Different Types of Fractures and Patterns

Last Updated on March 2, 2025

Fractures occur when bones break due to energy applied to them in excess of what these can sustain. There could be different types of fractures depending on the site and severity of the injury, the type of force that acted on bone, and the involvement of surrounding tissues.

There are multiple ways to list the types of fractures. The classification of fractures not only helps to suggest the severity and mechanics of the injury that occurred but also helps to formulate the most suitable treatment.

There are many types of fracture classifications and often more than one for a given region of fracture.

In this article, we will stick to the basic definition of fracture and the general classification of fractures that could be applied across all the regions.

Different Types of Fractures Based on Breaking Patterns

Different types of fractures which are based on breaking patterