Because most fractures are  managed in a way that results in some degree of motion, primary healing per se is rare.

Primary bone fracture healing can be divided into gap healing and contact healing. Union occurs in both types.

Gap Healing

If internal fixation leaves a gap between fragments, the fracture heals by gap healing.

Gap healing occurs in two stages.

Firstly, the width of the gap is filled by direct bone formation. An initial scaffold of woven bone is laid down, followed by formation of  lamellar bone as support. The orientation of the new bone formed in this first stage is transverse to that of the original lamellar bone orientation.

In the second stage, which happens after several weeks, longitudinal Haversian remodeling reconstructs the necrotic fracture ends and the newly formed bone to replace the woven bone  with osteons of the original orientation. In the end, the normal bone structure results.

Contact Healing

Contact healing occurs where fragments are in direct apposition with [< 0.1 mm distance] and neutralisation of interfragmentary strain so that osteons can grow across the fracture site, parallel to the long axis of the bone.

The process is initiated by osteoclasts forming cutting cones, that traverse the fracture line at 50-100 µm/d. This tunnelling  allows the penetration of capillaries and eventually the formation of new Haversian systems. These blood vessels are then accompanied by endothelial cells and osteoprogenitor cells for osteoblasts leading to the production of osteons across the fracture line  eventually leading to regeneration of the normal bone architecture.

Secondary Fracture Healing

Secondary bone fracture healing occurs when there is no rigid fixation of the fractured bone ends, which leads to the development of a fracture callus. It includes an inflammatory phase, a reparative phase, and a remodeling phase as described above in the beginning of this article.

Secondary fracture healing occurs with non-rigid fixation, as fracture braces, external fixation, bridge plating, intramedullary nailing, etc.

Bone healing can occur as a combination of the above two process depending on the stability throughout the construct

Factors Affecting Fracture Healing

Both local and systemic variables influence the rate and degree of fracture healing.

Malunited  fracture healing of distal third femur

Oblique Fracture Of Femur United In Malposition

Systemic Factors Affecting Fracture Healing


Young patients heal rapidly and have a remarkable ability to remodel and correct angulation deformities. These abilities decrease once skeletal maturity is reached.


A substantial amount of energy is needed for fracture healing to occur. An adequate metabolic stage with sufficient carbohydrates and protein is necessary. Studies have shown as high as 84% of patients with nonunion to have metabolic issues. More than 66% of these patients had vitamin D deficiencies.

Systemic Diseases

Diseases like osteoporosis, diabetes, and those causing an immunocompromised state will likely delay healing. Illnesses like Marfan’s syndrome and Ehlers-Danlos syndrome cause abnormal musculoskeletal healing.

Calcium absorption is affected in gastric bypass patients leading to decreased Ca/Vit D levels, hyperparathyroidism (secondary) & increased calcium resorption from bone

Diabetes mellitus affects the repair and remodeling of bone by decreasing cellularity of the callus and delayed enchondral ossification

HIV infection has higher prevalence of fragility fractures with associated delayed healing. Contributing factors are anti-retroviral medication, poor intraosseous circulation, TNF-Alpha deficiency and poor nutritional intake


Bisphosphonates and systemic corticosteroids  are associated with osteoporotic fractures in lon term use.

Use of NSAIDs is known to cause a 6.5% higher rate of intertrochanteric fracture non unions NSAIDs and prolong healing time because of COX enzyme inhibition.


Thyroid hormone, growth hormone, calcitonin, and others play significant roles in bone healing. Corticosteroids impede healing through many mechanisms.

Head Injury

ling nails head injury may increase osteogenic response

Local Factors Affecting Fracture Healing

Type of Bone

Calcellous (spongy) bone fractures are usually more stable, involve greater surface areas, and have a better blood supply than do cortical (compact) bone fractures. Cancellous bone heals faster than cortical bone.

Degree of Trauma

The more extensive the injury to bone and surrounding soft tissue, the poorer the outcome. Mild contusions with local bone trauma will heal easily, whereas severely comminuted injuries with extensive soft tissue damage heal poorly. This is due to a decrease both in the rapidity of differentiation of the mesenchymal cells and in their total number. The soft tissue envelope around the fracture in this situation, has to heal themselves as well as provide mesenchymal cells for fracture healing. In addition, the hematoma escapes into the soft tissues, leading to a diffusion of mesenchymal cell effort.

Vascular Supply

Inadequate blood supply impairs healing. Especially vulnerable areas are the femoral head, talus, and scaphoid bones.

In long bones also, studies have shown that un-reamed nails maintain the endosteal blood supply and reaming compromises of the inner 50-80% of the cortex

It is postulated that loose fitting nails would allow quick recovery of endosteal blood supply than canal filling nails.

Degree of Immobilization

The fracture site must be immobilized for vascular ingrowth and bone healing to occur. Repeated disruptions of repair tissue, especially to areas with marginal blood supply or heavy soft tissue damage, will impair healing.

Intraarticular Fractures

These fractures communicate with synovial fluid, which contains collagenases that retard bone healing. Joint movement will cause the fracture fragments to more, further impairing union. When intraarticular fractures are comminuted, the fragments tend to float apart owing to loss of soft tissue support.

Separation of Bone Ends

Normal apposition of fracture fragments is needed for union to occur. Inadequate reduction, excessive traction, or interposition of soft tissue will prevent healing.


Infections cause necrosis and edema, take energy away from the healing process, and may increase the mobility of the fracture site. Local defenses, which should concentrate on fracture healing would have to wall off infection, thus affecting healing.

Local Pathology

Fractures through bone involved with primary or secondary malignancies usually do not heal unless malignancy is also treated.

In nonmalignant conditions fractures may heal but in conditions likes Paget’s disease or fibrous dysplasia, fractures heal slowly or not at all due to failure of normal differentiation of mesenchymal cells and of ingrowth of capillaries.

Bone that has been irradiated heals at a much slower rate due to the patchy death of cells in the local region, to thrombosis of vessels, and to the fibrosis of the marrow.

Sometimes, one fracture fragment becomes avascular because fracture affects the blood supply of the fragment. Fractures associated with avascular necrosis of one fragment will heal, but the rate is slower. If both fragments are avascular, the chances for union are very poor

Exercise and Stress

Use of a fractured extremity promotes repair, and the recent development of weight-bearing techniques has confirmed this conviction.

How to Enhance Fracture Healing

Enhancement of fracture healing is desirable where the healing is not up to mark. Though the exact mechanism and efficacy is not known, following methods are used for enhancement of fracture healing.

Low Intensity Pulsed Ultrasound (LIPUS)

Exact mechanism for enhancement of fracture healing is not clear but alteration of protein expression, increase in vascularity and development of mechanical strain gradient are though to be the reasons to accelerate fracture healing. LIPUS is also known to increase mechanical strength of callus (including torque and stiffness)

Healing rates for delayed unions/nonunions has been reported to be close to 80%

Bone Stimulators

Bone stimulators enhance fracture healing by electrical stimulation. There are four main delivery modes of electrical stimulation

Direct current

Decrease osteoclast activity and increase osteoblast activity by reducing oxygen concentration and increasing local tissue pH.

Capacitively Coupled Electrical Fields

This supplies alternating current. These affect synthesis of cAMP, collagen and calcification of cartilage.

Pulsed Electromagnetic Fields

cause calcification of fibrocartilage

Combined Magnetic Fields

They lead to elevated concentrations of TGF-Beta and BMP.

 Impaired fracture healing

Normal fracture healing can be disrupted in numerous ways:

Delayed Union

Fracture healing takes about twice as long as expected for a specific location


Fracture healing does not occur within 6-9 months. Sites with known predilection are scaphoid bone, femoral neck, tibial shaft


It means healing of the fractures in the wrong position. It may or may not be compensated to a certain degree by remodeling of the bone.

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  1. says

    This is a very good explanation..its clear and easy to understand. I really happy to get this source and use it as my reference for my presentation on my learning issue tomorrow…

    Thank you and just to ask if you can add some more about other stages of bone healing and other factors influencing bone healing such as infection, diabetic or other stuff

    Thank you

  2. Dr Arun Pal Singh says


    Thanks for your appreciation and encouraging words. I am glad information helped you.

    I have made a note of what you have asked and would surely make a post on that

  3. Cristina says

    Yes, thank you Dr. Arun Pal Singh for taking the time to explain this process. I recently broke my 5ht metatarsal and was looking for a better understanding of the healing process so I could visualize and help my body heal. Your description was very helpful.

  4. aravind says

    i meet with an accident my foot toes bones are broken, doctor told me to have rest for 1 and half month, i have to go my office, please suggest for fast healing.

  5. Dr Arun Pal Singh says


    If your doctor has suggested you rest, there must be reason for that.

    Bone healing is a gradual process and till now there is practically nothing that would augment healing.

    You can discuss with your doctor. If you just have toe fractures, it might be possible to visit office with cast/brace you have after few days of rest.

    But you must discuss it with your doctor.

    I hope that helps.

  6. Elda says

    I broke (picture this bone-space-bone) my fifth metatarsal and kept walking on it for about 10 days (doctor's visit was impossible). When I saw my foot doctor, he put me in a "boot." Unfortunately, after about 5 days in the boot (during which time I walked with crutches), there was a death in the family and that necessitated four days with a great deal of activity on my foot. When I returned (because I definitely felt something else was wrong), one of the broken-bone segments had slid along side the other. Now I am in a cast. My doctor assures me that although I have osteoporosis (I am on Fosamax), the prognosis is good. How long will I be on the cast: weeks, months??Please notify me via e-mail of followup. Thanks

  7. Dr Arun Pal Singh says

    Usual waiting time is 4-6 weeks. Your osteoporosis should not adversely affect your healing.

    I hope that helps.

  8. Elda says

    Yes, your response does help! Just that little reassurance is so-o-o good for my mental health! I am normally a very positive person, but I must admit this had me a little down. God bless and happy holidays (whichever you celebrate) ! :) :) ! No need to respond this time.

  9. John B says

    I was in a car accident thanksgiving night. Among other things ( including a cracked vertibrea "C7" which has healed ) I completely fractured and tore my forearm; radius and ulna. They set the bones w/ metal rods and screws. At my 6 week check up the orthopedist said he wished it look a little better. They are now seeing me in another month.

    How long should something like this take. I have no other diseases and I am a 25 yr old male. If this helps I do not have any pain at all.

  10. Dr Arun Pal Singh says


    Was it an open fracture? Your records would help you to find this. What I am asking is presence or abssence of wound over the fractured bones.

    Why did your orthopedist said so? Dis you enquire further what was meant by that.

    Fracture healing takes different times in different individuals. We usually give 6-12 weeks range but by no means that is absolute.

    Let me know what else I can do for you?

  11. john says

    I had a spiral fracture of the fibula (lateral malelous). im moving on my 5th week since the day of my injury. i just want to know how long would it take me to heal my fractured fibula. my doctor adviced me to see him on april. is there a possibility that my ankle would heal before april. thanks.

  12. Dr Arun Pal Singh says

    6-12 weeks is the usual time a fracture takes. Because the fracture is spiral, it may happen earlier too if it is well in position

  13. Harshanie says

    This is a very importent and useful page. This will be helpful for students and other peoples also. I will use this as a reference.

  14. mrdetermine says

    Tibial Plateau Fracture Lateral side , non displaced about 3 cm long , no pain at all , use crutches when i can and when not too tired … how long do these typically take to heal ?

  15. yashwant anchan says

    Hello Doc, I met with an accident in which I have broken my patella and right radius . I was operated for the same , but there is a crackling sound in the right radius , I dont know why this is happening and as to the patella it getting good except wid some pain at times in the adjoining muscles. can u suggest me any particular food that will help heal faster.

  16. Krishna says

    Hi Very good explanation,

    I had a complete bone fracture of Left Humerus in 2002. The bone was jointed using a steel plate with screws and the plate is still in my body.

    Can you please tell me if it is advisable to take out the steel plate now?

    And can I do push ups ? Doing so will it hurt my bone in terms of strength and rupture with steel plate?

    Thanks in advance.


  17. john says

    Doctor Singh, by the way I had a spiral fracture of the fibula (lateral malleolus). and it has been 7 weeks and i had my cast removed yesterday. I just want to ask if the bone have callous formation; is there a tendency for it to break again if I will push myself to hard on my rehabilitation therapy? How long should the rehab be? Thank you.

  18. Dr Arun Pal Singh says


    if you have have been operated with satisfactory soutcome the sound cannot be from bone. It could be sound from gliding tendon.

    As such there is no special or particular food for healing of fracture. But you must take a diet rich in calcium and proteins

  19. Dr Arun Pal Singh says


    Until they cause problems, it is not advisable to remove the hardware. TO answer your question, if the fracture has united, the plate can be taken out.

    But remember! You would need to protected for six weeks in a cast after plate removal.

    If it is not causing any problem, leave it as such. If your bone has united, you can do all the normal activities because the stress would be taken by bone.

    Consult an orthopedician in vicinity. Discuss your querie with him.

    If there is any confusion, you can ask me any time.

  20. Dr Arun Pal Singh says


    First we need to see that lateral malleolus has united and is in acceptable postion. An xray would help in this regard.

    Lateral malleolus takes part information of joint. So your activities would affect not only the mallleolus but also the joint. Start slowly and progress gradually. Our body does not like onslaughts.

    Your would be able to decide how much is enough. if in doubt, consult your physio trainer.

  21. Nita Campbell says

    My 13 year old grandson is wearing a back brace for a football related compression fracture in his lower lumbar. Considering his young age: 1) approximately how long would you expect it to take for healing to be complete enough for a return to normal activities? (He will not be playing football again.) 2) In your experience, If a patient increases his protein and mineral intake, can the new bone repair become as strong or stronger than the original bone? 3) He is overweight. After he heals, what would be the best activity to lose weight and strengthen his spine? Thanks.

  22. Dr Arun Pal Singh says

    It usually takes 3-6 months. The bone will reach its original strength but compression might remain visible. High protein diet does help in repair.

    If he want to loose weight, he should do exercises under supervision.

    I hope that helps.

  23. Vanessa says

    I fractured my left ankle last week and damaged the ligaments. The doctor says I'll be in a cast for the next three weeks then will wear a boot for a number of weeks after that. Apparently, I do not have a serious fracture, I won't require surgery, and it will heal wtih little problems.

    My question is, when I get the boot, will i be able to walk on it? How long will it take to resume normal activities?

    Thank you. (Very good article, helped me understand what is going on.)

  24. Yvonne says

    This is a very useful page, thanks.

    I fractured my fibula when I slipped while jogging. How long do you think it will take before I can run again? Will running damage it? Would wearing a lace-up ankle brace help? Thanks

  25. Dr Arun Pal Singh says


    It would depend upon the level at which fibula is fractured. if it is near ankle, things take more time to get back to normal than if it was in middle or so.

    8-12 weeks is the usual time to normalise the things. Some people might take more depending on soft tissue injury.

    i hope that helps.

  26. Dr Arun Pal Singh says


    Most probably yes but only your doctor can confirm it. Tissues take about 2-3 months to heal completely. if injury is severe, it could be longer.

  27. says

    Dr. Singh.

    I had a fibula fracture just above the ankle. This happened on 11th Feb. 2009. I had an ORIF along with K wire. A plate was fixed with six screws. I have been in cast for 11 weeks. The cast was removed on 30th April, 2009.Now my rehab has begun.

    Dr. I want to know how long i had to wait for to attain the normal status. when could i start walking. My age is 34 years….Please help.

  28. Dr Arun Pal Singh says


    K wire and a plate? were there two fractures?

    Was there any particular reason that a cast was kept for 11 weeks.?

    Please let me know.

  29. says

    Dr. Singh.

    I had fibula fracture just above the ankle and right ankle trimalleolar fracture. For which doctor adviced me ORIF as the best option.

    On 11th Feb. i was operated. ORIF with 2 k wires and TBW of midial malleolus and 6 hole AO tubular plate on fibula was done.

    After ORIF x – ray was done and i was discharged the other day with follow up instruction to visit Doctor after 14 days for review.

    After 14 days i went to the doctor . And the SUTURE( hard bandage) was removed. Then the cast was done from the near the toes through the heal till just below the knee.This casting was done on 27th Feb. I was asked to come on after a month.After a month(30th March) X- ray was done and i was told that the report of the bone is good.

    I was told to continue with this cast and it will be removed after a month.On 30th April my cast was removed.Now i am told that for next 2 weeks dont put wight instead do "up and down" ankle exercise.Then apply 25% weight after 2-3 weeks and then again after 2-3 weeks 50 % weight on effected leg.

    All this has taken 11 weeks. Doctor i am really wondering how more i had to wait to walk on my legs. Please let me have ur guidance and advice. Please Helpppp !!!!!

  30. Dr Arun Pal Singh says


    You should have mentioned complete nature of injury in last comment. anyhow, if you have had trimalleolar fracture, you seem to be treated on right line.

    Operative treatment is the best option for trimalleolar fracture and they do take this much time.

    You can consult with your doctor but in my view you should be upright without assistance in another month. Sometimes soft tissues take more time to normalise but that would be better explained by your treating physician.

  31. says

    Thanks Doctor for giving ur valuable comments.

    This page is very educative…..the comments given by the Doctors are prompt and useful.

  32. Tiffany says

    Dr Singh,

    I was in a car accident exactly a month ago and had a compression fracture in my L1. They took an xray and CT soon after and determined I had to wear a jewitt brace for 4 weeks and return for a follow up, which I assume is to see whether or not I can start functioning without the brace.

    Today was my dr's visit and they took another xray, but no CT and determined that my spine has remained aligned, but for precaution I continue wearing the brace until June 15th, the next followup.

    I want to know is, why did they extend my recovery time. I felt a CT should've been done today to look at how much has healed. Overall, I've slowly started functioning on my own without the brace and now this news frightens me.

    How long does it usually take for this type of compression to heal? and should a CT have been done today along with an xray? I'm a 22 year old female that is completely healthy. I would really like to know.

    Thank you!!!

  33. Dr Arun Pal Singh says

    Tiffany ,

    You did not mention it but I assume it from your notes that compression was of mild to moderate degrees and there was no neurological deficit. In spinal injuries, protection is given for longer periods. I personally recommend them for up to 6 months wherever required.

    It appears that you assumed the removal of brace at your second visit. Because it did not happen so you are getting concerned.

    At first time, the CT might have been needed to know the exact fracture pattern. But CT is not necessary at every follow up nor it is done that frequently. Xray is good modality to note the healing and it was done.

    Compression fractures as such heal quite well. Usual time taken is 8-12 weeks. Additional protection may be given for longer period if required because of nature of injury.

    A brace is usually removed in gradual fashion.

    There is nothing to be frightened of. Unfortunately braces do not seem to be very friendly but they offer good support.

    As you are young and healthy otherwise, your tissues should show a good response.

    Take care.

  34. jon says

    Dr. Singh.

    Does the gap in bone from a small blowout fracture of the orbit fill in with new bone? No surgery was needed.

  35. says

    Hello Dr.

    I met with an accident when i was hit by the bumper of wagon R. The car was very slow when it hit me.My right leg caught up under the stationary bike and was injured. Though there was no open wound. I visited hospital after two days when there was no decline in swelling and pain.

    X-ray was done. it revealed two fractures. One fracture was on the fibula just above ankle and the other trimalleolar fracture. I was admitted in the Hospital and the next day my leg was operated.Fibula fracture was joined/supported by a plate with six screws and trimalleolar fracture was done with K wire.

    I was discharged and was asked to come after 2 weeks. After 2 weeks my bandage was removed and Casting was done.Now i was asked to come after a month.Now X-ray was done and i was told that progress is good and i was asked to continue with the cast for one more month.

    After a month i visited the hospital.Till now nearly 12 weeks have gone. This time again X-ray was done and then cast was removed.

    I m asked to put weight on affected leg gradually. My age is 34 years. And i m taking a diet rich in proteins, calcium, vitamins and other minerals.

    Now its a long time(12 weeks)on rest and really worried and so want to ask u.

    1. Right since the cast was removed i had slight swelling and stiffness. Dr. says its normal. When swelling and stiffness will vanish.

    2. when can i walk without any help.

    3. Wat restriction would be there in my life bcoz of this fracture…..could i ever run
    on trade mill in Gym.

    Regrds……Bharat Yadav.

  36. RAKESH says

    Dr Arunpal Singh,

    i had a car accident in which my left hand radius and ulna both were broken.It was not open woun , but surgery was done to fix the bone with plates and screw. The union was delayed. After 3 months my callus formation was weak.Doctor prescribed sodium alendronate and calcium tablets now the healing is going fine.Should i remove the plates after the healing is complete or can i leave it like that.Doctors are giving different opinions.My age is 32, they are concerned of the age factor.



  37. messier says

    Eight weeks ago I cut through my left arm with a circular saw. It cut 3/4 the way through the ulna about 3 inches below my elbow. I have a plate and screws in, I did’t loose any important tendons. I had an apendectomy 3 weeks ago, followed by a stomach virus. The doctor was dissapointed with my progress. The void in the bone still looked dark in the xray. He’s given me 4 more weeks to heal. If I don’t improve he’s injecting graphing material in. Do you think the extra month will really help. By the way I’m 31, male and, in good health, besides all of what just happended. Thank You for your time.

  38. Dr Arun Pal Singh says


    You would need to consult an eye surgeon/ facial surgeon for that. It is beyond my field of expertise.

  39. Dr Arun Pal Singh says


    1 Swelling and stiffness are normal after injury/surgery. As you work out on your ankle with physiotherapy, it would become better with time.

    2 That depends on your injury, fixation and physiotherapy but if everything is fine, you should be walking in another 4-6 weeks.

    3. Only time would tell that. i hope you are free of any restriction.

    Take care.

  40. Dr Arun Pal Singh says


    Plates are not removed before 2 years after fracture has united radiologically. That too if they are causing some symptoms.

    Early removal would increase the risk of refracture.
    I would suggest you to do nothing if you do not have any problem.

  41. Dr Arun Pal Singh says


    I would need to have a look at xrays before I could comment. Could you mail me xrays before and after surgery and then leave a comment here so that the mail is not lost.

  42. Anil says

    Hi Doctor,

    Thanks for the information. 2 weeks back my son (20 months old) has broken his right hand [just below his shoulder] it got into 2 pieces. Doctors say after 4 weeks we can remove the pluster. please advice me is it a right thing to remove the pluster at end of the 4th week?



  43. Navid says

    two months ago i faced a car accident and i had spine column injury and i was operated now can walk but
    i can not run and also i can not bend myself what should i do in order to run or walk fast

  44. murtaza says

    Dear Dr Singh,

    i was involved in a car accident about 2 months ago in a foreign city. the x rays and a later CT scan revealed i had a burst L4 fracture of the spine. The doctor -a neurosurgeon- had concerns about a slight compression/narrowing of the canal at the L4 and L3 junction and asked if i had any numbness or tingling feeling in my legs. i had none. He put me on a 4 week complete bedrest treatment without any bracing and allowed for short walking trips to the bathroom.

    After 4 weeks i was asked to get a follow up xray and an MRI to show the healing progress. he said that the progress was fine but i would need 4- 6 more weeks of bedrest. i had started getting occasional pains in my ankles and shin, he expressed concern for this but said he would address it after the bone had healed. he proposed a small surgery at a later date to relieve the pressure of the spinal cord at the point where it had narrowed.

    i also consulted an orthopaedic doctor who expressed his horror at my being allowed to walk a bit after 4 weeks! according to him, the fracture had actually disjointed more! he told me to immediately get back to bedresting for another 6 weeks! he asked me to use crutches when going to the bathroom and to avoid sitting at all. again, there was no mention of any bracing. he also asked me to keep a rolled towel below ths small of my back to maintain lordosis.

    i would like to know how long a lumbar fracture takes to heal and what are the precautions to take in order to aid the healing process considering i'm not wearing any braces. its already 9 weeks since the accident and i need to know when is it safe to travel so i can get back home and continue with the follow up treatments from there.

    murtaza, nairobi (but currently in dar es salaam)

  45. Ebags1 says

    I was wondering when I will be starting to walk after a trimalleolar fracture. I suffered the fracture on 4/4/09, had ORIF surgery on 4/9/09 4" plate and 8 screws. On 4/22/09, had staples out and was put into the darth boot and told NWB for 4 weeks. I am going to OS in 2 days for a follow-up, what should I expect? Some say I will be PWB, if xrays look good, but still have the boot. How much longer with this injury? I haven't had any complications, I did not suffer a dislocation.

  46. Dr Arun Pal Singh says


    Two months is too soon for all this if you have had a spinal injury. Talk to your physician before you do all this. He/she would be better to guide you on this.

  47. Dr Arun Pal Singh says


    These questions demand specific answers but I cannot provide you such answers. the best person to ask these is your doctor.

    Different people behave differently and very case is unique. So people tell you different things because each one assumes that this is the only course.

    Your course would depend on how you have made progress.

    In usual course, most of people start walking within 2-4 months.

    I hope that helps.

  48. Dr Arun Pal Singh says


    What i am telling you is the generalised treatment. your doctors are the best person to decide on your treatment as they have more information on your problem.

    On conservative treatment, the person needs to take rest for long usually 8-12 weeks or more if required. After that , a person is allowed to move around with a brace. But braces do not prevent any deformity as such. So some people do not prescribe them.

    If you can manage to go in lying position I think it is okay to travel. But you need to consult with your doctor for final decision on this.

    Take care.

  49. Dr Arun Pal Singh says


    children have a tremendous capacity to heal and it occurs at quite a pace. I think it is okay to remove the plaster after 4 weeks if everything goes well.

  50. Ebags1 says

    Thanks Doc!!

    My OS says I will be back to normal by July 4th. I am progressing pretty well, actually a little quicker than average. I can already dorsal flex my foot, wiggle all toes freely and put my foot down on the ground in a 90 degree angle. Doc also sd that my swelling or lack there of was amazing.

  51. Dr Arun Pal Singh says


    It is good to hear that you are making good progress. May you get well soon

  52. ebags1 says

    I saw my OS and I am now WBAT (50-100%). What type of gentle exercises should I do to decrease the stiffness in my ankle? I don't have any pain when bearing weight, however the ankle is very stiff. I let it soak in the bath today and that seemed to loosen it up a little.

    Thanks for any info you can provide.

  53. Dr Arun Pal Singh says


    Warm comprsses and active ankle mobilization exercises would help you to gain back ankle motion.

  54. Kate says

    What kind of conversation would you have with a patient if they had a non severe bone fracture in their foot.

    I know that's a silly question, but I mean, how would you explain it to them in simple terms,

    and what would you do about it, how would you help it heal. And how long would it take..


  55. steve mensen says

    I had minimally invasive spinal surgery march 24 09. The neurosurgeon advised the procedure was successful. I am still experiencing low back pain requiring medication. The procedure included laser shrinking of L 2,3,4,5 and trimming of osteophytes on the vertebrae. After reading the comments of others it seems to take months for the bones to heal. When should I expect to be pain free.


  56. Dr Arun Pal Singh says


    What was surgery done for and please also let me know a brief about your disease profile.

    I need that information before I can deduce anything.

  57. steve mensen says

    The surgery was to address herniated discs and also to relieve osteophyte pressure on nerves. I had lower back pain and numbness in both feet.

  58. Dr Arun Pal Singh says


    The answer varies according to type of fracture and patient profile and presence of any factors that might affect the outcome.

    What I mean is that untill you ask me something specific, I would not he able to answer. If you want to know about foot injury, you need to provide me details of it including the treatment if any.

    I would try to keep it as simple as possible :-

    Take care.

  59. Dr Arun Pal Singh says

    @steve mensen,

    Okay! In that case you must understand that backpain is very complex problem in terms of causes and behavior. While pressure on the nerve roots might be relieved by surgery, cause of backpain could be obscure and not localizable,

    As far as I gather you were operated for numbness to relieve the compression of the nerve roots.

    But backpain respondes a bit differently unless we are able to localize the origin.

    As you have so many osteophytes, it suggests degenerative spine an age related phenomenon. Thus there could be various causes of pain.

    You must discuss it with your doctor and ask him if you should expect a complete relief of the back pain.

    There should be some but your surgeon would be able to tell you better.

    Let me know and we can discuss it further.

    Take care

  60. Srinivas Rao says

    I had a trimalleolar fracture and on fibula near ankle. I had ORIF surgery on 11th Feb, 2009, a plate and 6 screws and K wire. On 26th Feb staples were out and POP cast was done. After subsequent x-rays cast was removed on 30th April, 2009 i.e, after 2 months and 17 days.

    For 2 weeks i did ankle up-down exercise and then I started applying 25% wt on effected leg. This I continued for 2 weeks though I was to do for 3 weeks. Then I start applying 50% wt. I use walker. I started walking little more like 700 metres distributed throughout the day( taking regular breaks). Now I feel little pain on the front of ankle(after walk) but disappears after some rest. When day finishes(before sleep at night ) I find swelling on the lower leg(effected part) but next morning the swelling almost disappears.


    I’m just wondering when I can walk without help. I’m 35 years old, weight 70 kgs, general health is ok.

    Please Advice……..thanks in advance

  61. andrew says

    hi Dr. Singh,

    i fractured the shaft of my fifth metatarsal 14 days ago today. the doctor had a cast put on me and said i would need it for five weeks. i got another x-ray yesterday,13 days since fracture, by a different doctor and does'nt think ther has been any healing. over the years, i've been unfortunate enough to fracture my cheekbone, wrist, scaphoid, ankle and ribs. all of these injuries healed well and quicker than the time i was initially told they would. the cast is driving me insane as i'm due to play overseas basketball in august, and this is the last opportunity i will ever get at 27. do you think the bone should be showing signs of knitting back together by now, and if it does start to heal, when do you think would be a good time to take off the cast. please tell me what you think i should do.


  62. Dr Arun Pal Singh says

    @Srinivas Rao,

    You seem to be progressing fine. Do not worry about minor swellings. They would go with time.

  63. Dr Arun Pal Singh says

    I can understand your apprehension but injury needs to heal before you can do anything.

    Before I comment on your injury, I need to know th nature of injury. Was it displaced? did you have a wound?

  64. Jay says

    I had a humeral fracture in Jan. 2008. After rodding in Feb. 2008 and grafting–morphogenic–in Jan. 2009, I still have no healing of the fracture. Now my orthopedic surgeon is talking compression clamp(?). What are my other options? It’s a clean break mid-shaft.

  65. Dr Arun Pal Singh says


    I do not think I understamd the word compression clamp
    Does that mean compression plating.

    Because that is a another option in these fractures.

  66. MIke Brown says


    8 weeks ago I fell and broke my 5th metatarsal on my right foot. I was put on crutches and a boot, no cast. I just got back from the dr and he palpated the area for pain, to which I had none, but the xray clearly showed the fracture…he said it was most likely filling with soft tissue and I could walk as long as there was no pain, and if that occured to go back to the crutches and boot………….I have been able to walk about 1 hour in total in the last 4 days, but being very conservative I dont want to re-injure the healing area. I am 52 years old, very active, swim, run (well until I broke my foot), a non-smoker. He has me scheduled to come back to see him August 7 (7 weeks away – which will make 13 weeks since breaking my foot), in your opinion, is there an average time when I can resume walking? Anxious to walk again……………then maybe resume running sometime down the road.

    Many thanks,


  67. MIke Brown says

    I meant to also mention, that it was not a compound fracture…..but a closed break. He also called it a Jones Fracture.

    Thanks again,


  68. Dr Arun Pal Singh says


    Sometimes the xray may show line for long time.

    If you do not have pain, you can work towards walking gradually.

    Jones fracture usually do not cause much trouble in healing. It is always difficult to put a time frame but most of people walk within 8-12 weeks with this injury.

  69. mike trillo says

    hi. i had a right humeral shaft oblique closed fracture, distal 3rd due to fall 3 weeks ago and currently on cast. surgery wasn't performed. i chose the conservative management. how long will it heal? how many weeks ill be on cast? thank you.

  70. Dr Arun Pal Singh says

    @mike trillo,

    Usual time for conservative treatment is 8-12 weeks followed by physiotherapy.

    It is advisable to get frequent xrays for initial three weeks to know if position is maintained or not.

    it is all the more important in distal third oblique fractures.

  71. footsahurtin says

    Dr. Singh,

    I recently fractured a bunch of metatarsals in my right foot. Last week I had xrays taken 3 weeks post-op, and so far it showed no sign of union. I think that can be normal. I'll get another xray in 2 more weeks to see if any cartilage is forming around the breaks.

    I show a picture of the metatarsals "PINNED" at , or you could google footsahurtin and then click HOME.

    Since i broke 4 or my 5 metatarsals, how long would you guess that it could be before I am actually walking comfortably again with FULL weight bearing? 8 weeks?? 12 weeks?? Up to a year??

  72. Dr Arun Pal Singh says


    I had a look at your images. your fractures have been fixed well and aligned satisfactorily. in a normal course the foot bones take from 4-8 weeks to unite.

    Every individual is different but people start walking independently after 12-16 weeks. Some vague pains may persist for sometime but generally foot shows satisfactory results.

  73. Sam says

    Hi Dr. Singh,

    I had fall from a ladder on 22nd June 2009 and fractured both my wrists, initially I had a POP plaster . After few days doctor said that alignment in left hand was not satisfactory, on 2nd July , doctor opened the cast and again aligned the bones in both my hands. Now I have a synthetic cast. Pain has subsided but there is pain in fingers and near elbow. How much time will it take to heal.

  74. Dr Arun Pal Singh says


    Fractures of wrist usually unite between 4-6 weeks. Return to previous function level might take longer.

  75. Tiffany says

    Dear Dr. Singh

    It has been 3.5 months since my car accident where I compressed my L1. The dr showed me my xray and it looks like a trapezoid on that one bone, but thankfully it's not compressed on the side of my spinal cord. I have stopped wearing the brace and overall have been feeling well except for mornings except for some stiffness occasionally. I was wondering if it's okay now to slowly begin personal training to build back strength from the time that I've been inactive. I would really like to get back into shape. Please let me know if it's okay. I'm 22 and completely healthy otherwise.



  76. nihsl says

    Hi..I broke my forehand in the middle of frontarm., not joins..after 3week i have still pain, does it normal..Is it necessary to have surgery..And when the healing occurs..


  77. Dr Arun Pal Singh says


    3.5 months is quite a time to start your back strengthening exercises but you need to ask your physician before you go about it.

  78. Dr Arun Pal Singh says

    No! It is not necessary to always treat these fractures surgically in fractures which were not displaced to begin with and fractures which have been reduced and held in the same position.

    Healing is an ongoing process and takes years to complete. But one can become splint free in 812 weeks.

    I hope that helps

  79. Sam says

    Dr. Singh,

    It has been around a month since I broke my wrists(both), Pain has also subsided, my Doctor says he will remove the cast on 10th of august, is it ok that I work on laptop and can I start picking up objects.



  80. Dr Arun Pal Singh says

    I do not think it should be a problem if you feel comfortable doing it.

  81. Holly says

    Hi! My 6 year old son fractured his radius and ulna in his right arm after falling off his bike about a month ago. The bone specialist saw him and said that the break was angled at 30 degrees, and recommended closed reduction to straighten the bones out. The first closed reduction (while my son was under anesthesia) which was not entirely successful. The doctor reported a week later that while the bone was less angled he was still concerned about the amount of angulation and suggested that we try again. We went to the outpatient surgery again, where the doctor cut the bottom of the cast and "wedged" the cast as he put it, and try to straighten out the bone again. He did this and said that they were able to move the bone slightly, and he thought this would be successful. I took my son back to the doctor two days ago and the doctor said that the bone was still slightly angled, which I understand, things like this aren't going to turn out perfectly. He then told me to wait 10 days, and return on August 5th to have the cast removed and to be x-rayed again. He told me that we would then decide if he was to be placed in a short arm cast. (He has been in a long arm cast for the past 3 weeks now.)

    I have so many concerns, and I feel kind of silly asking the doctor these questions! Do you think that he is going to completely take the cast off after only a month? Or when he said discuss the short arm cast option he ment that he was deciding whether or not to put a long arm cast back on?

    I saw the new x-rays this past Monday and his arm still looks quite broke, and I'm concerned that it's not healing correctly. I was also informed that when the cast is removed that my sons arm may look slightly bent until the bones start to grow back out again. Now I'm concerned that his arm will be weak and easily breakable once the cast is removed.

    I'm trying to include the initial x-ray of my son's arm in my gravatar so you can hopefully get a visual and possibly make more sense between the x-ray and the doctors thoughts. This would be GREATLY appreciated!!

    Thank you!!!

  82. Dr Arun Pal Singh says


    I am yet to see a healthy child of that age who does not get union of fracture. Union is a kind of rulle in children and if your child has been healthy, you should not worry about healing.

    I usually prescribe short arm functional cast in children after taking out long arm cast. It is okay to remove the cast at 4 weeks.

    Yes! the arm is weaker for some duration and that is why short arm cast is prescribed for another 2-4 weeks.

    Even after that bone takes time to strengthen. It does reach the original strength but till that time one should be extra cautious not to cause trauma again.

    And if it is not angled much, it would get better as he grows.

    One last thing! You can ask your doctor whatever you want. if it addresses your concerns, it is not silly.

    All the best.

  83. Janice says

    Dr. Arun Pal Singh,

    I fractured the proximal end of my 5th metatarsal 3 weeks ago and have been placed in a boot. Upon my 3 week orthopedic check-up 3 days ago My physician saw no indication of healing on the x-ray. There is an approximate 3mm displacement laterally with 1mm medially. He said I could have surgery or wait 3 more weeks to see if healing initiates. I am 48 years old, do not smoke healthy weight and eating habits. However was very disappointed to not have seen any sign of healing. Since yesterday I have had a sporadic tingling pain at the fracture site that kept me up a good part of the night. I am not a fan of medication. 1st. Is it ok to take so long for the initial signs of healing. 2nd. What would cause that tingling pain, again it is not consistant.

  84. Dr Arun Pal Singh says


    Fractures of proximal end of 5th metatarsal mostly unite without any problem. 3mmX1mm is not a significant displacement. So I think union should not be a problem.

    Xray might show a translucent line for a longer time. If you have reduced pain and decrease in tenderness, your body is attempting a healing process.

    Wait for 3 weeks and then get yourself assessed again.

    Check if your splint/boot is tight or becomes tight intermittently due to swelling of the foot. That may be cause of pain. If it is so, please keep your limb elevated for majority of time.

    I hope that helps.

  85. says

    Hi Dr. Arun,

    This is in continuation to my earlier posts,my cast of both the hands were removed yesterday, there is some pain in hand motion (a little more in the right hand) and stiffness is the wrists.

    I have given a link of my hand photograph, I am concerened about the shape of the hands after cast removal, in the right hand in the red coloured cicrle you can see the bone protruding a little, is it normal?

    Do you recommend any exercise.

  86. Dr Arun Pal Singh says


    If you you do not have any functional difficulty, do not worry about the protrusion.

    Consult a physiotherapist (after talking to your treating doctor) who would help you with physiotherapy.

    Best of luck.

  87. berna says

    Dr. Arun,

    Good day, i had a fracture almost 6 weeks already, it's on the left 5th metatarsal. They put me on cast for almost 5 weeeks. then now they removed on they just put tubigrip. But my problem is still there is swelling and pain on the site. Is it normal that swelling is still there and i'm still afraid to put my weight on that site. How many weeks it will take to the bone to be heal.

  88. Dr Arun Pal Singh says


    Pain and swelling may persist for some time but by this time the bone must have healed to allow sufficient weight bearing.

    You might take a stick for initial period if you ae uncomfortable.

  89. Barbara says

    Dear Dr. Singh,

    I am a healthy 65 year old, who fell after falling on very uneven pavement, turned an ankle, and broke my fibula this past Tuesday. The bone was not separated in the x-ray, so the orthopedist gave me a Biomet Brace with velcro fastenings and said to wear it for six weeks. He said that I could walk as long as I wasn't in severe pain and to just play it by ear. I can remove it to sleep and to shower. I go back for another x-ray on August 25, 13 days after the initial diagnosis. My question is, can I really be walking around, or should I be lying down and elevating the leg? What will help with healing faster? Should I continue with ice or use heat? I want to do everything "right," but it's unclear what "right" is. Any advice would be appreciated.

  90. Dr Arun Pal Singh says

    Your fibula could have broken in two ways – either by hitting a hard surface or due to twist itself.

    If it is broken due to direct injury to it, you can walk as guided by your pain.

    But if it is broken due to the ankle twist, it must have caused injury to the tissues on your medial (inner) side of ankle. This would be evident by swelling, pain and tenderness on inner side of the ankle.

    In this case, you need to provide rest to the ankle joint for 2-3 weeks+ limb elevation and active toe movement.

    In latter case, the fibula would be broken near the ankle.

    From your orthopedist's advice it seems that you just have a fracture of fibula without any injury to ankle.

    But if you have doubts or pain in the ankle, you can speak to him again.

    Ice is applied for initial few days only. Heat has no role in acute trauma.

  91. Manish Jayswal says

    I am a 27 year old university teacher in physics.

    I met an accident on july 8th 2009. I slipped while driving a scooter.

    It resulted in a fracture in my leg. the prescription of the orthopeadic reads like this : ” # LAT.MALLEOLLUS WITH 1/ST, 2/ND & 3/RD M. T.(LT) FOOT ”

    Moreover the ancle had twistedand was evidenced by swelling around it and on the back of it also. thogh the fracture was not evidenced in X-ray, the sever pain made us to realize it.

    The orthopeadic applied a slab for around 24 days. when the plaster were removed, i went under physiotherapy for around 10 days. And I am still practicing the exercises prescribed by him.

    my concern is that even after around 40 days, there is still some swelling around the fractured region. And it increases in measures when I am standing for just 10 minutes or I walk even half a Kilometer. As I am a Teacher in the University. this much walking is a must for me to move from one class to lab to department etc.

    I want to know that

    1.why does it swell when the fractured part comes under stress?

    2. will it have any negative effect on healing of the fracture?

    3. what measures should I take to let it heal fast along with my job, as the university is denying me further leaves( I have already taken more than 35 leaves for this.)

    4.i am not able to walk properly as well (no other defects are present). Physio and ortho have said that it will come in its rhythm in 3 to 4 months.

    Any advice or comments.(please do not mind the language, as I am not very good at English)

    Thanks in advance

  92. Dr Arun Pal Singh says

    @Manish Jayswal,

    It is common to have a swelling even after fracture is healed. The swelling is because of impaired drainage of fluid rather than stress on the fracture. This impairment occurs due to injnury per se.

    Typical swelling increases when you stand for a prolonged duration or walk for somet time. The reason is again the same. Because these positions put foot at further disadvantage.

    But except for unsightly look and shoe wear problem, the swelling does not cause much of discomfort. It would go slowly with time.

    Following measures help in tackling with this problem.

    Avoid standing for long time.

    Wear a good loose shoe/sandal/slipper with allowance for swelling.

    Raise your feet intermittently on a stool when you sit.

    Avoid keeping your foot in dependent position when you sit.

    Continue your mobilization exercises as advised.

    Things would get better with time. All the best.

  93. Randy Mills says

    I am a healthy 53 year old man who eats healthy and doesn't smoke. I fractured the tip (tuft?) of my left big toe when a guy at work dropped a 70 lbs object on my toe on April 10th. The impact shattered the bone and there are several breaks radiating out from the impact zone. I have been to 3 doctors and the first doctor would not give me anything and said they can't do anything for a toe tip break. They sent me on my way and I subsquetly hit and injured my toe six times before they would give me a boot. I had to modify the design of the boot sice wearing it caused more injury to my toe.

    The last xrays clearly show a shattered toe. The orthopedic sugeon thought I had soft tissue trama when a tender lump formed under the toe appearently pushing up the bones and keeping them apart. An MRI was done and he took a quick look at them and thought it was a healing fracture and not a non union as originally thought. I took a closer look at the MRI and clearly see jagged dark lines indicating a break. Some look as wide as 1 mm. What should the breaks look like if they are healing? Should the lines be white in an MRI or Xray if they are healing?

    I have painful swelling every night and yeasterday he said I should try to walk and put weight on the foot. I walked around all day today on it and now have more swelling and pain. The doctor told me to wrap my toe tightly to the to get the lump to go down. This doctor thinks that there is nerve damage and that is causing the swelling not the break. He wants me to have a "sympathic nerve block" done with an injection to the spine to temporarily shut down the nerve and reset it.. I don't like the sound of that! It has been 138 days since the break occured. Is this normal ? Will it ever heal? This last doctor seems disinterested in helping me since he sees it as such little break.

  94. Judy says

    Hi Judy here i fractured my 4th 5th metatarsal 8 weeks ago it does not hurt anymore but as soon as i start walking my ankle and the top of my foot swells it is fine if i keep it elevated is this normal after a fracture and how long will this take to go back to normal

  95. says

    My wife fell down on a slippery floor and suffered fracture on her right leg on 16th July 2009. Next morning she felt swelling and pain in the leg and was not able to move the leg she attended a local orthopedic centre where the doctor pur a plaster on her leg and advised for six week''s rest. The plaster was removed on 20/08/2009 and a xray was done which showed the fracture has healed. She was advised 4 week's rest. But she is not able to walk and a sort of filthy smell comes from her feet. What is your advise. Should we take a second opinion by visiting any other orthopedic centre? Please advese.

  96. WillJam says

    Dr Arun- On July 21, 2009 I sustained fractures in my 4th and 5th metatarsals. I was put in a splint by the ER and then was sent to a Ortho were they put me in a cast. 2 weeks later I go for a recheck and of course there is no sign of healing (that seems to be a common thing) so I am put into another cast for 4 more weeks with crutches. I am still able to work with the use of my crutches but I know that my boss isnt going to keep me around for much longer with a broke foot. I really need to get this foot healed or I am going to lose my job and not be able to support my family. What I really want to know is is there a higher chance that I will have to have surgery OR is there more of a chance that the fractures will heal within the normal time limit. I read an another website that it can take up to 20 weeks for them to heal and it has me just a tad bit worried. I am 21 years old and very anxious to get up and start walking, driving, dancing……all the fun stuff that I havent been able to do in over a month! From what I know there was no displacement and the bones were aligned at my last visit. I have also been taking calcium supplements (not saying that I do not get enough in my diet or that I broke my foot due to lack of it) but I have heard about all of the benefits that calcium can have on the bones and thought that maybe the calciun could maybe speed up the healing process or make the bones stronger. Are the calcium supplements worth taking? Thanks for your time!

  97. Dr Arun Pal Singh says

    @Randy Mills,
    Sorry for the delay. Could you please mail me an xray and a photograph of your toe.

    I need to take a look.

  98. Dr Arun Pal Singh says

    Yes. It can occur in some people and the time taken to to go back to normal may be frm few monthd to a year.

    Try to avoid prolonged hanging of the foot.

  99. Dr Arun Pal Singh says


    Metatarsal fractures heal most of the times until they are open or associated wita pathology or are displaced widely. The sign of healing on xrays may not appear untill 3 weeks. So do not worry about that.

    By your description, your fractures must have healed by now enough to let you walk with a stick.

    Calcium supplements are useless if you are taking a good diet.

  100. Randy Mills says

    Thank you for your response. I have a PDF file with my x-rays, MRI and photographs of my toe. How do I send them to you? Do you have a regular email address?

  101. says

    Hello Doctor……….

    In Feb. 09 I had an ORIF with six screws an plate for my fractured Fibula towards ankle and also ‘K Wire’ treatment is done for fracture at ankle joint.Final cast is removed 4 months back. Now i am in the seventh month when i have started walking normally without any help.There is no pain or swelling even if i walk a kilometre morning and evening. But only swelling occurs when i am out of home for 4-5 hours when i am either walking,standing or sitting positions.Even for that outing i have no pain but swelling.

    But Doctor i want to ask when a) when can i get rid of swelling during longer outings.
    b) There is a belief that during winter seasons, pain occurs. Is it true ? It
    really scares me.If it’s true, what remedy is there.
    c) I have started working in Gym for upper body since last three weeks(by
    doctor consent) and i didnt feel any uncomfort or pain. Doctor will i ever
    be able to do jogging or running in future.

    d) Six months gone and 1 more year is left where i can have the option to
    remove plate.If i do not go for removal of plate in the entire remaining
    life, then will the plate cause any adverse effect.

    Many Thanks in advance,

    Srinivas Rao
    Male 35 years

  102. LucyB says

    Dr Arun,

    I'm a 49yo female with osteopenia post-oophorectomy. On Memorial Day an object fell on my left foot from the top of a fridge. I had really sharp pain the rest of the day, bruising and swelling, with point pain on the top and bottom of the area of the 2nd and 3rd metatarsals… but hard to localize with all the bruising.

    Urgent Care said I most likely have a fracture, but the podiatrist wasn't sure, so he prescribed ice, ibuprofen, and a stiff surgical shoe, and the pain receded over weeks. However, even this last month it still throbs when I walk on it in barefoot, and, more disturbingly, when barefoot I have a sensation of a pebble on the underside of my foot, under the 2nd metatarsal. Also some tingling and partial numbness under the metatarsal, some pain shooting into the first and 2nd toes, and still point pain with some movements — but I can move the toes. I can stand on my tiptoes without pain, but I don't feel the floor as clearly with that part of my left foot.

    (I feel embarrassed that I hadn't caught this earlier. What I've just figured out is that I don't feel the pain in SAS sandals, which have a well-padded sole. (due to painful peripheral neuropathy I normally wear well-padded SAS sandals, even indoors, and put them on as soon as I get up) .. So I only feel the pain when I am in less-padded shoes, or barefoot on a hard surface, e.g. when showering ).

    Now I am concerned that I may have a partially-healed fracture, but with the bones misaligned, irritating a nerve. What should I do at this point? Assuming it is a fracture, what can be done this late after the injury? And, if the podiatrist didn't see a fracture on the x-ray 3 days after the injury, would it show up now? If it is not a fracture, what else can be going on?

    Thank you!

  103. Satish Nayak says

    I broke my left hand ulna and radius bone in a bike accident.. I am 28 years old. They have fixed my bone with DCP and screws on both ulna and radius bone.Now its almost 6 weeks and the cast is put below elbow. Doctor said that he will remove the cast after 2 weeks. Can i ride the bike after my cast is removed. I would like to know when the DCP will be removed from my hand? Is there any harm if it remains in my hand? Will they operate again to remove the plates? Please let me know in detail. Thanks…

  104. Dr Arun Pal Singh says

    @Satish Nayak,

    Plate removal is not advised if it does not cause a problem.

    If required it is recommended that a plate should be removed after fracture has healed completely and that is usually 1-2 years.

    Yes! There would be repeat surgery of the same magnitude and you would need a cast for 6 weeks to protect the bone after plate removal lest it might fracture.

  105. Dr Arun Pal Singh says


    Fractures usually do not result in such symptoms and metatarsal fractures should be visible on xray on 3rd day. You said you have painful neuropathy. It is possible that that has worsened.

    Morton's metarsalgia is another possibility.
    Discuss it with your doctor. Another xray can help to confirm fractures.
    I hope that helps.

  106. Dr Arun Pal Singh says

    @B Srinivas Rao,

    The plate does not cause any harm as such. It needs to be removed only if it is causing discomfort.

    Swelling would go by and by.

    You are doing quite fine. It is not good to be apprehensive.

  107. Jacki says

    I broke my fibula bone about 1-2 inches above my ankle on September 5th. ER placed me in a hard splint with bandage wrapping and next day my DR – she is a DO- . placed me in a boot type cast with Velcro and crutches and told me to come back in two weeks to see if it is healing correctly. Said if it is, I can ditch the crutches and start using a cast for an additiona two weeks at which time I can ditch the cast and just use the cane for weight bearing. Does this sound right? I am 54 yo female in relativeley good condition – I normally work out 3-4 times a week. When can I expect to be back at the gym? I am anxious. Thanks

  108. ajitendra says

    i got shaft of femur broken or u can say compound fracture.Intramedulary nailing was done in may the doctors says they need to pull the screws one each from both end as the fracture site stills lacks union, its over four month.Well i have no problem in walking without support ( although a little limping is there).

    Should I go for that operation?. Is it needed? will it be a beneficial one?

  109. Dr Arun Pal Singh says


    Line of treatment seems fine to me.

    You can still work out on rest of your body.

    I hope that helps.

  110. Dr Arun Pal Singh says


    If the fracture has not united, the nail is taking all the weight while you walk. One day nail would fatigue and will not support your weight.

    Before that happens, your fracture should unite.

    Pulling out screws would allow the gap between the fractured fragments to close and therefore enhance the chances of union.

    But usually we remove them only on one end.

  111. Chris Ivie says

    yes I broke my metacarpal # 4 going on 2 weeks ago and have had a cast on now for a week with my middle finger,ring,and pinkie pinger enclosed in the cast with it bet due to the slight rotation of the bone. My questions is , should I still be feeling a noticeable pop in my hand where I broke it? Also the swelling is very noticeable with great pain. Do you think I need to go have the cast cutoff and have the xray taken again to see if i need to have it pinned or plated?


  112. Eva says

    hi doc, i have a stress fracture of the second metatarsal shaft. the alignment is fine so i was place in aircast end of may. The onset of pain was mid may and i am still in aircast and it is now September 24th. The orthopaedist took xrays and said everything is looking fine and i should keep the aircast on and use crutches so i dont put weight on the foot. sometimes i dont use crutches around the house because i have to do things for my little daughter. when do u think i will be fine. Its already been 5 months and i am fustrated and depressed. the foot(r) swells if its hanging and sometimes there is some tenderness. is it normal for a second metatarsal fracture to go on for that long? Help!

  113. Eva says

    u should know i got this fracture after i increased my running by 4 km. its a stress fracture the Orthopedist said.

  114. Dr Arun Pal Singh says

    @Chris Ivie,
    Your doctor must have had an xray after the cast if the fracture was originally displaced.

    If that position is acceptable, it is unlikely to change unless strong forces are applied on the hand.

    If it was undisplaced tobegin with, it is even more unlikely to get it displaced.

    The swelling could be due to callus formation.
    In any case surest method to confirm the position is the xray and you do not need to remove plaster for that.

  115. ajitendra says

    Thanx Sir,

    Sir you mentioned about the nail get fatigued (If the fracture has not united, the nail is taking all the weight while you walk. One day nail would fatigue and will not support your weight.)

    so what should i do to avoid this?

    how much time is needed for the fracture to unite( its already 5 months and still there is a gap of around 1 inch)

    well i have no other disease per se. i am 24 yrs.

    Do i need to consult any other orthopedic surgeon.?

    should i go for dynamization?

  116. Joanna says

    My son who is 12 broke his spiral break to his tiblaabout 3 weeks ago. Could you tell me why we still have pain and still take pain pills. Also his toes still swell. Do you think they should put a plate in there. Please give me your opionion.


  117. bigboy says

    hi doc i just wanted to know if i should heel my broken finger i went to the docotor and he told me i need to see a orthopedist but i think that is a waste of time cause i need to stay at work or i will lose it for broken finger but i can still move it not all the way i am exercise it everday and i think its getting bettter so should i let it heel on its own oh yeah and the reason of the broken finger is cause i was finger wrestling thank you

  118. WillJam says

    Hey Doc!

    This is just an update and a couple of questions. I went to my last appointment almost a month ago and my foot is healing quite well. I have been given a walking boot with the instructions to use my crutches if needed.

    The foot is feeling fine and doesnt hurt at all but my ankle swells up and is very stiff if I do not use it for long periods of time. Could this be fluid retention? My ankle only hurts when I twist my foot. Do you have any suggestions as to what I can do to ease the swelling? P.S. When I sleep the swelling goes down but it is harder to walk on my foot. Is that normal?

  119. Dr Arun Pal Singh says

    Please discuss the options with your treating doctor. you are free to take second opinion anytime.

    If there is a persisting gap you need to evaluated for treating that, most likely with surgery.

  120. Dr Arun Pal Singh says


    A stress fracture should heal within a month and if the symptoms have persisted this long, I think you should discuss with your doctor.

    It should not be tender after 5 months if it was stress fracture.

  121. Dr Arun Pal Singh says


    Please see a doctor so that you can be diagnosed properly and get treated accordingly.
    Symptoms would get better in spite of lack of treatment but may lead to residual dysfunction.
    It is better to invest some time for your own sake.
    good luck

  122. Dr Arun Pal Singh says


    This happens in ankle and foot injury. avoid prolonged standing or sitting with foot in dependent position.

    The swelling is due to inefficient drainage of fluid in presence of gravity. This is a common phenomenon and may take quite some time to go.

    Gravity can be avoided by keeping your foot on table or stool when you sit.

    In standing and walking it is unavoidable but can be minimized by avoiding continuous standing or walking.

  123. Barb says

    2 weeks ago I fractured a metatarsal when I sprained my ankle…the pain I have now is different. If I hold my foot and ankle perfectly still it will be fine,, but if I am up and moving around in the boot and on my rolling cart, it feels like muscle spasms in my foot and up into my leg..the only way to relieve it is to take off the boot and hold it perfectly still and if I can take a vicodan. Is this normal? I have never broken anything before.

  124. Dr Arun Pal Singh says


    It might be that your boot is not immobilizing enough during walk.
    Please talk to your doctor.

  125. Ashley M says

    A couple of days ago. Me and my friend(s) were messing around on the field at our school…. We was rugby tackling each other, he was slightly heavier than me and he fell on my leg. I heared a big "Crack", So i paused for a seconed. and i noticed my left leg really hurt. So they forced me up and tried taking me to the medical room when we got half way there, a teacher came and dealt with it from there. I had an ambulance to our local A&E (Milton Keynes General) I was in there from 1:30pm to 5:45pm. I got X-rayed and i got told i had a break on my left leg (The seconed biggest bone in the body – Between my Ancle and the underside of my knee) i got put into a cast for 1 week to see if it got any better, it didn't so i had that cast removed, and i am now in a permanant cast for 6 weeks…

    The only main thing i would like to know, is….

    …will it heal and go back to it's normal strength if not stronger?

    Bottom line – Hey what are friends for…..?

  126. Karen says

    Hi Dr. Singh,

    I injured my foot last week Oct 9. The official result of the x-ray for foot injury is "Undisplaced fracture of the base of the fifth metatarsal". The doc said to continue with pain medication if I need it (I'm not in serious pain, but am facing discomfort) so I am not taking any pany killers. Doc also said to continue with rest, ice and elevation and to tape the last 2 toes together and that it should heal within 4-6 weeks, possibly in 2-3 with very good care. No cast given, no crutches given. I have been working from home this week, but doc said it's okay to go back on Monday the 19th as I work in an office and am not on my feet all day.

    However, I have been looking at various internet sites and researching on my own – I'm getting mixed messages for injuries of the fifth matatarsal – some a cast is required.

    What is your opinion? Is it normal not to receive a cast or splint or anything for this kind of injury? Please advise – thanks.

  127. Ken Barbusca says


    My 12 year old son broke his arm just above his wrist the radius and ulna Bones about three weeks ago during ice hockey practice. The doctor did a closed reduction to get the bones back in place. The bones aligned good and he is now in a short arm cast for 4 weeks. He wants to get back out on the ice and skate but if he falls can he rebreak the arm in the cast? Also in 4 weeks they will be removing the cast if he would wear a good arm brace while skating would that protect his bone if he fell? Any input would be helpful.

    Thank you,


  128. Dr Arun Pal Singh says


    the treatment varies from fracture to fracture and person to person.

    I generally prescribe splint but the fracture can be treated otherwise if not associated with displacement or severe soft tissue injury

  129. Dr Arun Pal Singh says

    @Ken Barbusca,

    A newly healed fracture does not have the strength of the original bone yet.

    A brace does not protect against major trauma.

    My advice would be to avoid falls at all. That might mean avoid skating for few months altogether.

  130. alok says

    i suffered fibula fracture lower 1/3.There is no twisting of ankle in it.The bones have not seperated n its a hairline fracture.i am in cast 4 seven weeks.I am serving in army n i wana know if by end of december I will be able 2 return to full duty?after that I can manage 2 months leave in feb n march next year.Will it be fine totally by then?

  131. Jo McG says


    I broke my 3rd & 4th metatarsals f weeks ago- the 3rd was slightly displaced but not operated on .

    I had the cast removed this week consultant stated that there was no point in re x ray. the only advice I was given was to start weightbearing with crutches when ever it was not painful -however it is really painful, much more so than when in plaster, I can put the foot down, but not stand weightbearing in any way and cant get shoes on – I have no idea how long it may take to get back on my feet properly, I work as a nurse and obviously there is pressure to get back to work but I cant estimate how long this might take. I would appreciate any advice, I have purchased an aircast and I can get around with this and crutches for a few minutes.

  132. Sekhar says

    Hi Dr. Singh,

    I had a bad fall while roller skating with my daughter and had a lot of pain in my leg. I have been to the doc
    two days later and got a x-ray done to find that i had a proximal fibula fracture (not sure what it means..but know its a broken bone)…Doc gave me a walking boot and said to use crutches if needed. Two weeks later had a follow up visit and Doc said that it has not displaced and it might heal and no need for a surgery. And told me that i should try put some weight.. i stopped taken all pain killers… no i am having pain while moving my leg up and down this common.

    in the mean time my ankle and fingers have swollen..i am not sure if the treatment is right ..i mean without the cast..just with the boot ( btw i am removing the boot in the nights at sleep and for shower from 11days since i got the boot as per doc's advice that i can do it)…i this all right

    Really appreciate your help

  133. Dr Arun Pal Singh says


    Fracture fibula does not cause much problem as the bone is not weight bearing. Most of the weight is borne by other bone-tibia.

    As you have just a hairline fracture, you should be better in 4-6 weeks.

  134. Dr Arun Pal Singh says

    Fibula is the smaller bone of the two bones. Proximal end is the upper end of the bone near the knee.

    You seem to be progressing fine. Things would get better with time. Ankle swelling can occur if foot is kept in dependent position. Try to keep it elevated when you sit. A chair or stool would help.

  135. Dr Arun Pal Singh says

    @Jo McG,

    First thing to know is whether fracture has united or not. Especially if it is painful. Surest way to tell is Xray.

    If fractures have united your symptoms would improve over next few weeks.

    P.S. I am sorry I missed answering this before. Your second comment was similar so I have not published it. Anyhow that made me look whether I answered your earlier query or not.

  136. alok says

    (plz ref my querry dated Oct 26th)

    thanx a ton doc..For how long should I take physiotherapy after the cast is out

  137. Ags says

    Hi Dr. Singh,

    5 weeks ago I broke my clavicle playing football. It happend in such a way that it is broken just over halfway along the bone but at the end closer to my shoulder. The bone coming from my sternum is raised upwards and the bone from my shoulder is touching at the bottom of the part coming from my sternum (such that it forms a upside down 'v' like shape. Most of the pain has gone and i have wide movement back, however i have not developed the lump associated with new callous formation and indeed my x rays after 2 weeks showed no new bone formation ( i was told this may be normal due to early stages and lack of calcification at that stage?). Occasionaly i can feel like a clicking from the bone that is painless. Do you think its a possibily that it is non union and if so is it still an early stage by where bone may form (if it hasnt already)? I am told that if it is non union as it is slightly raised it would be dangerous as it is not supporting my shoulder. I am just concerned about surgery in the main.

    Any help would be much appreciated

  138. Dr Arun Pal Singh says


    Non union is less common in fracture of clavicle but can occur.

    It is too early to call it a non union.

    Get an xray after 6-8 weeks of trauma and it would be better revealed if fracture has united

  139. Liesel Tan says

    Hello, Dr Singh.
    I have a comminuted fracture of 5th metatarsal Oct 14th. I have been wearing a walking cast ever since. On the 4th day post injury, I was able to do full weight bearing with my cast on, and was pain free, except for occasional pinch or shooting pain for 3 secs only. On the 3rd week, my calf muscle started to have cramps.
    Do you think I am healing well? What is the cause of my shooting pain…impinged nerve? muscle cramp from muscle tension? I took off my cast with good relief and massaged my aching muscle.
    Any in put is most appreciated.

  140. coral says

    Broke my wrist on the 5th August 2009, straight break on the hinge, not sure what else to call it:). Plaster off on 16th September, still have pain and stiffness in my wrist, although I exercise daily. I am a learning disability nurse and I am unable to have contact with my patients as I am unable to do the management of training and aggression course. How long will I have to wait for the pain to reduce and my wrist to get back to normal? As there is no shape and it still swells up on a daily basis, I cannot carry heavy objects and I am very frustrated at not being able to work with my clients. How much longer will I have to deal with this? And will I ever do cartwheels and handstands again:) thank you

  141. Susan says

    Hi Dr. Singh,

    I had a Galeazzi fracture and the radius was set 9 weeks ago with a plate and 6 screws (I fell from a standing still position on rollerblades).I am concerned about several things now at this stage of healing process (my Dr. is not very communicative for me). I am a 48 year old helathy, physically fit petite woman.

    1) He said that X-rays at 6 weeks showed that bone 'hasn't healed'.

    X-ray at 8 weeks showed "some healing'.

    I also noticed in the 8 week X-ray a round swollen -looking white area around bone – is this soft or hard callus formation or somehting else ? Is this a stage that healing should be in now /normal progression or is it slow ? I'm afraid of non-union happening.

    2) Also, I have pain where the fracture is when I write for short periods of time from the pressure of bearing down with a pen. Is this okay ? Does it help the healing (increased blood flow?) even though there is pain ? Or does this mean I should not write because is detrimental to the healing (I need to for work sometimes) ?

    3) The dislocation of the distal ulnar joint is prominent and I don't think it looks normal. First Dr. and 2nd opinion don't say much about it – just wait and see if when ligament/tissues under it settle down maybe it will get better. What can be done if not ?

    4) I want to have the plate/screws removed when possible because I am thin framed and very active and one of the screws is visible and prominent. I am afraid about possible nerve or other damage that can happen from the removal. How safe would it be ?

    5) Concerns about arthritis, does this always happen ?

    6) I am 48 years old in excellent physical health, should i still get a bone density scan due to these circumstances ? My Dr. says I don't need one until 60.

    Apologies for so many long questions but I am so nervous about all this – I appreciate your help.

  142. Ashley M says

    @ Dr Arun Pal Singh

    Thanks… I've been in my cast for five weeks…. I feel fine.

    I have one more qeustion….

    I've had my cast on for five weeks…. I have a full leg cast on (I can't bend my leg, but i can my toes…) when i bend my toes (Espicially my little toe) i get a little sharp pain on the under side of where my ankle is…. would you know why this is….? Does this normaly happen?

  143. elsa says

    hi Dr. Singh,

    My 6 yr old son had a bone fracture in his arm between his wrist and the elbow 3 months ago he has been on cast for a month, the cast has been remove and healed but the bone didn't connect properly and still dis align. Do you think it gonna be ok as he grows up? or do he need to go under surgery? and if he go under surgery can it be wait for another couple of years? because i can't afford yet for now for no insurance and no income reason.

    any help would really appreciated.

  144. stevecatalan says

    i had compound fracture on my right humerus bone 4 weeks ago on a motorcycle accident. i got external fixation with 4 threaded pins. my arm still hurts until now, is this normal or is it otherwise? they said it hurts because my bone is healing. and i also have wrist drop how many weeks or months should i recover from my injury/wrist drop?

  145. Dr Arun Pal Singh says


    What bone was exactly involved.
    Was there an associated ligament injury?
    Have you got an xray after injury.

    As wrist contains many bones and you did not mention it, so I need to ask.

  146. Dr Arun Pal Singh says


    I understand your nervousness and concern. It is not an unusual thing. We all get worried about ourselves.

    I do not have your xrayu pictures to look at. So my answers are based on deuctions I made from your description.

    At any given time a doctor whom you can visit physically especially your treating doctor is in position to answer them better.

    1) After a rigid stabilization as in your case fracture healing may not be visible on xray for long time as callus formation may not be there.
    But some amount of callus can also be seen. You can read more about this here
    What yuo describe seems to be a hard callus.

    2) Pain in fracture site may occur and it varies from one individual to other. Your this activity per se should not affect bone healing either way.

    3) Usually after radius bone is fixed in Galleazi fracture, the distal radio ulnar joint gets back into its position. I need to look at the image whether it has relocated or not. If you wish you can send me one.

    4) Plate removal is not advised before 18-24 months. It would not cause any problem if it stays there. the removal is advised only in case of problem.

    It would be a surgery of almost similar magnitude and you would need your limb to be protected in a cast for minimum of six weeks.

    So I would advise not to think about it if you are just wishing to get it removed without any other reason.

    5) Per se not if the joint has been relocated.

    6) There seems no need for that as your doctor advised.

    At present the first goal is fracture union and that should be main focus.

    I hope that helps. All the best.

  147. Dr Arun Pal Singh says

    @Ashley M,

    You would get better as progress with your physiotherapy. For your ankle stretching exercises would help. You can talk to your doctor about this.

  148. Dr Arun Pal Singh says


    I do not have a picture to look at so I cannot comment about the position. Fractures in children are very forgiving and realignment occurs with growth to quite an extent.

    All these fratures demand is an acceptable alignment, not a perfect alignment.

    If you wish you cab send me the picture and I could answer your question better.

  149. Dr Arun Pal Singh says


    Pain is common complaint after fracture and can originate from many structures around the bone. B

    Was your nerve explored or repaired. As it is an open injury, the nerve would have been damaged due to injury.

    Your doctor would be better answering it as he would have seen the condition of the nerve and extent of injury.
    I have seen your pictures and the trauma appears to be quit sever but I am not publishing the links for your privacy.

  150. Susan says

    Thank you so much you are wonderful to help so many people with your knowledge.

    You've answered my questions well, however a big concern to me is that I still very much want to have the plate removed even though you advise against it. Because I am small, very active, and I can feel a screw close to my skin at the dorsal end, I am afraid of physical activity with that in mind.

    But also afraid about the surgery involved…. have been reading about nerve or artery damage/ complications or bone fracture during screw removal.

    A friend had a broken radius (same as mine but not a Galeazzi fracture) 2 years ago. She had her plate removed after six months because the surgeon left the plastic positioning guides on the plate which he was supposed to remove at the time of implant. The reason for the quick removal was concern of infection from the plastic positioning guides.

    How how could that have been accomplished and she healed just fine after ?

    She was same age as me, 48.

    Just curious if you have any further insight please.

  151. Dr Arun Pal Singh says


    In that case the risk involved was higher – infection as you suggested.
    So the surgeon might have weighed that when considering removal.
    But the recommended time for uneventful conditions is what already suggested.
    In otherwise normal circumstances the risk involved is refracture.

    SO it is better to let bone gather its maximum strength and the period taken is 18-24 months. Before that the bone is definitely weaker.
    So removal is not recommended.

    You may talk to your doctor when your fracture unites.

  152. Susan says

    Thank you again Dr. Singh,

    I will wait and hope for good healing and then maybe contact you again when I am ready to think about plate removal within the recommended time period.

  153. coral says

    Hi doc

    No there was no ligament damage, just a break straight across the wrist, they did not tell me much else the doc just said it was a nice break. No xrays after and no physio they just gave me some exercises to do, it still swells at the side and clicks when I rotate it kind of a crunching noise although that does not hurt, it is still stiff though and hurts. is difficult to twist all way round. don't know what else to tell you. Many thanks for the reply. I just want to know how long before it heals properly thanks again coral

  154. Tez says


    moving to different subject although humans and animal are the same right?

    My cat has broken his leg and have been wearing a cast for 6weeks now but it has not healed at all…..

    he gets taken in every week to check for xrays if has healed but ived noticed that evrytime i bring him home his cast it not completely sealed although the drssing outside its change, i can feel an opening on both side of cast where vets needs to check for x-rays now my question if the cast should be completely sealed al the way through for the fracture to heal ???

    Many Thanks

  155. ajitendra says

    I got dynamization of upper two screws done one month back.Still the x-ray shows the gap between the two ends.The doctor says the clinical union has been achieved.

    I am now in a dilemma how can a doctor say when the X-ray are same.(before and after dynamization)

    Sir i will be very grateful if u can tell how can i differentiate between clinical and radiological union.

    i had my surgery and nailing done on 12th may 2009 on right femur.its now 6 months.

    at present i have no problms in walking nor any pain at fracture site.

    Sir What should I do?

  156. Dr Arun Pal Singh says


    With this much information, It becomes very difficult to answer your query. After a fracture has occurred, we need to know whether it has united. If the fracture was undisplaced, it almost always unites.

    A fracture is also accompanied by soft tissue trauma and that might cause a problem for significant time.

    If the problem persists I would advise you to see your doctor and discuss the issues.

  157. Dr Arun Pal Singh says


    First thing first. I am not an expert in vet science. Whatever I say would be based on experience with humans
    A fracture usually shows some changes towards union in 6 weeks period.
    I do not think I understood other part. What do you mean by outside dressing and sealing of the cast.
    Is there a wound?

  158. Dr Arun Pal Singh says


    A union is is just what it implies, union.

    There is no differentiation as such in the literature between clinical and radiological union.
    There are clinical signs of union and there are radiological signs of union.

    First is seen by examining patient and second by looking at the xray of the part.

    The clinician examines a patient and finds that union is probable.
    And it is confirmed on xray.

    But the ultimate verdict is always radiological presence of union because clinical signs may not be very reliable in all cases.

    So for all practical purposes the union has to be confirmed on xray.
    From your description alone I would say that you appear to have progressed well.
    But if your xray says contrary, I would go with xray.

    Just one thing. I hope you are not confusing a translucent line with gap.
    Sometimes in spite of union a faint line can be observed on xray for a long time in some cases but that is unimportant if other signs of union are present.

    But if a definite gap is present, it is not united yet.

  159. Dr Arun Pal Singh says


    The metal with repeated loading looses its strength at some point of time. This is called fatigue.

  160. Ashley M says

    Hey, I've had my cast removed, My bone is fine! (I had a full leg cast, From my toes to just bellow my Groin) But when i go to bend my leg, it is really hard to-do (My first day out of cast) but then when i get a twitch my leg moves and it really hurts… I am crying and shouting.. But is this normal on first day (Will this get better even with out physiology?) or before i go? is there any exercises i can do before i go?

  161. Dr Arun Pal Singh says

    @Ashley M,

    After cast is removed the body would take some time to get back in shape.

    Physiotherapy would help in that and is advisable.

  162. Ashley M says

    @Dr Arun Pal Singh

    So its completely normal for my toes to gor red, And if i tense (Like Tense) Its normal for it to hurt to?

  163. stevecatalan says

    hello doctor my pins are removed, what can you say about this xray photos?

    [Ed. Note – Link deleted to safeguard privacy]

    im on a fiberglass cast right now…

  164. Dr Arun Pal Singh says


    The alignment looks fine. You need to wait for signs of union.
    Good luck.

  165. Dr Arun Pal Singh says

    @Ashley M,

    If these problem persist I think you need to to see your treating doctor and ask him if it is something significant or trivial.

    You would need to be seen and examined before your question can be answered.

  166. stevecatalan says

    this is my xray 2 weeks ago, can you pls tell me if theres a callus formation?

    [Ed notes URL-removed]

    How long should i wait for signs of union? sometimes i feel wierd movements in my bone whenever i move my shoulder is this normal?

  167. Dr Arun Pal Singh says

    Union is a continuous process. There would be gradual improvement of symptoms as well as signs of union on xray.

    This xray does not show callus.

    A repeat xray after 2-3 weeks can show you if there is any progression.

  168. Susan says

    Hi Dr. Singh,

    I wrote to you about my Galleazzi fracture with plate and screws. It has now been about 13 weeks and still x-ray shows non-healing. I have no risk factors so why would this be ? My Dr, says "I don't know – some bones just don't heal'.

    If at 6 months it's still not healed then would this be a non-union necessitating bone graft surgery ?

    I am waiting to see if insurance will approve a 'bone stimulator' which Dr. says I could try. What are your feelings on effectiveness of this device ? Do you know of anything else that could be a cause for not healing (placement of the internal fixture ?) or that could help in the healing process ? As I've said my Dr. is not good at communicating or answering my questions. I'm very frustrated and scared.


  169. stevecatalan says

    thank you so much doctor… can i ask you what are the symptoms should i feel this coming weeks? my doctor does not answer me right. he even said that there is a callus forming. what should i do and not do to prevent non union? please doctor i need your answer…

  170. william stacy says

    one month ago i fell off a roof and suffered a displaced closed midshaft fracture of my left humerus.

    i was healing well with a hanging clamshell brace, but a week ago slipped on ice and reinjured it. the hand swelling and soreness had almost gone away, but now is way worse and the skin on the back of my hand is red and quite warm.

    following the 2nd fall there is also significant pain in the area of the break, and i don't recall much pain in that area before that.

    they xrayed my arm and hand after that slip and said the hand was not broken.

    what can i expect now and should i be alarmed at the hand pain and redness?

  171. Dr Arun Pal Singh says

    It is often difficult to establish a cause of non union. You can go through this articles for list of causes

    Ultrasound bone stimulator has been shown to improve healing in tibial shaft fractures, distal end radius fractures and scaphoid fractures.

    Not much data is available on shaft of radius fracture though. Because it is a non invasive method, I see no harm in trying it.

    If your bone does not unite in spite of this, a bone grafting procedure would be required.

  172. Dr Arun Pal Singh says


    Decrease in pain and better control on your limb are the symptoms that may tell you that a bone is healing.

    But the radiological confirmation is the final answer.

    Serial xray examination should tell us if the union is occurring.

    There is nothing active that you can do at this stage.

    Let us see how does it turn out.

  173. william stacy says

    Thanks so much for the info and link. it does seem to fit, so i'll mention it on my next orthopedic visit. my hand does indeed from time to time have such exquisite touch sensitivity that its hard to do anything with it. the range of motion of my fingers is now very limited, but i'll keep working them as much as possible as the article suggests. i wear an ace bandage now mostly to cover it from view, but the slight even pressure seems to help some as well. i'm an optometrist and don't want to scare my patients. also taking norco and applying some topical cortisone. will post back after my next visit.

  174. Venkata Prasad says


    I met with an accident and my thigh bone(Femure) was fracture in three pieces and i got treatment mailing at there. the accident was occurred at April 2008 and the bone is still minuet (little bit )growing in june 2009.So in Aug 2009 i met with bone grafting and the doctor has advice that not to bear weight on that leg so i do as per the doctor advice After 4 months now I m going to remove my bottom screws. the main point is that why my bone is not growing and what should i take for growth of my bone. I m taking the healthy food and from Aug-2009 medicines are : adlfo -2 tab a day, calcirol-week once,multivitegold -tab a day, previous i had taken the Gemfos=monthly once,1000mg of calcium 2 tab a day ,multivitamins a day,but when I change a doctor he advice me to no Gemfos in June 2009. and regularly milk also i m taking .

    venkata prasad

  175. Dr Arun Pal Singh says

    @Venkata Prasad,

    Non unions cannot always be explained. There are so many factors involved.

    Keep your diet healthy and follow your doctor's advice. If the screw removal does not help you a bone grafting procedure is indicated.
    Hope that helps.

  176. william stacy says

    update: i saw my orthopedist friday who diganosed mt swollen hand as an "impressive" hematoma. he had a trauma doc look at who concurred. my finger movement is slightly better and the pain is less, but the swelling is as bad as ever. i guess these clear VERY slowly, but i'm very happy it's probably NOT CRPS!

    as for the fracture, i too am not forming significant bone in the callus area. He says if still deficient in 3 wks he's going to recommend surgery to pin the bones together. he's kind of hoping that if i get more aggressive with using the arm/hand (instead of "guarding" it like i've been doing), it might help. agree?

  177. nabila says

    Dear Dr. Singh.

    Sir i've just frectured my 2nd,3rd & 4th t0e b0ne 0n the 20th dec…i would want to ask you how long a bone takes to heal and also will it hurt ?


  178. Dr Arun Pal Singh says

    Yes! The motion does help by improving circulation and hastening the drainage.

  179. mahart says


    I fractured my t4 and t5 vertabrae on 9-19-09 in a 50mph dirtbike accident. I was hoping the back would have healed by now but I rode today and now the back has major tenderness in the fracture site. how long does it take to heal and how will I know its ok to ride again? thanks

  180. S Subramaniam says

    My son underwent surgery (Closed Reduction Interlock Nailing) for fracture both bone right leg following road traffic accident on 13 December 2009 for Grade I compound fracture. How long it will take for joining the gaps between the fractured bones?

  181. Dr Arun Pal Singh says


    I advise rest for 3 months to patients with spinal injuries followed by movement with a brace.

    I would not suggest you to ride for next three months at least.

    If your pain and tenderness persist after 4-6 weeks, get yourself reevaluated.

  182. Dr Arun Pal Singh says

    @S Subramaniam,

    6-12 weeks is the usual time for union. Compound fractures may take longer.

  183. jen says

    I have a 2-part proximal humerus fracture which occurred almost 3 weeks ago. At two weeks, a friend of mine lifted my arm and rebroke the bone (long story short, he is a resident 1st year and we saw this under a motion x-ray; of course, in retrospect, I shouldn't have allowed him to examine me). Now, I can feel my arm "clicking" when I move my injured arm and can feel the two parts are separated, especially when I press the site of the break with my hand (of the other uninjured arm). I am worried that the re-break might result in a non union and am unsure whether I can fly overseas next week. Is this "clicking" sensation normal? Should I postpone my flight? Will my bone heal even though it was rebroken??? I am feeling extremely anxious; I hear this type of break requires 6-12 weeks of healing but now I'm worried I am not healing at all due to the re-break. I would greatly appreciate your professional advice. Thank you.

  184. S Subramaniam says

    In the post-operation x-ray the fractured bones have been aligned properly with almost 99% perfection but in the x-ray taken on 05 Dec 10 there is a slight gap in the top portion but my son does not complain about any pain and is able to move the knee to the maximum. I shall be grateful if you could clarify that it would not lead to any complications at a later date. Now he has been asked to take GEMITROL – one daily for fifteen days. Now my son is walking with a walker. When my son perform wait bearing exercises without aggravating the surgery already done?

  185. Elle Farraday says

    Dr. Singh,

    One of my family members injured their back – burst fracture at the T5 with three broken ribs around that area. I'm very concerned as I do not know how the spine heals from something like that. I've read how traditional bones heal in the rest of the body but I know the spine is different. It's hard to get clear answers and what they've been told is that it will stay spongy and bone will heal around the injury with some spurring. They have been wearing a brace for 12 weeks. Can you please tell me how long it takes for the spine to heal from a T5 burst injury, exactly how it will heal, and what the lifetime limitations and effects are from an injury like that? They are an older adult who has been all their life otherwise physically healthy. It would put my mind at ease to know what they can expect in this healing process. Thank you so very much for your time.

  186. Dr Arun Pal Singh says


    Proximal humerus fractures rarely go into non unions. Most likely the fracture should unite.

    Just get reexamined by a specialist to see if everything is okay.

    With fracture one needs to give rest to the part. If you can manage that while you travel it is good.

    I personally think that should take rest. Travels are not without hassles.

  187. Dr Arun Pal Singh says

    @S Subramaniam,

    I think your treating doctor is in better position to answer these questions. Detailed patient information and examination findings are necessy to answer your questions.

  188. Dr Arun Pal Singh says

    @Elle Farraday,

    The spine usually heals enough by 12 weeks to begin mobilization with brace. A further use of brace is controversial. Some authors suggest that it should be borne or 9-12 months while others refute this entirely.

    Spine heals like other bones and only follow up will show what would be the outcome.

    You did not mention if there was an associated neurological deficit [loss of motor power or sensations]

    That would change the picture. Burst fractures at this level are usually associated with neurl injury too.

    If there is no neurological loss as you should expect good healing by now.

    back pain is the most frequent complaint in these patients in the long run.

  189. Dr S Singh says

    Dr Arun, I am doing Residency in Ortho,1st year. My thesis requires that we determine the healing of fracture after surgery, during Follow ups at 1, 2, 3 and 6 month intervals. Now how do we determine this objectively-clinically as well as radiographically(simple X ray films), esp. the latter.

    Will appreciate any help.


  190. luke says

    I have a tibial fracture and it occurred on 21 November 2009. I am on plaster and the problem is that the X Rays show the bones not aligned I would like to know how long will union take place or will require surgery.

  191. Dr Arun Pal Singh says

    @Dr S Singh,

    Congratulations and welcome to the fraternity. For your query, you would need to dig the literature on subjects of bone healing.

    I assume you would already be aware about the subject and under your supervisor you would be able to find what you are looking for.

    My answers can only suggest you but you would need to reference the methods as well. Therefore it is better to look up the matter yourself.

    There is plenty of material available in form of text books and journals.

    BTW, where are you pursuing your course?

  192. Dr Arun Pal Singh says

    That depends on a lot of factors including type of injury, fracture configuration etc.

    Usually by this time the signs suggesting union should appear.

    You can talk to your treating doctor on matter of union and alignment.

    I think it is time if any alteration in the treatment is to be contemplated.

  193. Sam says

    Hi Dr. Arun,

    Wishing you a very Happy New Year 2010. Below is my last post and your reply:

    My question is that I still have pain in both my wrists, I have started going to gym again but am unable to pick up weights. Till when will the pain be there?




    Hi Dr. Arun,

    This is in continuation to my earlier posts,my cast of both the hands were removed yesterday, there is some pain in hand motion (a little more in the right hand) and stiffness is the wrists.

    I have given a link of my hand photograph, I am concerened about the shape of the hands after cast removal, in the right hand in the red coloured cicrle you can see the bone protruding a little, is it normal?

    Do you recommend any exercise.

    Dr Arun Pal Singh Reply:

    August 9th, 2009 at 2:19 am


    If you you do not have any functional difficulty, do not worry about the protrusion.

    Consult a physiotherapist (after talking to your treating doctor) who would help you with physiotherapy.

    Best of luck.


  194. Susan says

    Dear Dr. S,

    I have the Galleazzi fracture with plate and screws that is very slow to non-healing.

    My doctor says that it is a race to see whch happens first…. the bone heals or the plate breaks.

    I am very disturbed by this analogy and am wondering if you have ever heard it before. It just doesn't seem right .

    I have been using the electric bone stimulator for a little over a week now. You mentioned that the ultrasonic device has shown some effectiveness but what about the electric one ?

    Also I bought a bone supplement called "Bone-up" with vitamin K in it in addition to taking daily calcium and vitamin D pills. Do you think these help ?

  195. Dr Arun Pal Singh says


    If you syill have problems and things are not improving, get a wrist examination and if needed an investigation to rule out soft tissue injury.

    Did you talk to your doctor?

    What did you discuss?

  196. Dr Arun Pal Singh says


    When your doctor says that, he/she is talking about implant failure. I have slightly touched this issue in this article

    I think, in your case it is important to decide if it is healing slowly or not healing at all.

    In latter case you would need a kind of surgical procedure and it is prudent to do that within reasonable period.

    If it is slow union [called delayed union in medical terminology], then your bone should heal albeit slowly.

    I do not think vitamin and mineral supplement would have effect on union, until you have deficiency which normally a person of average built and duration does not have.

  197. Susan says

    Thank you Dr. A,

    I went to your article and also the related ones and I find them so fascinating but only hope that further surgery will not apply to me.

    How long can delayed union go on ?

    I know that technically after 6 months it is considered non-union, but my Dr. says that some people possibly can take much longer and slower to heal (up to and after 12 months).

    Hence the race annalogy.

    What would determine whether or when surgery is necessary ? I do not have pain but twinges sometimes especially if i use the arm with pressure (opening jars, pulling on boots…). I try not to push it too hard or lift anything more than 5 pounds.

    I will try tofigure out how to send you an x-ray.

    A couple more questions please if you don't mind…..

    !) What do you think of the bone-growth stimulator that I mentioned I'm using ?

    2) If bone-graft surgery were needed, I've heard that the bone tissue can be taken from the same bone –

    is that true ? My Dr. mentioned it would be from the hip.

    3) Could you explain a bit more about these reasons that you listed as causes of non-unions,

    especially the last two :

    – Inadequate immobilization

    – Distraction at the fracture site resulting in a gap between fractured surfaces

    – Energy of the injury

    Thank you once again,


  198. yogesh says

    i hv a fracture and have a gap of almost 2 cm, my query is will bone gets union in certain time frame or grafting is the only option.

  199. Dr Arun Pal Singh says


    Is it really 2CM or it was a typo.

    2 cm gap would not unite in any case until it is reduced.

  200. Dr Arun Pal Singh says


    Ther is no fixed time frame for delayed union. If a fracture healing activity is occurring slowly, it is labeled as delayed union.

    If there is a progressive changes albeit slow, a fracture can be expected to join.

    1) I have no experience with bone growth stimulators. What I had told you was from literature.

    2) Usually the bone graft is taken from ilium bone, a bone in the pelvis as you mentioned it. Graft from the same bone is used when only small quantity is required.

    And in non union, one always uses copious graft.

    3)Inadequate immobilization
    This mostly applies to patients treated with poorly applied plasters and traction. In modren orthopedics, this as a cause is reducing.

    Distraction at the fracture site resulting in a gap between fractured surfaces

    If there is a large gap between the bone ends they would fail to unite.

    Energy of the injury

    If initial injury disrupts vascular supply due to impact or damages soft tissues around the bone, chances of sound healing become less.

  201. Dr Arun Pal Singh says


    Then, you appear to be treated rightly. The primary aim is to reduce the gap and stimulate bone healing by grafting.

  202. Roberto Nelson says

    I fractured my left humerous a while ago, i got surgery, a metal plate with 9 screws.

    i lost movement of my thumb and index finger and im slowely recovering my movement. i think the surgery damaged my nerves or something. my skin started falling off after taking a shower or wshing my hands in those two fingers.

    right now i can move my fingers better but they are still numb and its been 5 months already. i also feel my skin very humid or sweaty on my fingers. My skin dosent fall off anymore but the underside of my finger tips look like raisins after coming in contact with water in a relatively short period of time.

    What is happening to me :( ?

    Will i be able to feel my fingers again?

    Do i have to remove the metal plate and te screws when im older to avoid these problems?

    Will my humerous be weaker or stronger with a metal plate? (might be weaker because of all the screws maybe?)

  203. Dr Arun Pal Singh says

    @Roberto Nelson,

    What nerve was involved?
    What is your age now?
    Has your fracture united.
    Plate should be removed only after 18-24 months.
    Humerus is not weak with plates but it is susceptible to get a re-fracture for initial few weeks when plate is removed.

  204. Roberto Nelson says

    My doctor said my internal plate could stay there for the rest of my life if i didnt feel any discomfort. The bone did unite. I dont know what nerve is involed im just speculating. I am 20 years old.

    All i know is that if i lift my fractured arm perpedicular to my standing body with my palm down. and then i tap the underside of my elbow area with my other hand, i feel a weird tingle throughout my whole arm all the way to my 2 fingers.

    It feels like when one wakes up from sleep and a part of the body is numb because blood circulation was interrupted due to too much body weight on it.

    my doctor said the it was due to the effects of morphine which would were off slowly. then another doctor told me to wait it out, that it was probably a damaged nerve from the fracture.

    But when i had my bone broaken i could move my fingers with no problem, it wasnt until after the surgery that i started having difficulty moving them.

    I have theorised that maybe one of the screws they put in my bone is going too deep into the bone or something and that maybe that is causing me problems (i dont know though, i might be making stuff up). When i saw the X ray, i noticed the screws are a little too big for my bone; they went in more than halfway into the bone's width.

    Heres a link to my X ray. (i dont have the one with the plate and screws on my computer)

    Note: The link deleted.

  205. Fahad says

    hi Dr Arun,

    I am 26 yrs male and had fractured my distal humerous fracture (right hand) a month ago doing arm wrestle.

    The fracture is oblique spiral and displaced. The doctor has decided to treat me conservatively i.e. by hanging cast. The treatment started after one week of the incident during that period I was in the backslab.

    X rays after first week of hanging cast showed that bones are slightly in contact but doctor adjusted the cast position for better alignment and set the reappointment after two weeks.

    Now two weeks are about to complete and I am feeling no pain at fracture site and some strength in the bicep and triceps area.

    Are these indications that bone is healing ?

    What are the general feelings of patient when bone is healing apart from x-rays ?

    Thanks for your advice.

  206. Dr Arun Pal Singh says

    @Roberto Nelson,

    I have looked at the xray and the fracture is at a place where radial nerve is very vulnerable to injury.

    If it was intact in the beginning as you suggest, it is very vulnerable to manipulation.

    Without looking at xray with implant, I cannot comment on screw as a probable cause.

    But there are higher chances of nerve getting injured in perioperative period than due to scre irritation.

    I recommend you to visit the doctor and get yourself examined. What you describe as tingling sensation appears to be attempt of nerve to regenerate.

    You can get investigated for nerve studies and we would be wiser.

    I hope that helps.

  207. B. PEARSON says

    My 13-year-old daughter fractured her middle and ring finger knuckles on her left hand playing basketball. She always kept the splints on, but remained active in basketball practices as well as volleyball practices, just not setting the ball or spiking with her left. She was able to do about everything else. Her 2 week follow-up xray showed "no new bone growth". Her pediatrician figures this is because of so much activity, the vibrations not letting the bones heal. She is again wearing the splints and will go again in 2 weeks for another xray. She is not participating in any sports at this time. Do you think that activity like that would be the cause of her delayed healing, or could we be looking another problem? Thank you.

  208. Dr Arun Pal Singh says


    They could be but it cannot be said for sure.

    Only confirmed way is to look for clinical signs and xray.

  209. Radhika says

    Hello Doctor

    I had a fall on Jan 4th with a fracture on my right foot toe bone and a ligament tear on the finger next to the toe.. I was in cast for 3 weeks and now I just have a Plaster. I stopped taking painkillers post a week as I really did not experience too much pain post the intial day when i fell and it was swollen. Now after 6 weeks i have having a poking pain in the exact spot of broken bone (toe).. Can i take it that its healing? Does it prick a little when its on its way to healing? I get this pain on and off. I am able to walk now on flat surface but also want to know when I can start driving safely?

  210. Dr Arun Pal Singh says

    @B. PEARSON,

    Inadequate immobilization can lead to delay in healing. Only way to tell if we have another problem is to first provide adequate immobilisation.

  211. Dr Arun Pal Singh says


    I think your treating doctor would be in better position to answer your question.
    The healing can only be confirmed by xray. Other parameters are subjective and reliability is less.

  212. william stacy says

    i have posted about my displaced humerus mid shaft fracture nov 1 that we tried to fix with a clamshell brace but i fell again on some black ice dec 15 and reinjured it; not sure if that 2nd fall caused the non-union but we threw in the towel jan 15 and had a compression plate placed under the triceps which the surgeon says should stay in forever (i'm 66).

    i'm still taking pain meds, but down to 2 or 3 norco 10's per day mostly due to difficulty sleeping with the discomfort, but also some dull aching during the day that wears on me (i'm still practicing optometry full time). Or partly it may be a bit of addiction? Anyway, am i ok to continue this for a while, or should i work harder at weaning off of them?

    also, my range of movements and strength are improving, but i have 2 areas i cannot do much in at all. i cannot reach around my back and put the belt through the loop with my left hand, and i cannot quite reach my right armpit with my left hand when showering. that seems like it's more a shoulder restriction or what? are there some exercises i can use to improve that range of motion?

    finally, i'm curious about a patch of numbness just on the left bicep, about the size of a coffee cup base. how long if not for ever will that last? my followup visit is not for a couple more weeks.

    p.s. my hand hematoma swelling finally went pretty much away, although my middle and ring finger are still pretty tight and a bit uncomfortable when pushed into full flexion.

  213. Lora says

    My mom fell and broke her humerous seven days ago. She went to the ER and was admitted to the hospital. They said it was a straight break in the lower part but then spiraled and shattered toward the top. They originally said it would need surgery and a rod. Contributing factors are her age (75), weight (275 lbs.), diabetes and her white cell count is high, indicating an infection.

    It has been seven days and she is still laying there with no surgery, sling or immobilization.

    Today they were going to transfer her to another hospital. We are now told the new hospital has refused to take her, after they had agreed.

    My main concern and question is "What will happen to the healing process of the bone with this much time passing and no treatment?"

    We don't want them to just do anything but we want to understand what is going to happen. Is there anything we should stop them from doing?

    Any information and direction is appreciated. Thank you.

  214. Fahad says

    Hi Arun,

    thanks for your reply.

    now doctor has removed the hanging cast after doing clinical evaluation and x rays and replaced it with u -slab for 4 weeks. callus was very visible on the x rays.

    i think there is more likely hood than not that bone will heal. what are risks you see ?



  215. Dr Arun Pal Singh says

    @william stacy,

    Things look better than what you posted last time. You seem to have stiffness of shoulder and hand joints. They should go with physiotherapy and range of motion exercises.

    For hand compressing a tennis ball or gripper can help you to regain the strength and range of motion.

    Shoulder exercises should be begun inn consultation with your doctor.

    The numb patch should go away with time. It usually does.

  216. Dr Arun Pal Singh says


    The first thing any patient should have after a fracture and while one waits for a definitive treatment , is the splintage. I think her arm would be splinted.

    Definitive treatment is not done on the urgent basis and technically a delay 1-2 weeks should not cause much change in the final outlook. The only problem in the waiting is the discomfort that patient suffers.

    I am sorry for delay in writing back. I think you needed an answer sooner. But I was quite occupied.

    How are the things now?

  217. Lora says

    Thank you for your reply.

    I don't know why they didn't splint the arm. It is incredibly swollen, black and purple. She has been very uncomfortable and is on Delottie every two hours or as needed. It has now been 13 days.

    The possible good news is that her white count is down and they will be doing surgery in the morning. The first option will be to insert a rod and if that is not possible because of the bone fragments then it will be plated.

    We will know more after the surgery and I am sure have many more questions about the rehab.

    Thank you again,


  218. jay says

    i have fracture of coronoid process. can this heal without surgery? i have some range of motion and no dislocation. Doc has res split and sling for 10 days, then re-eval. Common?

  219. rinku says

    i fell from a table and got my ulna bone fractured (vertically) and doctor advised me for 2 weeks plaster then extended to 3 weeks then told me came to me when u will not feel any pain and further said u can do ur office work too. i m 30 years old male so tell me how much time it will take to heal it thanks.

  220. Dr Arun Pal Singh says


    Coronoid fracuteres are also treated non surgically when the fragment is small enough.

    I think you would be benefited by talking to your treating doctor

  221. jenna says

    My 13 year old son broke his arm 15 weeks ago. He had one clean break the radius and a fracture on the ulna. He was taken out of his cast the second time around, but the Doc said it was still not healed so put him in a today he went in 15 weeks later and the Doc said it was still not healed come back in 6 weeks, but in the mean time leave the splint off and no sports or p.e in school. Is there something more serious wrong with my son that this is taken so long? Do bones sometimes just heal slower in some people for no reason than just being slow?

  222. rinku says

    Thx Doctor. sir can u tell me i am having swelling on my wrist and it feels little pain when i move my wrist and i cannot move propoerly my wrist and tell me what precautions i have to take from now can i ride a bike or drive a car and so on thx.

  223. paul says

    I have a 3-part proximal humerus fracture. XRays today, 12 days after break, show fair alignment (not perfect), surgery not indicated, ortho told me if it was him he would not operate. My question is I am supposed to run a marathon 7 weeks after break- that is full 26 miles (42 km). If I have a fairly good union at that time I should be OK to run- I hope. Is it possible to start running earlier? Docs tell me to stick to stationary bike for first 4 weeks. And as I’m sure you know, I am only in a sling, and it can be hard to keep the arm immobile. FYI the ortho characterized my fracture as “significant”- the neck broke completely across with the top outer part of the joint splitting off. It is that outer part that does not seem to be aligned so well- the main shaft and top of joint appear well set for union. Also, I am 48.

  224. Ik says

    I have broken my humerous mid shaft it was a clean break no nerve damage as I can move fingers and fist but it has been 2 weeks now and I still can't move my arm up and down my doctor seems really happy with x rays he says it is straight and gap is decreased, but I really want to know when I will be able to start moving my arm doc says 4 weeks I will be able to take humuroeus brace off. What do you think?

  225. Ik says

    And it iis healing naturally 1 week with a u slab and it has been 1 week with a humureus brace

  226. artach says

    I was put on surgery 10 days ago for a nonunion of the bones on my second toe of the left feet. I have two pins inserted but last night on of them fall out of the toe. Should i go to the hospital oris normal considering th resent surgery?. Tks for your help.

  227. kishore says

    I got neck of femur fracture gardener type 4 and surgery was done after 30 hrs of accident. My doctor recently said there is collapse but still it can union. The screws fixed came a little back because of collapse. What does it mean and how bad is it? The surgery was done about 3 months back and now I am walking with 50% weight on the leg. For how long more you suggest to use cretches. I am having some discomfort in the groin area sometimes. I took about 10 phisiotherapy sessions about a month back and now not doing any physiotherapy. I am travelling by Auto since last 15 days and is it OK. Do you suggest to take any cautions?

  228. kishore says

    I also have swelling on the the foot since last 2 months. Do I have to do something for that?

  229. Dr Arun Pal Singh says


    Delayed healing is a known phenomenon but 15 weeks is quite a substantial time for both of these bones to unite at this age.

    What I can think of is that some of these children behave like adult bones which show poor response with non operative treatment.

    In any case if the bones fail to unite only option left is fixation and bone grafting.

    You can discuss with the treating doctor

  230. Dr Arun Pal Singh says


    Please discuss it with your doctor if you can be allowed to do these activities.

    Just take care that for few months a lesser trauma can cause the fracture in the healed bone as it does not achieve strength in spite of union.

    You might have an additional injury in the wrist. You can get it examined. If xrays are normal and your pain and swelling does not go, MRI can help

  231. Imran says

    hello doc i posted once before but it was removed i am not sure why, my problem is i broke my humureus mid shaft clean break no bones peircced through the skin, the doc put me in a u slab for 1 week and i have been in a humureus brace for 3 weeks, last x ray was at week 2 which showed good allignment doc was very happy and said i would be able take brace off in further 4 weeks, where my problem lies is that i do not have any control over my right arm, i can move my fingers, wrist and write feel everything along my forearm can rotate my shoulder but i can not move my arm up or down or let my arm rest without a sling as i feel a great sensation of pain near my bicep and elbow, could you please tell me if its normal and when will i gain sufficient control of my arm. thanks in advance

  232. Dr Arun Pal Singh says

    A fracture takes around 6-8 weeks to heal. Following that you would need to work out with physiotherapy.

    Probably another 15 days.

    Good luck

  233. Dr Arun Pal Singh says


    Collapse is occurs because the head settles on neck as you bear weight.

    It is not a bad thing.

    Crutches should be used till union.

    I do not think traveling by auto is going to do anything.

  234. says

    Hi – I have a spiral fracture of the upper humerus. It has been 8 weeks since the injury. I was x-rayed after 7 weeks & the bone is aligned; however it is not showing signs of forming union. Does it need surgery to heal? I have been told that they will x-ray me again in 4 weeks as "there is no point in x-raying me sooner". How long will it yake before they decide to try surgery.

  235. sukhjinder singh says

    hello, i got 5th metarsal rt foot fracture on march 27, 2010 and was casted on 6th april for 1 month. I consulted Dr. for healing, he said healing is ok. But still i m having swelling on rt. foot while walking / sitting. Pl. advise

  236. Dr Arun Pal Singh says


    I think they would make decision next week. If bone has not attempted to unite till now, it is less likely.

    Have a word with your treating doctor when you meet him next time.

  237. Dr Arun Pal Singh says

    @sukhjinder singh,

    Swelling is different from bone healing and can continue for a period even after union.

    It would go with time.

  238. says

    Had a compression plate installed on my left humerus in Jan after a midshaft displaced fracture in Nov. Am thinking I might want it removed if I'm still aware/bothered by the sensation of the hardware next Jan or so.

    1. Is the removal of the plate and its 6 screws much simpler/safer than the initial install?

    2. Is the chance of a re-break any more or less likely after removal? Intuitively, I thought that the plate gives additional protection from that, but now I'm not so sure. Both ends of the plate seem to form a pair of fulcrums that could increase the chance of new breaks at those points.

    I'm a fairly active 66 year old who engages in manual labor like mowing, weed-eating, fencepost driving and tractoring, so I'm subjecting the arm to some fairly jolting, jarring activity.

  239. says

    broke upper humerous clean 3 weeks ago. Is on and off pain normal,? Is there stability in the boes already as currently there is no displacement and wonder how easy they could become displaced? I worry it could shift while sleeping or walking but this might seem crazy? Also, is swelling still to be expected in my forearm?


  240. Dr Arun Pal Singh says

    @Bill Stacy,

    1. It is almost a surgery of same magnitude though the duration would be shorter.
    2 Yes! You would need to be in plaster for 6 weeks after removal. The screws removed would leave holes which weakens the bone. Hence the protection.

    I hope that helps.

  241. Dr Arun Pal Singh says

    @james bartsch,

    Too many questions but little information to help me to deduce an answer.

    What is your age?
    What treatment has been given?
    What is level of the fracture?

  242. imran says

    i Thought i should leave a little update if you scroll to the top you will see i broke my humerus mid shift clean break, my docs decided on self healing so i had a u slab with a compression brace.

    I just wanted people to know it was a long recovery and still going on. initially i couldn't move my arm for 7 weeks, i tried many times but my arm wouldn't function little by little and i mean little i started moving my arm here after, baby steps weeks 8 -12 really week grip. 12 – 16 more free movement coming back but still find it difficult to lift stuff which weights a fear amount should be seeing my doc for final x rays to see how its mended. I personally think i have another 4 weeks before i can start some sort of proper exercise on it, but only on docs advice. i hope this helps anyone as i was worried reading horror stories about people not gaining any sort of arm movements or sensations for 6 months

  243. says

    37 yr old male, broke humerous just below shoulder, is not displaced, clean break. Have been in collar and cuff sling last 2 weeks, first 2 weeks u-slab sling. Just had xray, one day shy of 4 week mark, no calus showing yet. Should I be worried about non union and surgery or does it just take a few more weeks to show progress? Also do you have any nutrion tips to speed healing. I was a smoker but heard it hindered bone growth so quit 2 weeks ago, one positive from the fracture.


  244. Melanie says

    Hi !!! I am wondering — how fast can a hairline fracture near the base of the fifth proxima phalanx takes to heal ?? I am asking under general condition with no stress added to it. Also do I need a big cast to wear??? I appled heat treatment on –at the very moment of the impact and Hirudroid cream that worked marvellously. The swelling and pain gone within 2 days and I sought a GP advise. He refer me to an Orthopaedic doctor for next Monday appointment and I am posting to you now during the weekend.

  245. Dr Arun Pal Singh says


    On an average four weeks. An immobilsation is advised. It may not be in form of plaster but it is advised.

    All the best.

  246. Anna G says

    Hi I broke my right fibula bone (lower leg) on June 20th 2010. It was a clean break with no surgery required. I was in a splint for 10 days and than a cast for 6 weeks. My cast was removed on Wed August 4th. The doctor said that my bone is not fully healed and i should only walk lightly (no jogging) on it for the next 3 weeks until my follow up appointment. It still hurts and I have a burning sensation at night. Is this common to let someone with a broken bone to walk on it with no cast? Is it possible to delay healing or cause more injury within these next 3 weeks? What if my bone is not healed in the next 3 weeks? Will they put another cast on?

    Any reassurance will be much appreciated.


  247. Robert Y says

    Hi Doctor,

    I fractured my fifth metatarsal on my left foot. I'm in an aircast as of now, and I have a boot that i put on when I go to sleep. I've noticed that after two weeks, I have a weird, painful sensation where the fracture is. I can't describe it, but it's just a quick jolt when I move my foot in a weird position in the cast.

    Is this normal during a fracture heal?

  248. Dr Arun Pal Singh says

    @Anna G,

    If your bone has healed enough to take the cast out, I do not think you can injure it with your routine activity.

    And if it is healing, it should further heal with time.

    Let me know.

  249. Dr Arun Pal Singh says

    @Robert Y,

    A cast annot give you 1000% immobilization. Therefore it is advisable not to put your foot in weird position.

    Whenever you move the fracture or attempt the movement, it would pain.

    Take care.

  250. says

    fibula fx undiagnosed for 10 months. non-union with large gap, no bone. surg. done/debridement+bone plate, screws. developed non-healing wound which started first day surgical sutures removed with seepage near ankle area. many debridements of this open wound with pale, yellow drainage went on for next 8 months and 5 rounds of deifferent antibiotics for all this time(on bactrim x 35 days at present b.i.d.. Ha surgery #2bone plate removal and more fibula bone necrotic so removed more bone and cannot have a plate again. now diag. with osteomyelitis. lower leg gets purplish blue and turns snow white when push on skin with fingers. when up all day, ankleg, lower leg swells. developed lg abscess at fx site and had to be milked at top of old surgical incision which went down and pus type fl. came pouring out down at bottom where open wound hole was. fib. bone culture showed staphy. auerus and deep tissue culture showed staph. lugdunesis. now, it's been 6 weeks since emoval of plate, screws and see hole at lower leg where chronic non-healing wound is trying to come back along with a 2nd sunk in area which looks like maybe a 2nd hole opening will eventually appear. Questons: what will be the negative affects of a large area of no fibula bone, lower third of leg cause as far( as running, jumping, twisting body around to look at something, stooping to the floor, using treadmill, long ex. walks, etc, and can you think of any other things wihich may change in my life besides these?).

  251. says

    forgot to say had hip bone grat on first surgery which was mostly eaten up when they went in on 2nd surgery and this all was debrided with extra fib. bone removed to healthy bone. will the germs get into my bone left and can it develope into a sinus tract and get over into my tibia eventually?

  252. Anu says

    I got my fibula fractured on the ankle 7 weeks back,still the cast is there.There is also a crack in tabula on the ankle. How much time it will take in bone healing and do I need physiotherapy after the cast is removed. when will I be able to walk normally without the walker.

  253. Dr Arun Pal Singh says

    @sandy c.,

    I need to know the level of the fracture. A recent xray would be helpful.

    What are the problems that you are facing in your daily routine life.

  254. Melanie says

    I have had a tibial stress fracture since April from overtraining. I have not been running since and am now in a boot and there is still no change. I am taking a calcium supplement with 500mg of calcium and 500iu vitamin D twice a day. Is there something more I can be doing to help speed recovery?

  255. Graeme says

    Broke collar bone 5 weeks ago – bone slightly attached – had x-ray last week and no sign of any callus forming – x-ray was not much changed from original x-ray. Am I worrying too much?!!


  256. Dr Arun Pal Singh says


    Fracture generally heals within 6-8 weeks in most cases. It is followed by pohysiothearpy which may take other 2-4 weeks.

    All the best.

  257. Dr Arun Pal Singh says


    No! You are rightly concerned. Absence of callus after this period might suggest that bone is not uniting.

    Speak to your doctor if another xray after 2 weeks shows the same

  258. ahmad says

    Dr. singh i broke my metacarpal bone from punching a solid object with a closed fist. from what i remember the dr said it was shattered and that i would need surgery . the fracture happen i believe on the 4th or 5th bone also sometime called boxers fracture. i wanted to know what if i didnt do surgery what is the possibility of it healing on its own if i keep a splint on?

  259. yasha younes says

    my maid who is 18 yrs old , got a bullet pierced in her left forearm. x-ray revealed the bullet to be stuck in ulnar bone.doctors put a splint and bandaged her forearm saying that the bullet cannot be removed as she is 4 months pregnant.

    why cant the bullet be removed?

  260. Dr Arun Pal Singh says


    Metacarpal fractures usually unite on their own too but surgery is advised if the position is not satisfactory.

  261. Dr Arun Pal Singh says

    @yasha younes,

    Bullet is a foreign body. But leaving it as such does not cause any problem due to its inertness.

    Second trimester of pregnancy is relatively safer to get any surgery. But any surgery does subjects the foetus to extra risk during entire period of pregnancy.

    Therefore most of doctors recommend and do only surgeries which are necessary.

    The choice of surgery in your case is entirely dependent on the decision made by the patient after understanding the risks involved.

  262. Vasim says

    Hi Doc, My Tibia and fibula is broken due to road accident. Got operated by inserting Titanium rod below knee joint till ankel. It has been almost 4 week now. I just wanted to know how much time it will take to get completely ok. And the rod is only used to joint my tibia and not fibula. Does Fibula get joint or alligne automatatically.

    Pls reply

  263. Muhammad Nadeem Khan says

    Left forearm of my son, broke on 12 june 2010. He was operated at Rawalpindi Pakistan on 17 june 2010 and two plates were fixed . Now after three months of operation one bone is sufficiently healded while there is gap in eluna where some grafting was done . How long it will take for the gap to heal.

  264. Lizy says

    Hi Dr, I am 43 year old woman, with 3 hairline fractures on the ball of my right arm humerus. It occured on Sept 3,2010. I am using the sling as advised. The shoulder specialist advised me on Sept 17th to start rotating my arm slowly. Everyday, there is new pain in my upper right side. I do the in home physio as directed but am worried that i might injur the callus! Has the callus formed already? I don't have any displaced segments. How long should it be until full recovery?


  265. Haj says

    My aunt has a gap somewhere in her spine. As a result, she has constant pain, can't walk and has to be careful when she sits, walks, etc. She had an X-ray some while ago – that's how she found out she has a gap in her spine. Now she's so worried, she keeps on crying non-stop. What happened to her? Would her spine heal by itself or would she need to go through some kind of surgery? I'm just looking for some advice so that I can comfort her once I know that she's not going through a horrify thing.

  266. Dr Arun Pal Singh says


    Completely OK is avery relative term. In case of fractures we are concerned with union of bone which would take around 8-12 weeks.

    This is followed by a period of rehabilitation which again is variable with different people. Usual duration is 4-12 weeks.

    Most of the people are able to get back to their chores by this time.

  267. Dr Arun Pal Singh says


    Gap in the spine does not suggest any meaning. You would need to elaborate about her condition.

    Rather, you should visit a specialist and seek an opinion.

    Gap in the spine is a loose term that makes no sense at all even if it was used by a doctor to explain some process in vernacular language.

  268. Stephanie says

    I broke my right distal radius. How long should I put ice on the cast to help with swelling? Do you ever use warm compresses to reduce the bruising? Thank you?

  269. ricky says

    Hi, i have a distal phalanx fracture in my great toe. Was put into a half cast for one week and the ortho doc says i can walk without immobilization already? It has been 3 weeks since the accident and now i can walk without pain at all.

    But my concern is when i bend my great toe to a certain extent, it kinda hurts. And when i press on my great toe, i can actually feel my distal phalanx 'moving' or 'grinding' against each other. Is that how a non union feels like?

    Today marks the last day of 3 weeks. Tomorrow will be the starting of the 4th week. The ortho doc had scheduled another x ray appointment on the 6th week.

    So should i be worried now and go for an early x ray appointment or should i wait for the 6th week mark? And is the pain when bending too much of the toe and the feeling of the fractured bone 'grinding' or 'moving' against each other normal?

    Hope to get a reply real soon Mr doc, millions of thanks in advance.

  270. Carma says

    Dear dr Singh I have fractured my 5th matartarsal and it’s a hairline fracture no disposition or anything my foot is wrapped in a soft splin it isnt loose fairly snuggled with 2 layers I wonder is that good enough? I also have a cam cast boot but only wear it when I decide to step outside I am 6’6 290 what’s the best thing for me to do ? How long would you guess or believe it will heal?? It wud be nice if you could answer those question

  271. Lizy says

    Thanks for the response Dr. much appreciated. I am able to make bigger circles using my shoulder joint. There is still heaviness and stiffness in that area. I have another clinic appt on Friday the 15th. How long do you think it will take me to get my normal arm back? This is my dominant arm and I can't do much with my left hand.

  272. Anthony says

    I crushed my right thumb at work which resulted in a complete open fracture of my distal phalanx, it is not affecting the joint, just the top half is broken in two. I had a splint on for 2 weeks with daily dressing changes. I went to the doctor to get my stitches removed and the xray was similar to xray the day of the accident, there is still a 2~mm gap between bone ends. Is it normal for there to be little repair in 2 weeks? whats the worst case scenario? thank you

  273. Dr Arun Pal Singh says


    Did you visit a specialist?

    In set of acute injury warm compresses are not recommended.

  274. Dr Arun Pal Singh says


    A fracture usually takes 6-8 weeks to heal. I think you are doing fine.

    Your fragments must have started to unite but their may not be enough strength in the union which would come gradually.

    Its 10 days since you posted and I could not answer it before.


    How are you now?

  275. Dr Arun Pal Singh says


    A hairline fracture should heal in about 4 weeks. You are being treated adequately.

  276. Dr Arun Pal Singh says


    2 weeks would not show any radiological changes.

    Get an xray after two weeks.

  277. ricky says

    Hi, thanks for your reply!

    I am doing great now, no more feeling of the grinding or moving of the broken bones when i press on it or walk on it. But when i extend my leg straight and bend my big toe, i still can feel something in my great toe, is that normal?

    3 more days and it will be the starting of week 6. And I cannot really bend my toe all the way back.

    Hope to get a reply soon!

  278. Cameron says

    I broke my ankle where the lower end of the femur connects to it. No surgery all i was given was an aircast. It has been 3 weeks since the fracture and was wondering if the swelling that is still present is normal. I am able to walk now but my ankle is still kind of stiff without the aircast on. Thanks

  279. Don says

    Hello Dr. Arun,

    Two weeks ago I've fractured my right ring finger bone. See link for x-ray image.

    The doctor gave me 2 option to cast it or a surgery installing a pins. I choose to cast it. If you can see the x-ray image above, the bones were not properly align. What should I do? Should I undergo surgery with pins or let it heal on a cast?

    If I let it heal with a cast, what kind of problem should I occur?


  280. mya says

    Hi, i fractured my fibula, but it was stable and did not need surgery. i had a fiberglass cast put on Monday but it feels tight at the arch of my foot, i get a burning sensation and pain at random times. i went back to hospital on thursday about my concerns but they said it was not worth taking the cast off becase it would be too lose, they just said to keep my leg elevated above heart..i have been keeping it elevated but it still hurts and still getting the burning sensation, should i go back and get the cast changed? ? thanks

  281. Rajesh says

    Dear sir, I need your advice in case on my mother, she is aged 71, she fallen down at home 5 weeks ago, since then she is undergoing treatment by orthopedic, giving her pain kiler medicine and protin, vitamin, calcium etd. and diognised as compression in vertevrea namely D-10 & D-12, she has constant lower back pain both side but more in right side, she has also stomach problem and toilet going is very irregular, stool does not pass up to 3 to 4 days, our doctor suggests kiphoplasty if there is no relief in pain, what should I do ? she has bed rest but pill is not working to relief from pain, also reducing the body, please guide me, is it possibe to cure by medicine and rest ? or any other non operative treatment is there ?

  282. Tom says

    Hi Dr.

    I sprained my ankle from a fall ( I jumped off a high deck in the dark) & was examined with a nondisplaced oblique fracture on the most lateral aspect of the dome of the talus. The tibiotalar joint is intact, there is lateral soft tissue swelling. I am a 32 year very active male.

    So I got an x-ray 7 weeks later as a follow up and the x-ray came up unchanged. These were seen by 2 separate radiologists. I got an a opinion from an orthopedic Dr. a few days ago who looked at the x-rays and said there is healing occuring although he feels there may be a trimalleolar fracture and maybe a ruptured tendon. He said he does not think that surgery is needed, if anything to clean things up but that he does not feel that's necessary since things look okay and that I am doing what I need to be doing staying off of it.

    He recommended getting a cam walker or air boot to put my foot in.

    He also said that I would have pain for 6 – 12 months but did not give me a time frame for complete healing. Also, I was told not to weight bear (which I have not, I've been in a splint and on crutches for almost 8 weeks now) but that I should start moving the ankle around like doing the ABC's to prevent fibrosis. I am going to another orthopedic Dr. in 2 weeks for another x-ray and get a second opinion.

    I just want to get your opinion on how long healing may take until I am 100% & the fact that what I am reading about trimalleolar fractures (if that's what I have) usually require surgery.

    Thanks, I appreciate your feedback.


  283. Dr Arun Pal Singh says


    I hope you are quite better now. I try a lot but somehow could not reply early.

    Its bad habit but had been really busy with few things.


  284. Dr Arun Pal Singh says


    Something is wrongly stated. Femur bone does not come to ankle.
    Is it Tibia you are talking about?

  285. Anthony says

    Hi I posted a question about a month ago, and I have an update.

    It has now been over 6 weeks since I received a tuft fracture of my distal phalanx on my right thumb.

    The X-rays show basically no improvement since the day of accident, the bone ends are STILL completely separated. Is this normal? the X-rays from day 1, 2 weeks and 6 weeks look all the same.

  286. Dr Arun Pal Singh says


    It is difficult for me to commend on your situation as I d not have the complete info.

    In fact what you say is bit confusing.

    First you mention that it was talar dome fracture. I do not think that can be confused with trimalleolar fracture as both the fractures involve different bones.

    Can I look at the xray?

  287. Cameron says

    Sorry it is the Fibula that I broke. It has been a month now. I am walking normally it is still sore though when i try to jog and turn real fast. Is that normal?

  288. Dr Arun Pal Singh says


    My reply may be late for you but yess you need to change it if it feels too tight.

  289. Dr Arun Pal Singh says


    I do not why but your image did not load. How are things now?


    Yes it did fianlly. Because the injury is near the joint, a fixation would have served you better.

  290. Dr Arun Pal Singh says


    Medicine and rest followed by physiotherapy are the mainstays of the treatment.

    Role of kyphoplasty is debatable but some studies have reported good pain relief.

    BTW how are things now?

  291. Don says

    Dr Arun Pal Singh Reply:

    November 11th, 2010 at 12:16 pm


    I do not why but your image did not load. How are things now?


    Yes it did fianlly. Because the injury is near the joint, a fixation would have served you better.


    So you see the x-ray image… Right now my fingers are stiff and I know it needs therapy. It's been 4 weeks now. I guess upon researching I found out that this kind of bone healing is a mal-union thing. It was not properly aligned.

    What are the effects of a mal-union on my hand? I mean what should I expect? Will this cause me problems in the future? Thanks.

  292. sareena says

    i broke my wrist (displaced fracture that was reduced and casted) four weeks the two week appointment ortho said xray looked good.had another appointment two weeks later (yesterday) and ortho decided to recast in long arm due to it being lose and keep me casted for full 6 weeks in a long arm cast (2 more weeks) and i have a few questions.forgot to ask the ortho.(have no xrays, sorry)

    1. how likely is it for the bones to shift out of alignment at this stage? and will occasional muscle spasms move them much? wrist is casted in a bent position.he said it was to help keep the bones from collapsing.

    will my wrist be stuck in this position?

    when would be a ideal time to straighten it out?

    will it hurt as bad as last time (4 week mark) when it was removed from the cast next time?

    is a occasional burning sensation normal? i chalk it up as nerves.its not bad but annoying.

    i was thinking of asking them if they can just cut this cast down to make a short cast instead of recasting, granted my wrist area will still be tight.i dont want to risk harming the fracture prematurely at my next appointment when i get my short arm cast.

    thank you for your time.

  293. remita barnett says

    hello doc, i recently sustained a c2 fracture while in a car accident. i was wondering how long does it take to heal and how long do i have to wear a neck brace. secondly i sufferd a contusion to the elbow with a slight healing fracture, can that cause black blood to appear on my forarm with massive swelling while forming a scab and now from time to time has discharge? is the swelling why i cant bend my arm up to my face?

  294. Dr Arun Pal Singh says


    Pain and limitation of the motion in the affected joint are the usual consequences.

    The severity of the symptoms vary though with individual.

  295. Dr Arun Pal Singh says


    The fracture usually becomes sticky around 2-3 weeks and with this the mobility of the fragments decrease with passing time.

    Do not worry at this time about shift f alignment.

    After your plaster is removed, you would be put on physiotherapy which would help you to regain the movements.

    whether to shorten the cast or not is a decision that depends on your fractur configuration and healing response.

  296. Dr Arun Pal Singh says

    @remita barnett,

    A fracture usually would take 6-8 weeks to heal but brace could be advised for a longer period depending on your fracture configuration.

    Your forearm looks like having an infection. Get in touch with your physician.

  297. Ann says

    Hello – wonderful website.

    I injured my back 5 weeks ago by carrying a 30 lbs child up an unmarked hiking hill. Felt major "twinge" when I shifted the child from hip to hip. Since then, have been suffering with pain similar to the classic symptoms of sciatica: shooting pain down the back of my left leg, occasional numbness and tingling down my left leg and through my left buttocks. I absolutely cannot sit down for any length of time as that will completely exacerbate the problem, but I can stand and walk for hours on end without a problem.

    Had an MRI that only shows swelling at the tip of my spinal cord (conus medullaris). Very happy I did not rupture a disc. Now into my 5th week, the pain seems to be concentrating in my lower back and vary rarely are there shooting pains down my leg. I am careful not to do anything to tweak or shift my back in any way to cause further pain. Tried physical therapy (ultrasound, heat, electric stim) but it does nothing to help. Ibuprofen provides no relief.

    How long does it take for swelling of the conus medullaris to settle down and go away? Scheduled to see a neurosurgeon at the end of January but hoping it will go away before then. Thank you.

  298. Sadia Naznin says

    My Husband is 27 year old. He is suffering from Bone Tuberculosis detected recently. As per Doctor, the disease has not affected his nervous system yet. Doctor prescribed him medicine of 6 months. Some people are saying that Bone Tuberculosis does not heal fully. There is chance of lead a good time in bed. How true it is? I am very tensed, can you please clarify? And what can I do?

  299. Tom says

    Hi Dr.

    Replying to your reply below. Actually I saw a specialist about this a week and a 1/2 ago. He is telling me I broke cartilage on my talus mainly, not so much a bone fracture. He told me there may be a small bone chip & to start walking on it (he told me I have the leg bones of an old women for staying off it for so long) with 2 crutches, then 1, then working my way to without any support. He has me doing the ABC's with my foot vigorously to get mobility back. Eventually he wants me to get to the point where I can do calf raises.

    I was told there could be swelling for up to a year, and that I may have long term pain. I am going back in a week and 1/2 for a follow up and possible MRI. The Dr. said it may be possible to perform a surgery to tack the loose cartilage back on but it is difficult to do and may not be necessary. He doesn't think I tore or ruptured any tendons but there is a lot of swelling still around my ankle joint especially near the achilles heel.

    Right now I am walking with a cane. There is a lot of pain when I walk on it everywhere in my ankle & foot, not just where the cartilage damage is and the swelling is causing my flexibility in my ankle/foot to be limited. There is no pain when I am sitting or moving it around doing the ABC's, just when I walk on it. What I am wondering is what is the approx. time it may take until I am fully mobile & can run, train in martial arts etc. & when can I expect my ankle swelling to go down to where it looks like my other ankle? Again it's been about 3 months 2 weeks since my accident.

    I can send you the x-ray, just not sure how to attach it to this post. Please let me know, thanks!


    Tom says:

    October 27, 2010 at 11:16 pm

    Hi Dr.

    I sprained my ankle from a fall ( I jumped off a high deck in the dark) & was examined with a nondisplaced oblique fracture on the most lateral aspect of the dome of the talus. The tibiotalar joint is intact, there is lateral soft tissue swelling. I am a 32 year very active male.

    So I got an x-ray 7 weeks later as a follow up and the x-ray came up unchanged. These were seen by 2 separate radiologists. I got an a opinion from an orthopedic Dr. a few days ago who looked at the x-rays and said there is healing occuring although he feels there may be a trimalleolar fracture and maybe a ruptured tendon. He said he does not think that surgery is needed, if anything to clean things up but that he does not feel that’s necessary since things look okay and that I am doing what I need to be doing staying off of it.

    He recommended getting a cam walker or air boot to put my foot in.

    He also said that I would have pain for 6 – 12 months but did not give me a time frame for complete healing. Also, I was told not to weight bear (which I have not, I’ve been in a splint and on crutches for almost 8 weeks now) but that I should start moving the ankle around like doing the ABC’s to prevent fibrosis. I am going to another orthopedic Dr. in 2 weeks for another x-ray and get a second opinion.

    I just want to get your opinion on how long healing may take until I am 100% & the fact that what I am reading about trimalleolar fractures (if that’s what I have) usually require surgery.

    Thanks, I appreciate your feedback.


    Dr Arun Pal Singh Reply:

    November 10th, 2010 at 10:34 pm


    It is difficult for me to commend on your situation as I d not have the complete info.

    In fact what you say is bit confusing.

    First you mention that it was talar dome fracture. I do not think that can be confused with trimalleolar fracture as both the fractures involve different bones.

    Can I look at the xray?

  300. Evon says

    Hello Dr Arun

    I slipped in the office and had a fracture on the Ankle bone (fibula) on 12 October 2010, my Dr has asked me to get several x-rays to see if the bone has moved or not. Since the space between the bone has become less the Dr let me start walking from 14 November 2010. i have been walking ever since. I wanted to know about the burning sensation that i get (i walk with the fibreglass cast, but the cast isn't tight its comfortable for me) is it normal? what does the burning sensation here mean?, when will i be able to walk with out the cast?, will i be able to run or even jump anywhere sooner? Can i carry my 1 year old son n walk? can i carry any weight n walk(House work)? how long does it take to HEAL ?

    Appreciate if you could reply with the answers


  301. Dr Arun Pal Singh says


    Why should there be a swelling of Conus Medullaris?

    It is not usually seen and it cannot result from the strain that you describe.

  302. Dr Arun Pal Singh says

    @Sadia Naznin,

    Please follow your doctor's advice and support your husband. Take care of his hygiene and nutrition so that he has enough strength to resist the disease.

  303. Debbie says

    I am a 54 year old woman with a non-displaced spiral fracture of the fifth metacarpal of my right (dominant) hand. Injury occurred Oct. 2 or nearly 8 weeks ago. Spent 3 weeks in plaster splint, then fingers were buddy taped two weeks. X-ray at 7 weeks still showed black line and no visible healing. PA prescribed hand therapy for range of motion in fingers but exercises have increased soreness and swelling. Joint of fifth finger is stiffer and inflamed. Should I get a second opinion or is this normal healing process?

  304. himanshu bohra says

    i had a fracture in my right ankle.both the lower portions of tibia and fibia were made a cast and yesterday after 38 days the cast was removed.i want to know about the recovery time and what else i can do to start walking again and any other thing i can do for my treatment?

  305. Narayanan says

    Hi doctor., I have a fracture in 2 and 3rd metatarsal, and xrays and doctor confirmed, it is not displaced. Just a break and doctor had said it will take 3-4 weeks to heal… but on browsing the internet am really afraid, whether am in for a long haul… pls advice me regarding the healing time…

    It has been 7 days since the fracture, and i tried to move the fractured leg slightly, i walked around 4 to 5 feet, slowly with slight pain, and again i shifted back to my crutches.. I would like to know, by walking whether i would have done more damage to the fractured area or walking slowly for 3 to 4 feet daily is not a problem? IAppreciate your inputs..

  306. Ann says

    Hi Dr. Singh:

    As a follow up to my original MRI, I received my radiology report which indicates the following…

    FINDINGS: Sagittal sequences extend superiorly to the T10-T11 level. The 6mm x 6mm intradural lesion near the tip of the conus at the inferior aspect of the L1 level demonstrates fairly homogeneous enhancement. No other enhancing conus or spinal canal lesions are identified. There are no bony destructive lesions.

    IMPRESSION: 6 x 6mm intradural enhancing lesion near the tip of the conus. The leading differential considerations include ependymoma, nerve sheath tumor, and meningioma.

    My doctor is setting me up with a neurosurgeon. First available appointment is January 31, 2011. I was considering canceling since the pain and symptoms are really subsiding finally, but now knowing there is the possibility of a tumor, I'm going to keep the appointment.

    I'm now wondering if the tiny tumor has caused my sciatica symptoms in recent years…and maybe carrying the child up the hill in October really brought out the sciatica….and finding the 6mm x 6mm lesion on the MRI pictures was just pure coincidence.

    Any thoughts?

    Here was my original issue:

    I injured my back 5 weeks ago by carrying a 30 lbs child up an unmarked hiking hill. Felt major “twinge” when I shifted the child from hip to hip. Since then, have been suffering with pain similar to the classic symptoms of sciatica: shooting pain down the back of my left leg, occasional numbness and tingling down my left leg and through my left buttocks. I absolutely cannot sit down for any length of time as that will completely exacerbate the problem, but I can stand and walk for hours on end without a problem.

    Had an MRI that only shows swelling at the tip of my spinal cord (conus medullaris). Very happy I did not rupture a disc. Now into my 5th week, the pain seems to be concentrating in my lower back and vary rarely are there shooting pains down my leg. I am careful not to do anything to tweak or shift my back in any way to cause further pain. Tried physical therapy (ultrasound, heat, electric stim) but it does nothing to help. Ibuprofen provides no relief.

    How long does it take for swelling of the conus medullaris to settle down and go away? Scheduled to see a neurosurgeon at the end of January but hoping it will go away before then. Thank you.

    Dr Arun Pal Singh Reply:

    November 27th, 2010 at 7:28 am


    Why should there be a swelling of Conus Medullaris?

    It is not usually seen and it cannot result from the strain that you describe.

  307. Ashley says

    Thank you so much for this article, it was very informative. My 3 year old son broke both the bones in his right leg, about an inch or two above the ankle. he was sedated for realignment and was in a full leg cast for 7 weeks (no pins or anything). the cast removal took over 30 minutes (with him screaming in pain the whole time) and his foot and ankle were badly bruised. The x-rays, according to the orthopedic specialist, showed "90% healed", but now, 6 days after the cast was removed, he is still refusing to walk or even stand, and if we try to make him, he screams that it hurts (even though we are supporting most of his weight). He's able to scoot around and climb on the furniture but he's favoring that leg. Should he still be in pain at this point? I'm starting to get very concerned that something is wrong… thank you for your time.

  308. Narayanan says

    Hello doctor,

    , fracture happened to be at the base of 2nd and 3rd metatarsal (not displaced).. Is it a Lisfranc fracture? am not that much of physically active person.. will i ever be able to walk again in my life?

  309. Sathish says

    Hello Dr!

    I fell down, twisted my ankle and the result is a fracture on the 4th metatarsal. It has been 5 weeks now, I went for an X- ray yesterday and the doctor told me healing process has started. He asked me to come back after 2 weeks. Doctor gave me a boot instead of plaster. I am worried if it is slowing the healing process. Can you please tell me if the boot is as good as the plaster?

  310. Dr Arun Pal Singh says


    Base fractures are not Lisfranc, if you are correctly describing your injury.

    Did you take treatment?

    Metacarpal fractures heal well and usually do not cause problems.

  311. Dr Arun Pal Singh says


    Generally, by this time, there should be no pain. If there is radiological union as your doctor has suggested, there should not be problem in weight bearing.

    But because he is too young, most likely he remembers the pain that he had when the injury occur.

    Children tend to remember the trauma and refuse to use the limbs.

    However if there is no improvement over one week, you can get him to the doctor again.

    Try comforting him and make him understand that it would not pain. {But confirm first that pain is not there}

  312. Dr Arun Pal Singh says


    Yes! It could be both ways. But a lesion should not be ignored even if it has come as incidental finding.

    All the best.

  313. Narayanan says

    Thanks a lot for your reply doctor.

    As per my xray report, it describes that i have fractured the base of 2nd and 3rd metatarsals.. it is exactly 2 weeks now.. Doctor treated me with POP for 10 days and now he has removed the POP and has covered the fractured part with bandages…

    Also doctor, the fractured area has become slightly black, is it common, as it implies the fracture is healing? or is it a cause for worry?..There is no pain in the fractured area, only if i press it there is pain (Manageable).. According to ur professional experience, when will i be able to walk again normally doctor? Appreciate your comments doctor..

  314. Dr Arun Pal Singh says


    If you wish, you can get a second opinion. But spiral fracture, that too undisplaced should heal without problems.

    A radiolucent line may persist for longer though.

    Was joint involved initially?

  315. Debbie says

    Thank you, Dr. Singh. I did see another hand surgeon for a second opinion. He said progress looks good but will take time. Joint is stiff and swollen due to being immobilized. He adjusted hand therapy to focus on ROM and edema and not strengthening yet. I will see him again in 6 weeks.

  316. Evon says

    Hey Dr. yea my cast is out and he has asked me to gradually start doing things around not to rush in. thank you for your reply

  317. Amitoj Singh says

    Sir, 5 days ago i got hit by a friends foot during playing.The pain was very less but my friend insisted to go and see a doctor.I then visited a doctor who got my left hand thumb x-rayed and told me that it was a minor fracture and he plastered my hand and told me that he would remove the plaster after 3 weeks but since then i have no pain in my thumb.I wish to remove the plaster but can't decide to do so or not.I even try to move my thumd in the plaster and i absolutely feel no pain please suggest what should i do

  318. Maura says

    Dr. Singh,

    I fractured my fifth metatarsal (right foot) around the beginning of Sept. 2009. It is now into December 2010 (yes, more than 1 year later) and the CT and MRI still show a fracture. In all of the reports, even since November 2009 (last year), the radiologist commented that a healing fracture is suspected.

    There has never been necrosis and the last CT scan (in Nov of this year 2010), still shows a healing fracture. Although, this time the radiologist mentioned that this CT Scan shows much improvement from the original MRI and CT scans from last November (2009).

    I have not been allowed to go to work (I am an elementary teacher) due to policy that will not allow an employee to return to work from being out on medical leave if there are still work related restrictions and accomodations. My doctor says I can return to work, but due to the circumstances of my job (little kids stepping on my feet, constantly having to stand on feet for 8 hours a day — we are not allowed to sit down during class — and the constant walking) he does not feel its in my best interest to return without restrictions.

    Here it is December, and I am still having pain, although not as badly. I asked if surgery would help and was told that surgery is not needed right now because the last CT scan said the fracture is healing.

    I do not technically have a Jones Fracture because the break did not go across the bone, instead it went horizontal. In June, the bone finally showed some union, but as of right now, there is still not complete union.

    I have no health problems other than being hypothyroid and I take Synthroid and Vitamin D3 regularly. I use a bone stimulator, go to PT 3 times a week and have anodyne therapy and cold laser. I also wore a compression boot for 4 months, and now a surgical shoe.

    I have had calcification on the fracture almost since the beginning. My doctor said the only treatment is time, bone stimulator and PT.

    My question is, why do some fifth metatarsal fractures heal within 6-12 weeks and others, like mine, take an undetermined amount of time. Is there anything that can do to speed this healing process for complete healing?

  319. Dr Arun Pal Singh says


    You should avoid walking for initial 2 weeks. You could walk on your heel. It is easier and weight is not distributed on the injured area.

  320. Dr Arun Pal Singh says


    You seem to be doing fine. Most of the patients do extremely well after metatarsal fractures.

    All the best.

  321. Dr Arun Pal Singh says

    @Amitoj Singh,

    If you have a fracture, you should continue with the treatment. I cannot suggest you to remove the plaster.

  322. Sathish says

    Thanks Doctor.

    I have 2 more questions, Please answer them as well.

    I got a 4th metatarsal fracture and the 4th toe is numb (most of the time). I noticed that it is okay when I have the foot in the ground, but when I elevate it, it is numb.Now it is the 7th week and is it normal for the toe to be numb?

    Normally how long it takes to walk after the fracture has healed ?

  323. Anand says

    Hi Doctor,

    I broke my 3rd metatarsal 3 weeks back and the fracture happened to be at the base.. I was in POP for 2 weeks and for past 1 week, am in a bandage. And also doctor has advised me to put full bearing using crutches, as it will support healing faster.. When i try to walk with my full weight, fractured area is paining, though not heavily, but it's still paining.. I would like to know ur views whether if walking will actually help the fracture to heal faster?.. also if it pains do i have to stop walking?.. Appreciate your inputs..

  324. daisy says

    Dear Doc,

    Need your very kind advice, Selayang hospital confirmed my 5th metatarsal got simple fracture, its been 5 weeks from the day of fracture but i can still the pain but the bone feels tight now, is this anyhow a sign that bone is still healing?bones guarantee to heal right?im still 29and so worried as I need to start my new work very very soon, your very kind advice is greatly appreciated.. God bless…

  325. Dr Arun Pal Singh says


    If it is occasional it should be okay, otherwise plaster tightness should be checked.

    How are you now?

  326. Dr Arun Pal Singh says


    These are individual variation and what you are going through is called delayed union.

    Why it occurs in a person cannot be answered as there are many factors that affect rate of healing. You can go through this article for more insight on this.

    Unfortunately, there is nothing more that I can add to what you are already doing.

    All the best and do let me know when you return to work.

  327. Dr Arun Pal Singh says


    What has your doctor told you.

    Simple fractures heal very well. BTW how are you now.

  328. Dr Arun Pal Singh says


    If it pains you can wait for a week or two before you put weight on that foot.

    How are things now?

  329. Anand says

    Doctor.. I feel close to 80% fine… Doctor has asked me to take anothert X ray coming Saturday (25/12/2010), exactly 34 days after fracture. Doctor has asked me to put on full weight from 3rd week onwards.. The 1st 2 days was hell as i thought my doctor has asked me to put on weight pre-maturely. But day by day, the pain slowly subsided and now i have reached a point that it pains really less..

    And my question to you doctor, still am not able to tune my mind to walk properly.. if am walking slowly with full weight bearing there is no pain..But wen i try to walk properly, it pains a little.. Is it normal or is it a sign that my foot is not ready to walk in a normal manner? Also doctor is be there be any chance will we be able to walk without pain if the fracture is not fully healed? Appreciate your inputs doctor..

  330. Sathish says

    Thanks Doctor.

    It has been 8 weeks after the fracture. Now I can walk slowly without crutches. I don't feel any pain and don't have plaster or walking boot.

    But my 4th toe is numb (had 4th metatarsal fracture). It is okay only when the toe is in the ground or if it is touching any object.

    I asked my doctor, he didn't give me a proper answer. Please tell me if it is okay for the toe to be numb as I am able to walk slowly.

  331. Shriram Nadar says


    I am Shriram from Mumbai, I got a Mid Shaft Humerus Fracture without a radial Nerve damage & without an skin damage on 28.10.2010,which was treated surgericaly by implanting plate with 8 screws, Operation was delayed for a week because of Dengue Fewer which i had from 23.10.2010, now after operation i had slings for 2 weeks & then my hand was left without sling & armrest, my last Xray taken on 18.12.10 shows 70% of Bone Union, while a small gap is seen at one end of the bone but the other side of the bone seems to be Compeletly Union without any gap, My Doctor told be by End Dec 10 bone must be healed compelety as i have full range of motions upto 90% & he also told me that I can Drive My Bike from this new year -1.01.11-as of now i can lift upto 3kgs of weight with doctors permission .. ..

    Now if you have Any Suggestions for me .. for better improvement of my Bone ..Pls suggest & also i want to know "will it be safe for me to start Driving from 1st of jan 2011 or not ? & also What Would be the maximum time in months for my Bone to get the Complete strength & to to be completely strong as it was earlier ..?so that i can join GYM to make Muscles..Pls Suggest at the earliest…& How long it Would take for my bone to be healed & to be normal & strong as it was earlier befor accident. Pls Reply


    Thank You

    With Regards

    Shriram Nadar

  332. Shriram Nadar says


    Some more info :-

    I am 21 year old & its a left Humerus Fracture

    i am working in a BPO, From last Two months i am off work , I Spent about 60k for the operation

    now i am leading tough time with regards to finance & health so now from this new year i want to rejoin & i am scared of travelling by TRAIN OR BY BUS ..Thats a Reason I want to start driving from this new year

    because i feel i will be safe in my bike rather than public transport

    pls doctor reply asap

  333. Dr Arun Pal Singh says


    Its part of normal recovery if it does not worsen. You seem to making fine progress.

    All the best.

  334. Dr Arun Pal Singh says


    It should not be so for a long time. If it is occasional it should be harmless

  335. Dr Arun Pal Singh says

    @Shriram Nadar,

    If you have a united fracture, driving per se is not the problem.

    But you must also know that the united bone further remodels to take the strength originally it had and this takes around one year.

    So any impact that your normal bone may resist may not be tolerated by the bone that has just united.

    All the best.

  336. Dr Arun Pal Singh says

    @Shriram Nadar,

    I understand your concern. I have already answered your previous question.

    I would advise you take public transport rather than bike.

    Two wheeler riders have higher chances of falling. As your bone is not that strong yet, even a minor fall could cause the harm.

    But driving as such would not cause any harm to your already united bone.

  337. menal says

    hello Dr.

    my daughter is 6 years old compliang from spiral fracture of the lower part of the shaft of tibia which is spiral fracture not displaced she was 35 days ago but without any sign of calus fotrmation by x-R ,she is asthmatic and she need steroid but not depedent i asked if any relation between asthma and #union and is 4 week is suffecient for removal of the cast or full weight bearing with cast

  338. Anand says

    Doctor, wish u and family a happy and prosperous new year… am in 6th week after suffering from 2nd and 3rd metatarsal fracture… Doctor has asked me to start walking from the 3rd week and when am walking it still pains, though not heavily but still it hurts….. Doctor my question to you is..

    1. Is it normal for the affected area to pain even after the fractured is fully healed?

    2. Still there is swelling where it got fractured.. is it a normal sign or is it a cause to worry.,. will it take time for the swelling to come down?

    Appreciate your comments doctor..

  339. says

    i have big quetion ,if inflammation help in the bone formation or curing of bone crack then how we can use the anti inflamatory drug or anti arthritic drug to reduces the inflamation

  340. shriram Nadar says


    Doctor Thanks for the Reply

    I went for doctors visit on 31st

    he told me everything is normal, i can ride bike & i can lift upto 4-5 kg but not more than that,

    he told me every month slowly we increase the weight lifting process as slowly & steadily strength of the bone will increase & within next 3 months it will be much stronger then it was earlier,

    he asked me to visit again on 15/1/11 to Take an Xray to check out the growth..

    if you have any suggestion for me .. then pls reply

    Thank You

    Once Again Happy New Year

  341. shriram nadar says


    Doctor Thanks for Your Reply..

    After 2 months of Injury, Everything seems to be fine Now ..

    if you have any suggestions or advise for me then pls reply ..

    I would Really Appriciate, if you can tell me, What would be the safest & secured time

    frame in months for me to start Driving & to start Body Building ..

    Thank You

  342. Ms Fehmida says

    on dec 27,2010 i fell down and injured my right arm. X- ray result showed proximal humerus bone is broken. Doctor suggested to leave the hand in sling for 9 days so by force of gravity bone comes in place. On second visit with x-ray reports first he decided to go for surgery ( metal plates + screws) then after a while he said he wants to discuss with a collegue before finalizing for surgery. He said he still wants to wait for another 7 days and on next visit he will decide. Could things go wrong from this point? If he dont decide for surgery he told me after this visit i need to come back after 6 weeks and arm will be in sling. Slowly after that therapy will start. At this point i can feel alignment of bones but only untill arm is at 90 position its perfectly comfortable . If i rest ankle then i feel sudden discomfort. Should i ask the doctor for surgery ( include risk of veain damage) while right now all the rest is finr its just the time n patience n fear what will be the result after 6 weeks is bothering me.

  343. Matthew says

    It has been 14 weeks since an angulated tib/fib fracture in my lower right leg. Tibial nail and rodding procedure was performed. I am just now getting out of the walking boot. Xrays reveal that the fib is still not healed as there is significant separation still present. In my opinion – it looks as if i fractured the fib yesterday. The 8 week xray is linked here however the 12 week wasn't all that different.

    [URL Moderated]

    Should the fib be healed by now or show significant progress toward healing after 14 weeks? The fracture site is tender to touch but not significant pain. I am starting to walk around with tenderness and slight limp. The biggest issue other than the fib is ankle pain all around where the two screws are positioned? Is this normal? can they be removed? Is that recommended? Range of motion is returning very well however that pain is at time very debilitating. NSAID medication helps and stretching prior to normal activity is a must.

    Thanks in advance for any insight and suggestions.

  344. Dr Arun Pal Singh says


    Minor pains are common. Swelling if due to callus would go gradually.

    Happy new year.

  345. Dr Arun Pal Singh says

    @shriram Nadar,

    Please follow your doctor's advice.You are making fine progress.

    Thanks for the wishes. Happy new year to you too.

  346. Dr Arun Pal Singh says

    @ramani falguni,

    Yes! It is agood question and ideally speaking they should not be used. Ideally opoid drugs are better choice.

    But the studies have shown that the effect on fracture haling by these NSAID drugs are not significant.

    Intravenous opoid have their own risks and not many drugs are available for oral use.

    Therefore NSAIDs are used frequently.

  347. shriram says

    Thanks for yor Reply Doctor

    As of Now seems to be fine .. If i have any questions I will get back to you

  348. nahid says

    how long does a fractured finger take to heal, its a small fracture on my index finger left hand

  349. Rahul says

    Hi Doctor… it has been 2 months since my metatarsal fracture of 2nd and 3rd base.. Although pain is not severe, it still pains sometimes when i walk.. Doctor when can i walk normally without any discomfort?.. I know its hard to predict but in your professional experience how long will it take to walk normally after a metatarsal fracture. Appreciate your comments doctor.

  350. Dr Arun Pal Singh says

    @Ms Fehmida,

    These fractures are managed both by conservative management and surgery.

    It depends on fracture pattern and patient demand.

    I need to look at the xray before I can comment further.

  351. Musab says

    Hi Doctor,

    I recently broke my left tibia in a car accident. An IM nail was inserted on the same day with 4 screws. I had a 5 week check up last week and the leg radiograph showed no sign of healing. I am a 19 year old healthy male and was simply wondering how long it would take to visually see any kind of union on an x-ray after surgery?

    Thanking you in advance.

  352. Dr Arun Pal Singh says


    Though another view [lateral xray] is needed to confirm this but I do not see any sign of union in tibia too.

    Union in fibula is not that important. Tibia is main bone that carries the function of the leg and its union is main concern.

    Do you have another xray.

  353. Dr Arun Pal Singh says


    As you said, it is really hard to predict. It depends on type of fracture and the patient profile.

    Few people get better within 6 weeks while other take few months.

  354. Li Heng says

    Hi Doctor,

    I have fractured my right foot last year (November 2010), specifically my Right Navicular. I was in a cast until the end of December, but the xrays then shown that my bone has not shown union yet and was advised to stay off for another 2 weeks, which I didn't do, as I had to return home overseas a few days later with 30+kg of luggage. I walked with a cane from then on until now. I went to Singapore for vacation for a week, at which I walked for about 9-10 hours a day. After I got back home I had another x ray which showed barely any improvement from December, could this be because of the excessive walking I did?

    As of now there's still a bruise at the fracture area and I have to shift my weight to the side of my foot to walk, I have heard that unless I immobilize my foot again, it will take months, maybe even years to heal. I'm hoping that's not the case, I have an x ray copy, is there a way to show you (e-mail?) without posting it in the public domain?


  355. bryan says

    Hi Doc..

    im bryan.. my fibula is fracture during playing football on 19 December 2010 and doctor advise me to put fiber glass. now 8 weeks already the fiberglass still in my leg. actually how long the healing taken?

    tq Doc..

  356. Angela says

    Hi Doctor,

    I have a Jones Fracture in my left foot. I've been in an air-cast for 6 weeks now and saw the Doctor today. His exrays determined that I have primary bone healing and no callus formation as you would see in secondary healing. I'm wondering if it's best to have primary versus secondary healing?

  357. Dr Arun Pal Singh says

    @Li Heng,

    Please send it to contact [at] boneandspine [dot] com. Please include xray after initial injury and the one after removal of cast and the latest xray.

  358. Serene says

    I read on Wikipedia that "osteomyelitis is often based on radiologic results showing a lytic center with a ring of sclerosis". How does this look on xray? I could only read the different densities of the bone based on lucenicies. Thank you.

  359. prabha says

    my brother has been asked to use bone stimulator for faster bone growth of his fermur fracture for a period of 3 months. But i am not able to get any dealers for hire of this bone stimulator machine. so can anybody recommend us from where we can get this urgently.


  360. Dr Arun Pal Singh says


    That seems to describe Brodie's abcess, a kind of osteomyelitis but seen rarely.

    More commonly the osteomyelitis is seen as a sclerotic bone shadow [sequestrum] surrounded by radiolucent line and is considered as hallmark of chronic osteopmyeltis. cavitation is another kind of presentation.

  361. Dr Arun Pal Singh says


    I am not sure. Did you ask the doctor who prescribed it. If you have got it please let me know the whereabouts.

  362. AAD says


    I'm using a bone stimulator know…and believe that it really has helped my healing process.

    Smith and Nephew is the company that makes them. My doctor put in a script for it and the rep brought it to my home. They are expensive but most insurances will cover it.

    ps…after I bought it I noticed that people sell them used on ebay. Had I known I would have bought mine that way.

  363. bryan says

    evening doc..

    doctor say usually healing time fibula fracture taken 6-8 weeks.actually hong long i can walk normally after my fibula fracture? is it after 8 weeks from fracture i can walk without crutches.

  364. Yogesh Kamra says

    Hi Doc,

    I had a bone infection after getting injury, doctors removed the inplant from my forarm (ulna) 1 year back to remove the infection. now from last 1 year I am not having infection in my hand.

    I need to know how much chances are there to union my bone after surgery,.



  365. michelle says

    When i feel my ulna bone there is a gap. I have had this for years. I dont have any pain, what could it be?

  366. Jitendra says

    Hello Dr. Singh,

    I was hit by a car on right foot on the morning of 14th March, 2011. I was wearing leather shoes by that time. After hit byt the car there was ignorable swelling and pain. I used crepe babdage in the night while sleeping. On 15th morning I felt pain while walking and went for an X-Ray in evening.

    In X-Ray report, it has been identified as Avulsion Fracture in Cuboid. But I do not have pain near the cuboid from the first day. However, I had pain near fourth and fifth metatarsals towards proximal joints.

    I consulted to a doctor and he advisedme to use anklet in the socks and go for cold compression for 2/3 a day.. Now I am wearing anklet since !7th march evening and doinf cold compresson.

    Now there is no pain near fourth and fifth metatarsals.

    There is some swelling in my foot but I feel it is because of ANKLET. I do not have any pain in my foot. I am not putting full weight on my right fool.

    Is it possible that there is no pain even having fracture in cuboid. When should I go for another X-Ray?

  367. Gisele says

    Hi doctor,

    My name is Gisele ,25 years old and I got into a very bad car accident on Christmas even,I broke my 2 femurs,my right hip and arm.

    Right now,3 months later,my femurs are good ,my arm but my hip is not healing so quickly and I m using the stimulates.should I wait more time to heal naturally or should try another surgery which they take bone from my pelvis to replacement?

    What's my chance to my hip heal without any other surgery?

    Tks doctor

  368. Qasim Javed says

    hello sir,

    Sir me qasim.Sir i had a fracture 12month's ago

    which was gun shot wound in femur shaft and

    doctor's have removed 3'in bone piece they implant

    rod in it and in the center of shaft 25percent bone

    piece which is healing doc's says that bone will

    grow but till now i don't seen any bone growth in

    bone loss area please tell me is bone growth is

    possible i m 19 but 6feet hight please tell i shall

    be greatfull to u>thankz

  369. Dr Arun Pal Singh says

    @Yogesh Kamra,

    You need to elaborate. I could not get what you want to ask.

  370. Dr Arun Pal Singh says


    Get an xray after you see your doctor. It would be of help. You can then send the xray to me.

  371. Dr Arun Pal Singh says


    What does your treating doctor say? I have too little info and no images to comment on.

  372. Jitendra says

    Hello Dr. Singh,

    Thanks for the reply.

    I went for another X-Ray on 23rd March and then consulted to my doctor same day. He said why did I go for secod x-ray. There is no point in going through rays. There is visible fracture.. He has asked me to continue with the anklet for next two weeks and come back after two weeks i.e. (6th April.2011)

    In secon x-ray it is clearly showing Avulsion Fracture in Cuboid. A minor part is separated from Cuboid. The size of separated part seems slightly bigger than a button.

    I do not have pain at all in my foot. However, I have fear so I do not put fulll weight on it and limp while walking.

    I stay at third flooor and everyday I come down once in morning and go up in evening.

    Is there any risk involved? Is anklet is sufficient for its proper treatment?

    Please advise.



  373. Priti Punam Lal says

    Hi Doctor.

    I had a fall in October 2010 and had an xray done in January 2011, 3 months after the fall which revealed a compression fracture of the L1 Vertebrae. After that my specialist referred me for a CT Scan in February 2011 and according to him lytic lesions were found in the compressed bone which had reached up to 50% of the injured vertebrae. Is there any treatment for this as I am going through immense pain and experiencing numbness in my limbs at times. Its been 5months since the injury and no treatment of the fractured bone has taken place yet.

    My blood test results also showed a few nucleated red blood cells and lymphocytes and leukocytes was noted.

  374. michelle says

    Re my previous question.(gap in ulna bone)

    Do you think it could be anything serious as I am a bit wary of going to the doctors a sI feel I may be wasting his time, due to the fact that I have had this gap for years with no pain?


  375. Mohammed Hamed Ali says

    Hello Doctor

    i had an accident almost 2 and half year ago by car broke right femur with multiple fragment, did an operation with long plate screw fitting but unfortunately operation was not successful due to huge gap between bones, after one year the plate was broked and did operation again fixed with same procedure with grafting, now one and half year gone still iam not bearing weight but this time healing showing possitive, i consult different doctor for opinion in india at present iam in saudi arabia and not taking any medication only doing physiotheraphy at home i need your fruitful advise what should i do for quick recovery and weight bearing. still using walker.

    thanks looking forward your tactful advise.


  376. Debbie says

    My husband (44 yrs) broke one of the bones in his arm, just above wrist. He has been in a cast now for 5 weeks (had the cast changed at week 3). He is still in a substantial amount of pain and it is affecting his sleep. The clinic has x-rayed it twice and said that everything is healing well. He has explained the pain and discomfort to them and they have dismissed it.

    They have told him that it could be as much as 4 more weeks before the cast is removed. Should he be seeking a second opinion?

  377. emy says


    i'm emy.i want to ask about what is factor to improve fracture healing? how about increase the number of bone cell? its one of the factor or not? actually I'm was doing my research about bone fracture healing.


    p/s: sorry about my english..

  378. Dr Arun Pal Singh says

    Should surfice however personally I prefer plaster slab/cast.

    How are you now?

  379. Jitendra says

    Hello Dr. Singh,

    Thanks for the reply. I am feeling better now.

    My third meeting with my doctor was on ^th April. He asked me to walk without anklet. He asked me to walk on outer feet, inner feet, heel and on fronf part I was not comfortable with front part. I asked him if I can continue with anklet. He said if I feel more secure, continue as there is not harm.

    I am just taking Cipcal-500 once a day.

    Importan point. He said that as I do not have pain at it is possible that there is no fracture. The extra visible bone part could be additional since my birth. This part is called Cuboid accessory. I am surprised.Dont know if he is saying true.

    On last Saturday and Sunday, I walked too much. I do not have much problem now. Although there is slight itching now which was not on friday and saturday.

    Anyways, I will write again to you in two days..

    Thanks alot.



  380. Dr Arun Pal Singh says

    I did not mean that it is serious but the phrase gap in ulna does not provide full picture.

    It is up to you to decide if you want to see a doctor.

    But if you have concerns about what you have, you would need to see a doctor to tell you what it is.

  381. Dr Arun Pal Singh says


    If you feel that you have doubts or queries which are not being answered, surely you can.

  382. Yogesh Kamra says


    I have been advised for Stem cell transplantation for my forarm fracture. this fracture happened last year and then bone get infections after implant. To get ride of the infection doctor has removed all the implant (plate) since then its in two pieces.

    Please suggest how successful is stem cell transplanation.


  383. Jaya says

    Hi sir,

    My husband had a femur fracture ( approximately 3 inches above the knee) 7 months back. He had the surgery and a rod was inserted. The healing was happening at a good pace. Now he has a swelling just above the knee where the nuts of the rod are placed. We consulted his surgeon and we were told that the swelling was due to exra bone growth. He was given medicines for 2 weeks.The doctor also said that he can walk without using the stick. After taking the medicines he's a bit relieved of the pain. He's able to walk and bend his leg. But this pain keeps haunting him. The swelling goes up and down. There is no consistency. Like, there is swelling and pain for 2 days, subsides for 1 or 2 days, and again it shows up again.

    Is this b'coz he's walking without using the stick. Is this extra bone growth normal. Would it subside once the healing is complete. I'm asking so many questions because after 4 months of the fracture he was able to walk and bend his leg considerably. This swelling has litrally slowed down the pace with which he walks now. Please advice.

  384. veis visvananda says


    I am 51years old, last December I broke my right hand at the wrist area damaging the cartilage. The doctor who attended to my hand did a fantastic job, its been like 5months now, the operation was on the 24th December. The cast is off with just a screw left in my hand for good.

    I feel good except it hurts from time to time when i use my hands to work. I am a technical worker, My therapist says i am far better than most of his patient except that my doctor warned me not to use the hand.

    I sometimes push a little hard during work after where it hurts in the night but with some ointment i feel better the next day. My question is, will i suffer later if i go on like this? cause this is the comment i use to get from others saying if i go on like this i will damage my hand in time to come. My doctor asked me to wait for 6 to 8 months before i could use it again, but every morning when i start my day there is improvement to my hands. Please advise if i can go on like this or really have to go real slow? I just use my hands to work lightly, exercising with dumb bells but no real heavy lifting. Thank You.

  385. Dr Arun Pal Singh says

    @Priti Punam Lal,

    Sorry for the delay!

    A lytic lesion indicates a pathological process and it is likely that the process was present before you got injured.

    It needs to be investigated. What does your doctor say?

  386. Dr Arun Pal Singh says

    @Mohammed Hamed Ali,

    There is no tact involved in bone healing. You cannot force the bone healing. All you can do is to provide the best mileu for the fractured fragments to heal in best alignment.

    As I am not aware of what your images are like, I can only provide a general guidance.

    Follow your doctor's advice.

  387. Dr Arun Pal Singh says


    It should be but I think activity is more important. Can the number be increased?

    I am not aware.

  388. Umesh Naik says

    Hi Dr I had met with a bike accident and had sustained fracture of proximal left radius and ulna and undergone an open reduction & interna fixation(plate and screws) of the same on 28/01/2011. my arm was in cast for 6weeks after that its free, I have 100% of all range of motion now, and feel absolutely no pain now. Dr can u advice me as to when I 'll be able to lift weight upto 5kg?

  389. Dr Arun Pal Singh says

    @Yogesh Kamra,

    I am not aware of the statstics of success rate. This is a novel procedure and though it seems promising, I am not sure how effective it is.

  390. Dr Arun Pal Singh says


    When you say extra bone growth, I am not able to make what it is. Can I see xrays?

  391. carol says

    Is it normal to have an imflammation one month after a bone fracture in the forearm?

    What should I do?

  392. says


    I broke my 3rd metatarsal in basic training about week ago i have a cast up to my knee. I was wondering how long would it approximately take for it to heal. It started off with stress fractures then a brake. The doctor told me that it was a hole in the 3rd metatarsal not a full brake as in bones separating. I am on leave at home for 30 days and was wondering if i could also take the cast of soon because i feel no pain i can already walk on the cast and everything. i can move the foot in the cast because swelling has gone done so much. i would appreciate the advice.

  393. Stephanie says

    Hey doctor '

    I had fracture my fibula n 3 pieces playing softball. Its now 18 days today I'm on a cast now for 2 weeks allready I'm going to get another x ray on Friday hopefully it healed allready i don't feel any pain like i use to bu5 i my ankle when they was putting the cast on it was purple now with the cast my feet gets swollen i don't know what to do to make my bone heal what do you think doc what should i do i take vitamins also

  394. mike says

    broke my fiblua bone on feb. 28. Was in cast until last Wedesday, Now he told me to put alittle weight on it and move it around, but no special treatment. When I put maybe 10% of my weight on it it hurts at the heel. Please send message.

  395. Dr Arun Pal Singh says

    @veis visvananda,

    Your doctor knows the best about your healing and advice on hand usage.

    I think you should follow his advice.

  396. Dr Arun Pal Singh says

    @Umesh Naik,

    I think you should ask this question to your treating doctor. BTW why 5 kgs?

  397. Dr Arun Pal Singh says

    @Jaaziel Ramos,

    I cannot give advice in regards to your treatment. A week is not sufficient period for removal of cast.

    Please follow your doctor's advice.

  398. Dr Arun Pal Singh says

    You can. I hope by now you are out of the cast. How are things going?

  399. Dr Arun Pal Singh says


    Do as your doctor has advised and you would be able to put the complete weight gradually.

  400. Qasim Javed says

    Dear sir, i have send u my x-ray but u did not reply it why sir?????????

  401. Qasim Javed says

    Thanks sir for your reply ..sir is there is any alternate solution for my bone healing i m tired of sitting at home i m always in pain i want to do some job but only because of problem i cant do hard work and some times i feel disheart from my life i don't know what to do sir this incident has taken me years before doctors say that after 1 year we will see what to do may be bone graft sir please reply>>>>i m waiting for your reply..

  402. Narayanan says

    Hi Doctor,

    Am having an ACL complete tear in my left knee. Now am able to walk with almost no limp. I would like to get suggestion from you, whether i should go for a ACL surgery. Am not going to participate in any level of sports that's going to involve cutting or pivoting. Also i feel i can manage day to day activities with almost minimal pain.

    Based on ur experience, i want to know whether am going to do any damage to my knee, if am not going to opt for reconstruction? I had a partial tear in my right knee about an yr back and that knee almost feels like back to normal.

    Though it's difficult to predict about the future consequences, i want to know your views based on your professional experience. Appreciate your inputs doctor.

  403. Dr Arun Pal Singh says

    @Qasim Javed,

    I think that is right approach. Give your bone sufficient time to heal and wait if it gains its thickness.

    Otherwise bone graft.

    I understand it is painful to wait this way but I do not think any other intervention is justified at this juncture.

  404. Dr Arun Pal Singh says


    If you do not have a symptom or functional limitation, I do not think you require a surgical intervention.

    Physical therapy helps in such cases. Please discuss it with your doctor.

  405. Sin says

    Sir, I am having triple fracture in my lumbar spine. Fracture in L2 and L3 and got dislocation in lower back. Spondyolisis? I am not sure about it. How long will it take to heal, Sir?

  406. Dr Arun Pal Singh says


    Cannot answer your question until you provide me detailed information.

    As of now there is too little information.

  407. Sin says

    Sir, what are details that I should provide you? I am not sure what kind of details are they.

  408. paresh khunt says

    dear doc,

    14 days ago, there was fracture in my left forearm. the findings are below,

    radius ulna L upper M/3,

    ulnar nerve paresis

    two pieces of both bones

    operation was done like CRIF done with close IM nailing AE cast applied.

    so what time it take to healing?

    but there is pain over baby finger and ring finger like stretch of veins and artery and the skin above this two finger does not feal any touch. the doctor said it is only due to stretch of artery from elbow at the time of accident and it will recovered naturally. but some times it pain hard. i take vitamin B12. so please diagnose it and suggest proper medicine for fast recovery .

  409. Dr Arun Pal Singh says


    Detailed symptoms, image reports and things you want to know

  410. qasim javed says

    Hello sir,

    sir please tell me some best medicine which can heal my bone faster…….

  411. Dr Arun Pal Singh says

    @qasim javed,

    While a good diet rich in calcium and proteins would help you to maintain a natural growth and repair.

    There is no medicine to accelerate the healing.

  412. Dr Arun Pal Singh says

    @paresh khunt,

    I am sorry I cannot make the diagnoses. Probably you do not need one as you already have it.

    Symptoms you describe come from ulnar nerve paresis as you doctor must have explained.

    You should already be on medications. Nerve recovery would take usual time in spite of anything and everything.

  413. amanda says

    I broke my bone(around my wrist) in 2009 and i went skating recently and fell on it and now it is giving me pain it hurts should i just wear a wrist brace?

  414. Caroline says

    hi dr singh.

    my 78 yrs old baby sitters' shoulder was dislocated and was also told that she has a fracture in the socket. the ortho doc was able to fix the dislocation so her concern is the fracture. right now shes wearing something to hold her arms. my question is: long is the healing process?

    2. can she still carry a 2 yrs old baby (like putting him in the high chair or the toilet bowl) or she needs to avoid doing it because it will damage her shoulder again

    3. what is the long term effect of it?

  415. Tiffany Gaston says

    Dear Doctor:

    I broke my ankle march of this year, got surgery a week later which included 5 screws and a plate. On July 11th the hardware was remove. I spent two weeks in a soft cast and on July 26 received a walking boot. My doc says the holes in my bone should heal in 3-4 weeks. Now i know recovery depends on many factors: rehab, diet, bad/good habits, age, gender etc. My question is do the holes in the bone from the screws usually take that long to heal??

    Thank you,


  416. Dr Arun Pal Singh says


    Better ask the person you bought it from. He/she would help you better.

  417. Dana says

    Hello. I broke my 3rd metatarsal on my right foot in Feb. I went to the emergency room and was given a hard soled orthopedic shoe to wear and was told it would heal in 4-6 weeks because it was not a bad fracture. I told the doctor that I live on the 3rd floor and asked if bearing that much weight and climbing stairs would hinder the healing process but the doctor assured me that I would be fine. He advised me to follow up in 6 weeks.

    I lost my job shortly after breaking my foot and no longer had health insurance. I have not been back to the doctor and 5 months later it still aches. I still cannot walk correctly and there is a slight pain when I walk for long distances.

    Based on what I have written, do you know what could possibly be wrong? Is it just healing slow or will I need surgery? I was very active before but now I have gained weight. I am anxious to resume normal activities.

    Thanks for your help!!

  418. aditi says

    i have broken my tibia and fibiula on 15th june,2011,had gone ORIF 8 weeks have gone.when can I walk properly without any support?plz help.

  419. brit says

    Helllo, i fractured my femur bone from running 4 years ago, and the pain comes back every once in a while, especially when exercising. is this a normal thing to happen? if not, what could possibly be the reason for it to always hurt?

  420. Dr Arun Pal Singh says


    In immediate period after reduction of dislocation, an absolute rest is warranted. Following that gradual mobilization can be begun.

    If there is an accompanying fracture, the rest needs to be prolonged.

  421. Dr Arun Pal Singh says

    @Tiffany Gaston,

    I am not sure what is meant by healing of holes. The holes would have screws in it. Are there any other holes.?

    An xray would help.

  422. Dr Arun Pal Singh says


    Please see a doctor who can examine and investigate you if required. It could be nothing but we need to rule out the causes of pain.

  423. Lisa says

    I fell on July 7th and slammed the inside/top of my right foot against a concrete step. I experienced severe bruising across 3/4 of my foot, both top and soul but pain and swelling only at the sight of injury. Since I could walk without any pain I never got an xray. Long story short I am still experiencing pain at the sight of impact and now have a palpable lump. It is extremely painful to put a shoe on b/c of the pressure on the sight.

    I am considering getting an xray to see if it had been broken but I am wondering if it is a waste of money. If I did break it on July 7th, will the fracture even show up on the xray? Is there anything that can be done to help the pain. If I put a shoe on or bump it or any type of contact to the area it feels like someone is stabbing me with an ice pick.

    Any advice is greatly appreciated!


  424. Brandon says

    Hello, I fractured my 5th metatarsal (Jones Fracture) July 13, 2011. it's not been exactly 1 mo and couple days had a cast for 2 weeks after a week I had no more pain. Dr. removed cast after 2 weeks and gave me a boot been on the walking boot for 2 weeks. have none to very minimum pain. is it ok to walk on a boot or should I have it non weight bearing? I see many diff opinons on this. is the 5th metatartsal a weight bearing bone?

    thanks for the advise.


  425. anne says


    My mother-in-law fell and broke her arm. She could move her fingers for a few hours

    after the break occurred.

    Straight after the x-ray she could no longer move her fingers on the hand of the damaged arm and has nerve damage.

    Could this have happened during the fall and did not show for a few hours or could it have been moving the arm during the x-ray procedure?

  426. Ed says

    I recently spiral fractured my tibia. I have been in a fiberglass above knee cast for over two weeks now. The break starts from the ankle and stops at the mid point of my tibia. Is there a chance of displacement while I am in the cast, the swelling decreased so my cast is a bit loose and I am worried there might be some displacement in the healing process. I did not get any rods or screws attached to my bone.


  427. RitaA says

    Dr. Singh,

    Thank you so much for explaining and illustrating how a broken bone heals. I had a M2 stress fracture in my right foot in 2007. The first x-ray didn't demonstrate the fracture, but I asked to be reassessed 14 days later after discovering on the internet that a stress fracture may not always show up. A callus had formed by the time of my second x-ray where "minimal flattening of the second metatarsal head consistent with mild avascular necrosis" was noted.

    I had what felt like another stress fracture in the spring of 2009 but my foot wasn't x-rayed until the fall despite my ongoing pain and complaints. This was the finding on the fall 2009 x-ray: "Circumferential solid callus formation and mild cortical thickening is seen along the distal shaft of the second metatarsal. This may be in keeping with an old healed stress injury/fracture in this location. No acute fracture is identified". My family doctor assumed it was the callus from the 2007 stress fracture but that x-ray is at a different hospital and therefore could not be compared. Would a callus normally be visible for 2 years? Based on a physical exam, a podiatrist told me I had managed to break M3 as well along the way, but there is no mention of M3 in the x-ray report, so I'm a bit puzzled.

    Now in August 2011, I had my left foot x-rayed just last week because of a suspected M2 or M3 stress fracture, but the initial x-ray was negative. Since my bone density test didn't show signs of osteopenia/osteoporis and I don't walk very fast or very much because I'm waiting for an arthrodesis of my 1st MTP joint (left foot), I'm wondering why I'm experiencing so much pain and possibly recurrent stress fractures. I do think my slightly awkward walk because of hallux rigidus is putting extra stress on my other metatarsals. Since my surgery date is more than an year and a half away, is there anything I can do to mitigate that? What questions should I be asking my doctors in Canada? I'm 55 and not ready for the pasture yet.

    Thank you for helping people by explaining things so well and by answering questions whenever possible.

  428. Lupe says

    Hi doc i had a pilon fracture of the distal right ankle tib/fib broken ORIF medial plating on both fibula is healed my question is when I looked at xray tibia still looked cracked after 2 months of healing my doctor said he used bone graft does bone graft show up on xray film?

  429. brit says

    yeah, vitamin c deficiency. I just got another random fracture last week in my foot, and that femur is prone to breaking again very easily. I'm only 19 years old, and I'm going through this. :(

  430. lucy1617 says


    I fractured and dislocated my neck. C3 is fractured and C3 and C4 are slightly out of line. I am walking and moving properly which is a relief. My consultant said he will review me next week to decide if he needs to intervene and re-allign the dislocation. What sort of treatment would this involve and how long (roughly) will this take to heal? I am anxious to keep my work informed as best as possible as to how much time I will have to have off.

  431. Felicia says

    Hi Dr Arun. I am just curious regarding the fracture healing. As you mentioned in the article, periosteum works as a primary source of precursor cells which develop into chondroblasts and osteoblasts.

    If let said bone graft is used (maybe is osteosimulative, osteoconductive or osteoinductive), does it actually stimulate the periosteum to develop to condroblasts and osteoblasts or bone graft stimulates osteoblasts to be more produced as in a duplicate cells?

  432. Murad shalabi says

    Hey doctor…i broke metatarsal in 2008 nd was givin a boot nd some meds nd was told not to walk on it nd me being careless I did well it was giving me pains every now and then but it went away for awhile but noe came back nd hurts to walk on everyday and wanted to see if u had some advice because I dont want to go to thw doctor and pay money when its nothing big…and I been takin meds nd nothing helps even took a week off..if u can please get back with me asap…thank u

  433. Dana Smith says

    Dear Dr Arun Pal Singh,

    Update from your response:

    I did get another xray done and the doctor said that my ligaments are damage. The third metatarsal is healed however he performed a squeeze test and said I may need surgery. He also said that because my injury is 7 months out surgery may not be an option. He scheduled a MRI and said he will look to see if the ligaments are seperated if he can put a screw in. If not then he said I will have to live with the pain. My follow up question is that if surgery is not an option would I be able to do physical therapy or will my ligaments start to feel better over time? I miss running! Of course I will ask these questions to my doctor. Just looking for another opinion so your help is greatly appreciated.

  434. Sophia says

    Hi i had a tib/fib break and I had two different cast for two months after having rods installed. The doctor gave me a boot which i have worn about for about three weeks. I feel comfortable walking like nothing ever happened. Can I leave the boot? I can feel the callus and it has hardened.

  435. Dr Arun Pal Singh says



    Sometimes radiolucent lines are visible for longer time whereas other signs of union are present.
    Depending on the duration of surgery, a novice eye may not be able to appreciate that.

    Some graft are in powder form, they might not be visible on xray.

  436. Dr Arun Pal Singh says


    I think this reply is delayed and any advice would not serve its purpose unless I know how are you now?

  437. Dr Arun Pal Singh says


    What is status of your fracture? If it has united, it is okay to walk with weight on the foot.

  438. Dr Arun Pal Singh says


    Serial xrays would determine if there is a displacement. Displacement has more chances of occurring if a fracture was initially displaced.

    If it was undisplaced to begin with, it has lesser risk for getting displaced but still possibility cannot be ruled out.

    Loosened cast is a risk for enhanced movements at the fracture site and should be replaced by a snug cast.

    Please consult with your doctor.

  439. Dr Arun Pal Singh says


    The question as you have yourself put it is to look for cause of recurrent fractures.

    You should be investigated for the diseases that might weaken the bones. That means looking at other bones by skeletal survey, investigating for metabolic causes etc.

  440. Brandon says

    @Dr Arun Pal Singh: Last X-rays taken 8/24/11 showed bone calyst already forming around the fracture but is not

    seal completly yet. I bought a metatarsal sleeve pad that is very comfortable and keeps my foot compressed.

    I'm still in the boot, altough I have no pain at all. and I have stopped taking pain meds couple weeks ago too.

    Dr. said this type of injuries because of the location (jones fracture) take an average of 12 weeks to heal due to lack of blood flow. I'm also considering having surgery (titanium screw) put in to just heal the fracture but I'm kinda concerned about long term side effects. thinking of just letting heal on its' own since I'm close to the 12 weeks anyhow.

    what is your input?



  441. Dr Arun Pal Singh says


    You would be best answered by your treating doctor as he is most informed about your case.

  442. Kyle Weis says


    I’m 25 years old and I broke my 2nd metatarsal two weeks ago. I was wondering what the average recovery time was for this injury? I’m a triathlete and when I say recovery, I mean on average how long until I can start training again? Do people usually recommend swimming and biking but waiting another 2 or more weeks to run or what? I know you don’t know my case exactly, but averages would be good to calm my mind.

  443. sarah says

    hi, my friend has a c5 fracture, he has been in a halo vest for 15 weeks but the doctor said the bones have not fused/healed and they think there is tissue growth inbetween the bones and this may require an operation if his

    xrays show that the bones are not "in position" on either side of the tissue.

    would you beable to give me some information on this, and what are the risks of further spinal cord injury with an operation? why did the bone not heal if the 2 broken bits were lined up when the halo vest was fitted? any feedback would be appreciate. thankyou.

  444. Jason says

    I fractured my fibula a week ago. The doctor put me in a temporary cast and said he will put a real cast on in two weeks. I have been in the temporary cast for the last week and the pain continues to get worse. What can I do or take for the pain?

  445. Dr Arun Pal Singh says


    There are three types of grafts osteogenic, osteounductive and osteoconductive.

    Osteogenic grafts carry osteogenic potential. It means they can start osteogenesis on their own. that means they can the formation of bone from their own precursor cells.

    In addition they stimulate the local periosteal precusors to carry out osteoblast formation.

    Osteoinductive graft has ability to induce but cannot form the bone by its precursors.

    Osteoconductive grafts neither carry osteogenesis nor they do osteoinduction. they just provide scaffold over which host cells can affect bone formation.

  446. chethan says

    hi doctor , i met with an accident the both tibia and fibula was broken , this was happened on Aug 12 , doctor has operated with nail , firstly i want to know there is lots of pain in knees and secondly fibula is not operated doctor said its waste bone , after 6 weeks i e 24Sep i took an x ray the tibia bone there is a gap so in how many days able to walk with out support doctor said to leave 50 % weight for next 6 weeks .

  447. Dr Arun Pal Singh says

    @Dana Smith,

    Usually, if a fracture has united, the discomfort from soft tissue would go over time.

    I do not think surgery is an option if fracture has healed and seven months have passed.

  448. Dr Arun Pal Singh says


    Pain relief is a good indicator which needs to be confirmed on xray for fracture healing.

    If your fracture has united there should be no need for surgery.

  449. Dr Arun Pal Singh says

    @Kyle Weis,

    Fracture would take between 6-8 weeks to heal. Add another 2-4 weeks of physiotherapy before you get back to routine life.

    As for as your athletic activities are concerned, they might take more time depending upon your demand.

  450. Dr Arun Pal Singh says


    There are so many known reasons known for causing nonunion but it is very difficult to pin point in a particular person.

    If nonunion is there, the neck would remain unstable and therefore cause persistent symptoms.

    Therefore, it needs to be fixed.

    Please understand that this is general view on the subject and by no means it is any prescription or recommendation in your friend's case.

  451. Dr Arun Pal Singh says


    If your slab [temporary cast] is loose, it would result in motion at fracture site and thus cause pain.

    Please see your doctor if the pain persists.

  452. Dollars says

    Hello Dr. Singh,

    I has a fracture of my left humerous in 2008 and was operated on (using plates and screws). However, the fracture site did not unite. I then went for a bone graft surgery 5 months ago and the callous is till not forming as expected. What can be done to hasten the callous growth as the doctor is suggesting another surgery.

  453. NC says

    I am a 50 yr-old woman with Primary Sjogren's Syndrome who had a spiral fracture of her humerus spanning from just below the shoulder to just above the elbow 11 months ago. It was treated immediately with a hanging cast, and then with a compression brace (no pin, no surgery); the brace was removed more than 6 months ago now.

    I have done basic movement & strengthening therapies now, under the orthopedic PA's orders. I am concerned that the "final" X-rays taken today still show a severe displacement (which has shown all along, since week 2) and only callus growth — after 11 months. The PA (I have never seen an actual orthopedist — I went to Dartmouth Medical Ctr [part of Dartmouth Medical School], and the PA was assigned to me in their ortho dept) says it "looks good" to him and that I was dismissed from care.

    The pain is still intense enough to prevent me from regular use of the arm, any weight-bearing over 5 lbs, and requires painkillers 3x/day. The PA says that pain, and the movement I feel inside the arm (where the displacement moves, whenever I lift or move my arm), is "normal" and should be with me the rest of my life.

    I don't think this is normal, is it? Should my humerus still be without real bone growth (more than callus) after 11 months? Should it be moving inside and still be so painful — for the rest of my life? Is displacement "normal"?

  454. Michelle says

    I fractured my fifth metatarsal dancing Sept. 1, 2011 (comminuted fracture on the base). I have been in a boot air cast since than & right from the start my orthopedic told me I can walk on it as tolerated. I have been walking on it since & after about 3 weeks I have no more pain. I'm wondering if he is correct allowing me to walk on it because 5 have been reading comments from other people saying that their doctors told them they can't walk on it till there is a union. Also since my foot doesn't hurt anymore does that mean that it's healing

  455. JP Escobedo says

    I broke my collarbone in the middle third about 4 weeks ago. I have had a sling on for 4 weeks, no surgery. My shoulder and arm are starting to feel stronger. How long does it take for the clavicle to start healing? If my arm feels good would it be ok to take the sling off? After how many weeks can I start exercising my arm?

  456. Monty says

    Hi I fractured my small finger at the joint 5 months ago

    A cast was placed on my finger for 8 weeks and exercises given, however my finger is still painful and very swollen at the joint, The Dr said he would not reset the joint as it is too small?? However this is painful and I cant grip with this finger still. A physio told me they should off reset it, but probably didnt as it would cost. If I was private I am certain they would have

    Can you advise if this is normal after 5 months to still have such a lump on my joint? and if not what would you suggest

  457. Kathy L Stallings says

    Hay Doc. Back in Feb 26-2011 I feel of my house and broke the hurmuse bone , im 47yr,. and it did not heal

    and frist the Dr. said that he want to a bone graft and now he wants to do something and i need some help

    not understanding the New rhBMP-2 and he want's to try this I want to know about the long threme side effces are I have read so much on this still not understing is this the best I see Its mostly used on the Jaw bone repairs sometime work and sometimes not, Is this the trement you would use, BONE MORPHGENIC

    PROTEIN can you help me still not useing the left arm. need it back PS i did see another Dr. about the bone graft not the other. also a Bone growth stimulator.

    Thank's for the help

  458. Angine says

    i broke my fifth metatarsal on 8/20/11, Dr. did a open reduction on 9/15..wire was used cause the bone was splintered… 3 weeks post op the bone is slow in healing…..I am non weight bearing since 8/21/11 till 12/1/11 and I have been elevating my foot all the time…My questions is, is elevating it stopping the blood flow thus slowing to the bone healing….I forgot to ask the Dr. if I should still be elevating…..I am concerned that elevating is hindering the blood flow. Do you have any insight on this?

    Thank you…Angie

  459. Chris Gutierrez says

    Dear sir, I broke my forearm twenty years ago. Now its beggining to hurt a lot during the the cold months. Why is this?

  460. Kim says

    Hi Dr

    My son has a small buckle fracture in his left distall radius. He fractured it 4 weeks ago. The Dr placed him in a short arm cast. The cast was just removed yesterday and Dr told him to wear a splint for 3-4 weeks. He took another xray and he said it look pretty good. From what I read these fractures typically heal pretty quick (my son just turned 12). My son said his arm feel pretty good. When pushing against an object he did have some pain in the fracture site. Is this normal? Does this mean that it is not completely healed? WHat is the potential for him to reinjur? From everything I read online it seems like there are differences of opinion as to how long to treat these injuries. Is it possible that it is pretty much healed yet there can still ba a little pain at the site? My son wants to try out for a basketball team this weekend. They know he fractured his are and will need to wear the splint. I am just trying to get a guage on the risk that he could injur more

    Thank you!

  461. Dana says


    Hi Doctor. Just to follow up..I received my MRI results and I do not have ligament or nerve damage. The doctor said my 3rd metatarsal had not healed completely. He gave me an orthopedic hard sole shoe and told me to wear it for 3 weeks and then to wear tennis shoes for 3 weeks and I should be fine. It has been a month and I still have pain and discomfort. I originally broke my foot on Feb 21st! Are there any supplements I can take? Or should I use a bone stimulator? Why isnt it healing??

  462. Dr Arun Pal Singh says


    Not hurting can mean healing but needs to be confirmed on xray. Fracture configuration determines whether one can walk or not.

    If your doctor did recommend it, I think he must have done it after evaluation of your case.

    Any xrays taken?

  463. Dr Arun Pal Singh says


    I cannot tell you anything unless I am sure what happened to you.

    Can you provide your xray images [old and latest] and a photograph of your hand.

    Please post your query at Bone And Spine Forum

    You would be able to upload images as well. A registration {free} is required before you could post.

  464. Sandeep says

    Dear Doctor,

    I had a complete fracture of my fore arm bones in Feb 2010 and I underwent an surgery to fix the bones with screws and plates. In Feb 2011 the plates were removed as the fracture was healed completely, after 6weeks from the day the plates were removed I lifted a bi-cycle and had a small hairline fracture again in my ULNA near to the previous fracture location and it took 3 months for healing and the cast was removed in July 2011. My doctor told me that I had a slow rate of bone formation and this was the reason why it took such a long time healing a small hairline crack and he said I will have the screw holes forever in my bones. Is this true? and can you please suggest me, how long do I need to be carefull with the hand and will I have my bones back to the original strength over a period of time? I am planning to go for swimming now, is it advisable?

    Thanks in advance.

  465. Sandy says

    I fell backwards on June 18th 2011 and landed on my right elbow. I have a midshaft transverse humeral fracture. It's been 18 weeks now and I've been seeing the OS at the Fracture Clinic. He isn't keen on doing any surgery and has told me this could take another 12 months to heal. I'm requesting surgery. He has admitted that I have a non-union, but he still feels surgery is too risky for my Radial nerve. I have no use of my right hand or arm, and my arm still wiggles at the fracture site. I am 59 yrs old and do not have osteoporosis. I am taking medication for low Thyroid. Am I pushing too hard for surgery? How do I share my xrays with you?


  466. Dr Arun Pal Singh says

    @Kathy L Stallings,

    That makes it 9 months old fracture now and if it has not healed, it needs bone graft. Please use bone graft from your own body rather than the readymade products.

    Bone stimulator is probably of not much use at this stage.

    If you have xrays, I can comment better. If you have images please ask your query at and you would be able to upload images as well.

  467. Dr Arun Pal Singh says


    No! elevation should not affect the blood flow enough to slow the healing if you are otherwise normal.

    Some people have slow bone healing and that is pretty normal variation. Good thing is that it is healing.

  468. Dr Arun Pal Singh says


    This reply is delayed for your needs and I am sorry about that.

    So did he participate? How is he now?

  469. Chris Gutierrez says

    i had a plate and screws in my fore arm. the pain is really intense that i can't even make a fist. Some days it doesn't hurt but other days its bad.

  470. Sarah NEARY says

    Hi, my daughter 14 14 months old, she fell whilst trying to walk and immediatley started crying she was taken to AE who sent her home, she was taken back and xrayed where she had fractured her right arm mid length. A cast was applied. Visted follow up appointment cast removed, no xrays bar looking at her arm, prior to the cast she could move her arm etc is this normal practice, do not feel 6 DAYS is long enough to heal a FRACTURE not sure what to do next, PLEASE help.

  471. S Neary says

    Hi please can you advise me in relation to my daughter. My daughter is 14months old she has recently fallen and was taken through to A/E who discharged her without xraying, she was taken back and xrayed where she had 2 fractures to her right arm. The arm was put in to a cast. 6 days later follow up appointment and DR removed cast. 6 DAYS does not appear long enough to heal a fracture, spoke with him who stated that she was moving her arm, however pointed out to him she was moving arm prior to the cast put on and that she is receiving pain relief. I am really not happy about the cast being removed, not sure what to do next PLEASE advise.

  472. Lee says

    Hi, I broke my humerus mid section 6 weeks ago and at the 4 week mark I started doing exercises. I have a humerus brace and tensor bandage for forearm (optional at this point). Now, I've been taking the brace off during the day to bath and do exercises and leaving it off during the day. Is this a bad idea? I'm usually sitting down and do minimal walking around. I put it back to sleep and with the tensor.

  473. Dr Arun Pal Singh says


    When plates are removed, it leaves holes in the bone which are called stress rises and could initiate process of fracture following small injury.

    After plate is removed, the limb is generally protected in slab or cast for at least 6 weeks.

    And I always advise to take extra caution to my patients for another 3-6 months.

    The holes will fill in a year or two. Just be cautious with the limb.

    All the best.

  474. Gilbert says

    Hi Dr.

    I was reading your article as being interested in knowing more about bone fracture.

    I had a severe femur fracture, and under gone surgery inserting a rod through all the bone with two screws at the top another two screws on the bottom side of the bone. Doctors were satisfied with surgery and just asked me to give time for recovery and healing.

    It is a little frustrating to know when I can walk again; the x-rays are horrible, the gaps are huge and fracture is scary. Do you think you can have a look at it and estimate a progress time to heal? It is impotant that I know when can I run again.

    Accident was also puzzling; I was playing rugby, and broke it while simply running hard, doctors said that my bone is healthy I shouldn't be worried and I was just unlucky. I can't believe a hard run would break this particular bone. Can I ask for your advice in email? Your response is very much appreciated!

  475. Dr Arun Pal Singh says


    Would you please ask the query at It is our forum and you would be able to upload images as well and It would be easy for me to have a look.

  476. Dr Arun Pal Singh says


    18 weeks is enough time to guess if it would unite or not. And my contention is that if has not shown any sign of union by this time, it probably would not, on its own.

    The next step is surgery for fixation and bone grafting.

    The risk for radial nerve always exists but is avoidable in most of the cases. Discuss it with your doctor and if you feel the need, take another opinion as well.

    P.S. If you post at Bone And Spine Forums, you would be able to upload images as well and I can have a better idea about your ailment. This would also mean the advantage of creating a personal thread where you can always come back for recent doubts and updates.

  477. Gilbert says

    Thank you doctor.

    I have registered as Gilbert in and created and entry 'femur fracture'

    Not sure if you can see it or how to get you to see it.

    I hope I get a feedback from you. If there should be another way to do this, please let me know.


  478. SHEREA MALCOLM says


  479. alice brooks says

    please help with this surgery had surgery for fractured ulna with plate and 8 screws . one end is healing and the other one is not healing it has been since june the 30 any idea why dr . can't seem to know . i really am trying to avoid another surgery thanks

  480. Dr Arun Pal Singh says


    Why MRI? Xray is much better modality. If there is no h/o fresh injury it would be sign of previous injury.

    Healing is a rule in children and if the child has no symptoms, I do not think there is a cause for concern for old injury.

    BTW, Why was an MRI done?

  481. Dr Arun Pal Singh says

    @Chris Gutierrez,

    Please get an xray and consult the specialist near you to see the status of plate and screws.

  482. Dr Arun Pal Singh says

    @Sarah NEARY,

    You are right. Six days is not enough time. Can I see the image.

    Would you please post your query at Bone And Spine Forum

    You would be able to upload images as well. A registration {free} is required before you could post.

  483. Dr Arun Pal Singh says


    If it is being done under the advice of your treating doctor, it could be okay.
    Decisions about your arm should come from him/her not some third person.

  484. Dr Arun Pal Singh says

    @alice brooks,

    I need to see the image.Please post your query at Bone And Spine Forum

    You would be able to upload images as well. A registration {free} is required before you could post.

  485. Sam says

    Hello Doctor,

    I started playing badminton recently after 12 years and I surely overdid it. Now for last 1 and a half week I have pain (really bad pain) just below my knee and above my ankle. I am unable to walk and climb stairs also. There is too much pain and sometimes it is really unbearable. The knee also seems to be unstable. Please help what it can be and how can it be cured. I am having pain killers.



  486. Joyce says

    Goodday Dr.

    I've fractured my femoral shaft 4 consecutive times & dis happened wen i was aged 6-9yrs. I am now 19yrs old. After undergoing several surgeries, i ended up wt bow legs, my left leg is now longer than my right & my left hip is very protruded while my right hip is as straight as a metre rule. Often times i get severe sharp pains in my knees & sometimes in my left hip. Whenever this happens, i find it hard walking. That's not all, i can't walk fast,walk or stand for long, run, carry heavy load or do any form of exercise that requires me putting pressure on my legs. My thighs and legs are always fatigued. I don't limp even though my left leg is longer than my right. I discovered that if i lifted my right leg some few distance from the ground, both hips would be equal. Mind u, my right leg is now shorter & bower than my left. I'm not a doctor but from my own deduction , my right is bower because it touches the ground otherwise i should have a limp. I've been to my doctor but i couldn't get any result.

    I know this is very lengthy but please what do you think because i feel very miserable.

  487. sagar c says

    I met with an accident 5 months( i.e., Aug 2011 ) back and i had a compound fracture of right humerus upper middel 1/3 junction. I have undergone orthopeadic surgury by inplanting a rod on the same day.

    Even after 5 months it is not healed completly. How long does it take heal completly ???

  488. says

    Dear sir,

    My right leg tibia and febula was fractured on 6th of january 2012, doctor did surgery on 10th january 2012, he inserted the long rod and two screws, for febula the kept one plate, pls advise me when can i walk, i want to do my professional job quickly


  489. Dr Arun Pal Singh says


    The best person to answer this is your treating doctor. But generally speaking if your fibula needed fixation, you would need to keep limb off the ground for average 8-12 weeks.

  490. Jenny says

    Hi Dr,

    I fractured my mid spine last week, i was only told that it was a verterbra or something like that, i dont know what to do, i was given pain killers and thats it. I feel as though all my pain has gone to my right side of my back and going down my side. I also experience like a nerve or vein pulling in my left temple area and ive also been feeling really light headed and just been making silly mistakes in anything i do now. Do you think this is related to the fall i had that caused the fracture or something else and also i dont know which side to sleep on or how to sit etc. im sorry i know this alot but please can you help me.

  491. Jenny says

    Oh and i forgot to mention the doctors said that my rib cage was keeping the fracture stable so im lucky? And how long will it take till i can move around however i want or in other words when will my back fully heal. Thank you so much.


  492. PANKAJ says

    My mother is 67 yr old , she slipt in bathroom , she is suffring from back pain we got X – ray one dr. asked to admit my mother for 7 days in his hospital, he said there is fracture in backbone . But i m not bleaving because my mother is walking with some suppport.Pls tell is this possible to walk with some fracture in backbone.

  493. Rishabh says

    Hi sir my mother got humorous fracture in the month of november2010 and she got operated and a shaft is fixed but no calcus formation after three months of operation when we taken out the xray. then we went for auyurvedic medicine for six month then again we have taken out x ray then only 5 % of calcus growth has seen affter that now i have taken a x ray what it showing i m not able to understand so kind tell what is the position after seeing the xray so how should i must post the xray to u pls reply asap

  494. Dr Arun Pal Singh says


    Not to trust a qualified opinion based on prefixed assumptions may be counterproductive.

    You must take another opinion and confirm.

  495. sanjana says

    sir, i fell from the scooter 6 months ago and suffered lateral tibial plateu fracture with depression around 4 mm.. also had lcl injury ..did not have any surgery. also had a history of pcl injury 4 yrs ago..i m not able to bend knee more than 90deg ;; also have pain and swelling,almost been on bed for past 6 months.. how long does healing take?. and wat shud i do to recover fast?

  496. trimod says


    my father had an accident 2 months ago against a truck in eastern ghats.

    The accident lead to a seviour fracture in leg and rod has been inserted .

    Bt 2 months had passed bt there is nt even a single percent in relief frm pain..

    HE IS A SUGAR PATIENT and its becomin vry tough fr him to control d pain..

    Lukng at d other posts i thnk u wuld be needed to luk at d xrays n al.. Bt problem is im stayin in hostel n preparng fr forth comng entrance so even i had nt met my dad. Since i am nt in hom so i cnt send u ny xray.

    Sir u pls jus

    Say dat accordng to u isnt it unhealthy to listen 2 months passed n no betterment..

    Can u estimate if everythng is alryte in leg den atleast hw many months it wl tak to recover…

  497. Helen Theng says

    hi Dr Arun. nice to meet you! My dad fell down when he is working on friday which is few days ago. From the x-ray, we found that the T-12 and L-2 fracture. So, doctor in charge recommends putting screws on the T-12 and L-2 (5-6 screws are needed).The recovery will be much faster compared to letting the bone healing on its own. What i concern is the long term side effects after putting the screws? i was informed that he can't bent down his back after that. may i know to what extend he can't bend his neck? Will he feel pain or whatever after that? how long will he take for full recovery?

  498. TY says

    what do you think about playing badminton 2 and a half months after breaking my wrist(just above my wrist)? is it a bad idea?

  499. Dr Arun Pal Singh says


    That would depend on your injury and how it has behaved. Follow what your treating says.

  500. Dr Arun Pal Singh says


    Sorry for the delay in replying. There is a lot of information that you are trying to squeeze in few sentences and I am not able to make much.

    Would you please elaborate. Never mind the length.

  501. Dr Arun Pal Singh says

    @sagar c,

    Can I see your xrays. If it has not united by now it should most likely be non union.

  502. Jigar patel says

    sir i have fractured my fifth metacarpal of right hand. My doctor has applied a plaster/case. Will there be any problem in healing? Is perfomance of normal movement possible after healing?

  503. Dr Arun Pal Singh says


    I do not think my answer would be relevant. It is phenomenally delayed. And I apologize for the delay.

    How are things?

  504. Dr Arun Pal Singh says


    I think you need to work on physiotherapy of your knee. Get in touch with your doctor and follow the advice please.

  505. Dr Arun Pal Singh says


    It is an unsual thing have the same quantity of pain even after two months following fracture.

    Please discuss with your doctor and ask the questions so that you get better answers.

  506. Dr Arun Pal Singh says

    @Helen Theng,

    There is no relation between the T12-L2 surgery and neck movements. Moreover even the bending of lower back would not affect the daily routine.

    Recovery may take from 3-6 months.

  507. Dr Arun Pal Singh says

    @Jigar patel,

    I do not have the required info to answer the query. Please ask the qustions to your treating doctor.

  508. Naushad Rattansi says

    Dear Dr. Arun,

    Please assist me, my mother is 90 years old. She fell down one early morning, after having a black out and fractured her right neck of femur. She was adimitted in hospital, whereby it was confirmed fractured of right neck of femur, in different positions AP, Lateral, Oblique view. The orthopaedic surgeon with a team of physician counselled us that the risk of ORIF with aritificial head of femur in her case outweighs the outcome intra operation and post op. She was transfused 3 units of blood. Skin traction was not recommended as she was vulnarable to skin ischaemic changes, Due to severe pains she is on tramadol 100 mg TDS daily, Fessolate 1 twice daily and amlodopine 2.5 mg daily. She got discharged and we are nursing her at home. I observed that the right thigh is swollen and tender, the right lower limb is shorten and deviates lateraly, Mobilising her on bed is very painful. My family is so worried and very concerned about her malnourished state as she is not feeding well, she is always drowsy, her oral cavity is always dry with aphtous ulcers. She get confusions sort of atherosclerotic changes which were not there prior fracture. Please let us know how can we mobiles her on bed, with less pains? will the fracture heel on itself? will she be able to walk agian? why is she not feeding well like before? what can we do to avoid pressure sore on her back and the right ankle joint (calcanoues area). We are so worried as she is very much attached to us, as all mothers do to their children.

    Thankyou for your time Doctor


  509. shaurya misra says

    hey dr

    im a 18 yr old girl and recently fractured my malleous bone. my cast will be coming off next week on the 19th. (after 2 and a half weeks of pop and 1 and a half week of having the plank) before this plaster, a dr had applied the wrong plaster as he hadnt placed my leg at 90 degrees to my ankle, which lasted for 2 weeks. will this effect the healing now.?

    and what sort of precautions and care can i take after the cast has been removed.

    i will be attending college soon and would like to know when i can return to my normal routine. also, is there a chance of this injury causing trouble later on?

    pls reply. thanking you.

  510. says

    Dear Bone and Spine,

    I broke my fibia and tibia badly about ten days ago. They are now neatly realigned with rod and bolts from knee to ankle. About six days ago I noticed a pale brown blister under the lower bandage. A locum hospital doctor diagnosed that the wound was infected and prescribed penicillin. The nurse who re-dressed my leg after completely removing the previous dressing said that the wound was not infected and that it was a fracture blister. Two days later I went to my GP to check progress. He thought it was a blood blister as it had gone dark red. Yesterday I went to the fracture clinic. The Consultant had a look as it had gone flat and dark green. He said no worries it is a fracture blister. It will just go dark and drop off. It is on shin over where the fracture was. His registrar said there may be some green gunk. I am finishing off the course of antibiotics. Is there anything I should look out for just in case?

  511. Dr Arun Pal Singh says


    A blister after 10 days should not be much of concern. How are you now?

  512. William says

    I'm a 68 year old male who had a mid-shaft displaced fracture of the left humerus 2 years ago. First treated with a gravity type brace for 2 months, followed by a surgery to place a compression plate to fix a poor union. Well, now I feel a fair amount of discomfort from the hardware and am trying to decide if I should ask my surgeon to pull it all out. What are my options and my odds for such a revision compared to living with the discomfort for however many years I might survive?

  513. Dr Arun Pal Singh says


    If the implant is causing a trouble it should be removed. You would need to protect your arm in a splint for about six weeks following plate removal

    Take care.

  514. Gilbert Haydamous says


    I have posted a comment earlier last year when I had a femur fracture, I had a surgery and inserted an IM rod into my femur with two screws at the top by my hip and two at the bottom by knee. The fracture was a clean break, almost in the middle of the femur. the bone was split apart.

    today, after one year, the bone has shown significant healing, and I am back running and working out. Of course the muscles on the left leg, with the fractured bone is still weaker, but my workout performance is gradually increasing. The last time I checked my bone with the doctors, they asked me not to follow up on it anymore, because it has reached a significant stage in healing.

    Two questions I wonder about, where I can't find firm answers for:

    considering that the doctors were not able to find the reason why I broke my femur – (I was playing rugby, but was not in any contact, I was simply running hard, and the bone just broke while running) – density of the bone was checked and examination under my surgery were made, nothing was observed, the doctors said that I was just unlucky in a high energy sports. Is this something I shouldn't worry about if I want to continue playing?

    Another thing is, Can I play again with IM rod inserted? I was not able to see if players still play with IM rods inserted, specifically high energy sports. In spring 2013, season starts again, if I keep the progress I have now, I think I am fit again to play. But the question is, are there risks playing again? can someone play again with IM rod inserted? what are the risks?

    Notes, age 28, athletic, intensly enganged in sports.

  515. apsingh1975 says

    Theoretically, once the bone heals, the road is not bearing any weight. As one year has passed, the bone must have remodeled too. It would take some more time to reach its original strength.

    The physical activity should not be much of concern as long as hardware itself is not causing problems So physical activity should not be a concern.

  516. Gilbert says

    Femur Fracture,
    I have posted here earlier in late 2011, I had a broken femur, and had a surgery, inserted IM rod in my femur with two screws by the hip and two by my knee. few months later I removed one screw at the bottom, the other one got stuck. Anyway, I have done good progress working out back again, and the leg seems to get back in good shape although slightly different than the other leg, but performance wise at the gym I am going just well.

    The question is, I was not able to get more information on whether I can do extreme sports again with the rod in the bone. doctors don’t give me convincing answers. They say I can, but I might have to tolerate some pain, otherwise it is okay to play again with the IM rod in the bone. What are the risks to start playing rugby again? and any precautions required?

    Appreciate your input on this.

    Thanks and regards

  517. Katherine says

    My 6 year old fracture his nose his distal bone is lightly depress is only been 3 days sence it happen should we do the surgery that it may or may not work he is 6 and is very hipper.

  518. Decy says

    I have a fibula fracture. At first, the crack was just like hairline. after 1 month, that crack gone worse. After 6 weeks, there is no sign that the bone is growing. I’m bothered. I felt something on the fractured area. Can any one tell me how will I know if the bone is growing aside from looking at the xray? Is there any feeling inside the fractured part.

  519. Lauren says

    I broke my left humerus sept. 13th and had an ORIF surgery done on Sept 16th. I have a plate with 20 screws. Subsequently the radial nerve was bruised and I have radial palsy. Nerve seems to be coming back where I can lift my wrist now and couldn’t before. I can lift my fingers too, but thumb still hurts the most. I do get a neuropathy from time to time where my hand feels like its on fire. Will these neuropathies ever go away and when will the feeling in my arm come back? Also I think I feel my plate in my arm is that normal? I am on week 10 and will need a cat scan done to see if it is fusing soon. Do you think it is? If it doesn’t fuse would I need further surgeries? (God I hope not). Also will I ever be back to 100 percent where I can do normal things like clothe myself, open things, shower, do my own hair, go back to vet teching? When will I be back to normal? Will I ever have to take out this plate? I only do gentle exercises at home. My ortho wanted me to wait till my bones were fused to start real PT. It just worries me and all I do is think. Please help.

  520. says

    My son is 12 years old. He broke his right fore arm for the 3rd time while playing. During the 1st and 2nd time, his hand healed after 1 month with plaster only. But when the cast was removed after the 3rd time, his hand looks 25 degrees bent. Please tell me what to do ?

  521. Arun Pal Singh says


    In your case, first outcome goal of surgery is fracture union. If fracture does not unite, then other measures may be introduced, one of which is resurgery. Second goal is to achieve the motion of all the joints so that limb can function normally. That is done by physical therapy which would be started when your treating doctor deems it suitable. Wen those motions and controls return you would be able to function like before.

    You say that your nerve functions are improving. That is a very good sign and other sensations you mention might vanish with time as nerve regains its function.

    How did CAT Scan go. Let me know how are you making a progress. You can also stay in touch at

  522. Imran says

    Hello Lauren, I am no doctor but I broke my right upper humerus 4 years ago, it was a clean break. They offered me surgery route I chose to not take it and so they put me in a humerous brace, fortunately for me my bones showed fusing within the first 5 weeks and from then on it goes from strength to strength, as for movement that comes with time and excercise, I can’t see why you can it make a full recovery if I did. Good luck

  523. Lauren says

    Just wanted to let you know I went to your Facebook page and sent you a Facebook message with CT results and questions. Hope to hear from you ASAP. Thanks so much!


    It is Lauren from your bone and spine website. I received your e-mail to contact here. Just a reminder I broke my left humerus in 5 places and was plated with 20 screws or more. I am 3 months in from my ORIF surgery. I have radial palsy but wrist motion is coming back. I finally received a cat scan yesterday, but my ortho is on vacation so he won’t tell me what is going on till Monday. I do have the results in medical jargon so maybe you can tell me what you think. Unfortunately I do not have the cat scan pictures. It goes as follows.

    CT-Left arm w/o con

    History: Status post internal fixation of a humeral fracture.

    Technique: CT of the left was performed using a volume acquisition acquired at 0.6 mm slice thickness. Coronal, sagittal, and axial reformatted images were created in both bone and soft tissue algorithms. This study was performed using automatic exposure control (radiate dose reduction software) to obtain a diagnostic image quality scan with patient does as low as reasonably achievable. The administered radiation dose was 15.76 mSv.

    Findings: Bone are normally mineralized without focal osseous lesion.

    Patient status post internal fixation of a comminuted fracture along the junction go the mid and distal humeral shafts. Fracture is traversed by lateral side plate with numerous screws. Interfragmentary screw is also seen separate from the side plate. There is no evidence of hardware fracture or loosening.

    Comminuted fracture line persists along the humeral shaft with a separate butterfly fragment medially, series 5 and 6 image 29 measure 6 cm in length. There is no internal fixation of this fragment which demonstrates a small region of bony bridging to the remainder of the humerus for approximately, series 507 image 106. Minimal early callus formation is seen along the remainder if the fractures as well without or bony bridging. Alignment of the fracture is unremarkable.

    The remainder of the humerus is unremarkable

    Limited evaluation of the shoulder and elbow are unremarkable

    The unenhanced musculature is normal in appearance


    Status post internal fixation of a comminuted humeral shaft fracture. There is no hardware fracture or loosening. A separate butterfly fragment from the medial cortex does not demonstrate post surgical fixation and there is only minimal bony bridging at the superior margin of this fragment. Early immature bridging is seen at the remainder of the fracture. Alignment is unremarkable.

    My questions include: Is this normal for a bad fracture at 3 months in? How long do you think it will take me to heal? Will I need another surgery especially with the butterfly fragment? And if I need another surgery isn’t that risking all my improvements especially with radial nerve palsy? I do feel clicking in my arm when I move it, Could it be that butterfly fragment? It took three months for minimal healing, does bone healing have a pattern that it will be super slow or in 6 months could I see vast improvement? When do you think I can start PT? Do you think an electric bone stimulator will help my case and speed up the healing process? My arm can almost fully extend just short of 30 degrees. Do you think I will ever have full extension? When will I be more independent e,g,: putting up my own hair? How long until the numbness goes away? My husband wants to go on a cruise on april 4th, do you think this is realistic with my bad break? I can’t do excursions with this arm like this. I am having a hard time seeing a light at the end of the tunnel. But at least I am finally accepting my predicament.

    Thank you so so much for taking your time out to read this and answer my questions, I am looking forward to hearing from you as soon as you open this.

  524. Arun Pal Singh says

    Hi Lauren,

    There are many a questions which form part of your treatment and I would be unable to comment on them. I will try to answer others as much as possible.

    First CT report: Your Ct does suggest attempt at union, both by main fragments and the butterfly. But because quantification is not there, it is difficult to gauge how much progress is there. Fractures fixed by plating do not form much callus and do not get worried by the fact that there is not much callus thrown. The report mentions bridging and and it is a good sign. Your doctor, after looking at the images along with report would be able to tell you better.
    Now let us come to your questions

    1. Is this normal for a bad fracture at 3 months in?

    Every person heals at a different rate, and in your case, I frankly cannot gauge how much union has progressed. But the attempt is present and we should further wait.

    2. How long do you think it will take me to heal?

    Again, not predictable. Course of the process cannot be drawn but I have seen people taking as long as 6 months.

    3. Will I need another surgery especially with the butterfly fragment?

    Forget about butterfly. If your main fragments, those which are fixed, unite, butterfly will oblige in due course.

    4. And if I need another surgery isn’t that risking all my improvements especially with radial nerve palsy?

    Every surgery carries the risk in one form or another but at this moment, you should not think about other surgery.

    5. I do feel clicking in my arm when I move it, Could it be that butterfly fragment?

    Fixed fragments do not move and you do not have any hardware failure as per your report, so it is unlikely from bone.

    6. It took three months for minimal healing, does bone healing have a pattern that it will be super slow or in 6 months could I see vast improvement?

    Even if it is slow union, if the bone continues to unite, your fracture will unite, albeit it would take longer time.

    7. When do you think I can start PT?

    You would need to ask your doctor for that.

    8.Do you think an electric bone stimulator will help my case and speed up the healing process?

    Electric bone stimulator has been shown to improve the outcome in some studies though it is found more effective in superficial bones like tibia. You need to ask your doctor for your case.

    9. My arm can almost fully extend just short of 30 degrees. Do you think I will ever have full extension?

    Most likely you should improve with PT

    10. When will I be more independent e,g,: putting up my own hair? How long until the numbness goes away?

    Your doctor would be able to guide you better though second question is difficult to answer.

    11. My husband wants to go on a cruise on April 4th, do you think this is realistic with my bad break?

    As of now there are restrictions of activities with your involved arm. Consult your doctor before taking the decision.

    Take care,
    Arun Pal Singh

  525. Rachael says

    Your site is incredibly helpful! Thanks in advance for help w/an issue.

    I have a few questions about a 5th metatarsal Jones Fracture I obtained in a fall December 3.

    Dec 3, went to ER, X-ray confirmed break- 5th metatarsal, referred to ortho.

    Dec 8, ortho said I could walk out of office in aircast, despite significant pain w/any weight bearing. Nurse told me to ‘wean into boot.’ Continued pain, inability to weight bear.

    Dec 12, 2nd opinion w/new ortho diagnosed ‘jones fracture’ was offered surgery, opted to try & let it heal naturally.

    Dec 30, all had been going well, kept it in splint at home/aircast when out, no pain. Was getting out of bed and put pressure on top of foot, above toes, trying to scoot to the edge of the bed, felt a pop directly in the break area, and pain that has gradually lessened but not back to no pain at all.

    Jan 2nd, doctor said I hadn’t rebroken it as I had worried, that it was showing signs of healing, but could give me no estimate of how much longer I would have to be non weight bearing. Said that he had treated patient with similar injury and healing and it was six months till weight bearing. Said he had another that had to get surgury after six months and nonunion. Said if I got surgery to put screw in I could start weight bearing in six weeks. Said that after healing was complete in 6-12 monthes he would likely have to take screw back out because it often bothered patients bc of location. I opted for surgery because the non weight bearing situation has been difficult and he could make no prediction of how much longer it would take to heal enough to bear weight. I have surgery scheduled
    In two days and am now
    Second guessing my opting for it. I am 35, nonsmoker, no significant health issues other than weight- 230lb female.

    Do you have any experience with Jones fracture and the procedure? Trying to make the best choice and wondering if I should delay the surgery to see if it can heal w/out screw… Concerned about liklihood of rebreaking it, slow healing and inability
    To weight bear w/out surgery. Any advice
    Or details much appriciated!

  526. Arun Pal Singh says


    One of the most important thing that we see when a fracture occurs is displacement – or how far the fracture fragments have moved. It is most important factor for treatment decision in most of the regions of bone, followed by patient age and patient’s demands.

    So naturally that is the first thing required, essentially, before I could aanswer is – how displaced is your fracture?

    Other things –

    You have been treated very well with non operative treatment and your discomfort is reducing, as I guess from your writing. If it is not improving, we need to have a look at your fresh xray to find whether there is radiological sign of union or not.

    Most of these fractures heal within 6 to 8 weeks. Mostly! Few may continue till more as your doctor suggested. But from that example you should not deduct that worst case scenario would apply to you. Every person is different and each person for similar fracture would behave differently.

    Surgery may enable early mobilization but it is a procedure and not without the risks. So one should go for it when it medically becomes required and not under the influence of life or work pressures, though these are important factors.

    Your injury is more than one month old now and there are signs of healing. Now this is important! Your body is attempting to heal the fracture. Have you discussed with your doctor if there is effective healing. Because if there is, you just need to weight.

    Yes! it cannot be gauged how long one takes to heal and return to weight bearing but most of my patients do that within 8 weeks. Many take longer, much longer.

    I have not seen your case or xray. So I am talking in general terms. If a fracture is not displaced and is healing, one might want to continue non operative option.

    If you are confused, you might consider a third independent opinion from a specialist because nothing replaces the doctor in person.

    All the best

  527. Avinash Anthony says

    Hi Doctor,

    I’m 26, M, I had met with an accident on 14th Dec, On 15 dec the surgery morning the surgery was completed, skin had healed within 7 days and the skin staples were removed, and the doctors were expecting the bones to be healed in weeks, its been a month now and in the X-ray there so no heal at the i had few hairline as well which shows healed, but the broken bone is still not healed, now i’ve been asked to have Union Tablet thrice a day.

    I’m really concerned and want to get back on track as this has happened at a very crucial stage of my carrier, i was supposed flying next month abroad, now the time has come that i’m sitting from dec 15th onwards.

    I’ve fractor at right hand lower 1/3 radius and same with left hand, i had complete dislocation at left hand and mild at right hand , which is fine now,

    I don’t have much pain, by looking at the Xray i stopped moved my hand and my wrist strated paining.

    Now i really not able to understand how long would it take to heal as its already been 4 weeks now.

    Please help.

  528. Zach says

    On Christmas Eve I had an ankle inversion and felt pain in my foot. Got an x ray which was clean, but due to where the pain and bruising was (initial bruising was right below where the paroneal tendon meets the tuberosity) a 5th metatarsal avulsion fracture on my right foot was diagnosed. I currently can walk in the boot with no pain and can also poke the fracture site without any pain. However, if I hold my left and right foot together the tuberosity on my right foot seems to protrude more noticeably than the tuberosity on my left foot. However, if I set both my feet down on a flat surface then there becomes no noticeable difference in my feet. I have a doctor’s appointment in a couple weeks, but this has been worrying me, so I’m just curious if this is normal? Am I maybe just able to visibly see the callus, due to the skin being right on top of the bone in that area? Or is it more likely that it’s something serious? Thank you in advance.

  529. jayanta kr. bhattacharyya says

    Dear doctor,
    I met an accident and fractured occurred in right leg on 29th Dec 2014. As per the X ray report it is “fracture lateral malleolus right(closed) with fracture 2nd and 3rd metatarsal(closed)”.

    Initially,the doctor thought for surgery for ankle injury but another senior Orthopedic surgeon of the same hospital after examining the X ray plate, put a POP BACK Slab for 15 days and as per his version chance of displacement was there. On 13th Jan 2015, another X ray was done and the doctor surgeon wrote in the prescription ” X ray shows good alignment, no displacement”. On the same day synthetic casting was put in place of POP Back slab and I have been told to meet him after one month. I was allowed to walk with two elbow supported crutches without giving any load to the right leg.

    Now I am off from my office since more than one month.Although I am obeying all the instructions given by the doctor, i am feeling some pain on the ankle fracture occasionally. Pain is like needle pushing and some sorts of inflammation but tolerable. No swelling is there at present.Rarely I feel tolerable pain on metatarsal fractures.

    Is this pain normal ? Can I join my office using crutches now ? when i can walk on my feet? How many days it will take further to drive car ? Please note that I am now 49yrs, wt-74kgs normal built, no BP and diabetes.

    Eagerly waiting for your observation, doctor,

    Jayanta Kr. Bhattacharyya

  530. Arun Pal Singh says

    On average, bone union takes about 6-8 weeks. Add two weeks for further physiotherapy and mobilization to make your foot functional for non demanding jobs. Pain could be normal. Worrisome pain is which is not relieved and persists in spite of medication. For specific instructions like weight bearing you would need to ask your treating doctor.

    You cna join your office if it suits you and your employer.

  531. Arun Pal Singh says


    It is difficult to say if it is something serious because what you might be looking at should be just a swelling and not any bony deformity. If you have that, it should not go away in any position. You should see your doctor or get an xray done if there is displacement.

  532. Arun Pal Singh says

    Avinash Anthony,
    Average time for fracture union is about 6-8 weeks but may take as long as 6 months because some people just heal slowly. You should give your injury more time.

  533. jayanta kr. bhattacharyya says

    Thanks a lot doctor for your valuable reply.I have a question in my mind that is whether displacement can occur after 3 weeks or more after fracture. In my case stated earlier today although X ray after 2 weeks showed no displacement, can it be displaced afterwards under synthetic cast ?

    I have taken paracetamol tablet of 1gm thrice daily for only five days after fracture, Now, my doctor suggested a calcium based medicine for one month. Should I take any paracetamol for tolerable pain >

    Please opine me.

    Jayanta Kr. Bhattacharyya

  534. jayanta kr. bhattacharyya says

    Dear doctor,
    I am really grateful for your valuable comments. I have a few more queries on it.

    Firstly, I have taken paracetamol tab of 1gm thrice daily for just 5 days after the fracture occurred, as prescribed by the treating doctor. Now I am taking a calcium based medicine as prescribed. Should I take paracetamol for occasional tolerable pain ?

    I am using two elbow crutches for walking inside home and not giving any wt. on right leg. Is there any chance for displacement at the ankle fracture now ? I am asking it because initially there was a chance for displacement there which found ok after 15 days of the accident in X ray.

    Is there any medicine or method to reduce itching inside the cast?

    Please give your valuable opinion.

    Jayanta Kr.Bhattacharyya

  535. says

    Hi, can you help me out? Last january31 i broke my forearm (both the ulna and the radius) while playing basketball, cause someone bumped me while doing a lay-up. My question is, can I still play with the plates and screws still inside my arm? Please answer :)

  536. Lucy says

    I am a 58 year old woman with osteopenia. I had a two part proximal humerus fracture with significant displacement & significant comminution 12 weeks ago that was repaired with ORIF. The x-rays right after surgery show a 1mm gap of the medial calcar. At my 12 week xrays I can still see the two pieces of bone, although the sharp edges look a little rounder & the area is a little foggy, which must be the callus. How long should it take for those two pieces of bone to look like one on an xray? Does the fact that I still see two pieces of bone at 12 weeks mean I am healing slowly? Is this delayed healing?

  537. Arun Pal Singh says

    The radiological signs of union are evident as early as 4 weeks and may take up to 6 months too. In your case union is progressing and as I have not seen the xray, I cannot comment whether it has united or is still in the process. Sometimes, the fragments unite but the lines that separate them may remain visible for a very long time.

    Whatever the case may be, it is good sign that process of union is there. Rest is matter of time. However, you must confirm with your doctor too.

  538. Arun Pal Singh says


    Chances of displacement reduce with time. A periodic xray would help. How are you now?

  539. Dale H says

    Hi Dr, I broke my arm on the 8th Jan this year and went to get my cast off yesterday which was 6 weeks after the surgery where plates and screws were fitted to my ulna. It was a complete break about 1 3rd down from my wrist on my left ulna. The Dr told me that in the new X-ray there is still a void so there is still some healing to do but didn’t say how long. I am 27 and a healthy guy so no idea as to why it still hasn’t healed. He prescribed me physio and then told me to come back in 6 weeks for a another X-ray. Is this normal? How much longer will it take do you have any idea?Can you still use the arm even though its still broke? I want to get back to work as soon as possible and also start training in the gym but so worried about doing myself even more injury and prolonging the recovery? Any help and guidance would be much appreciated as my Dr was to be honest rubbish.

  540. Arun Pal Singh says

    Dale H,

    There are many a factors which can be responsible for slow union and it is not always possible to pinpoint the reason in every case. As you suggest, just six weeks have passed and you have been put on physio. A fracture can take anywhere between 6 weeks to 6 months in a normal healthy subject. A lot also depend on the injury and type of fracture, whether it was open or closed and other things.

    Your doctor would have advised you regarding the use of arm. In general, you should not use your limb for heavy works unless it unites and becomes strong. So gym is out of equation. You can use for activities of daily living too. For answering specific question, I would require to look at your xray, if feasible. I hope that helps.

    Take care.

  541. Natasha says

    HI, I am a 40 year old female. I am an avid athlete. I slipped hard on ice and fell on my left shoulder and fractured my proximal humerus. Clean break, no surgery just a heavy duty sling. It has been a week and in 3 weeks more x-rays to determine if it is healing. Doc said in 6 weeks from injury, I can go without sling and start PT, and in 3 weeks I will begin pendulum exercises. When do you think I can run easy? Obviously I will not now but maybe at 6 weeks? or 5? what are your thoughts. I am eager to get back at it but will of course allow it to heal sufficiently. Please advise your thoughts and experience with this type of injury in athletes. Thanks very much!!

  542. Linda Teh says

    Dear Dr Arun,
    Hi! I have a 5th Metatarsal fracture. After 8 weeks, and an x-ray check, my Dr. said soft callus has formed. He said to walk as normal (using normal shoes, w/o the boot or crutches), but expect some swelling. I am now into my 10th week, but my foot is still swelling badly. Within 1-2 mins each time after I start walking, the foot swells to the extent the toes can’t touch the floor, and I have to resort to using the crutch again. I feel twitch pains, and muscular aches on the foot and above the ankle. Is this swelling normal. I am concerned that the more I walk, I am causing injury to my leg. Look forward to your advice. Thanks.

  543. John says

    Hi Dr I’m 35 and had an x-Ray recently and discovered that I have broke my back at some point and it has healed itself, I’ve just been sent for a mri, and was wondering can the mri tell me when I did it as I have an idea, or how long would it of taken for the repair of my lower vertebra to repair its self, I recently sneezed and it put me in bed for 3 days due to pain I’ve never had before and don’t want again, this is how the x-Ray came about???

  544. Arun Pal Singh says

    Breaking a bone requires tremendous energy and at your age a compressed vertebra without any previous history of significant trauma raises the concern about any underlying pathology. MRI is the best choice for that. I hope that helps.

  545. Arun Pal Singh says

    Swelling may persist for some time after fracture has healed. If fracture has healed, walking should not cause further harm. It may be inconvenient for some time but gradually it would become better. This fracture is known for not uniting, so make sure it is united before you use your limb. Discuss it with your doc.

  546. Arun Pal Singh says

    Let the fracture unite and I do not think it should affect your running. You need to start gradually though and be cautious enough not to trip. In usual course it would take 6-8 weeks before you could start. How are you doing?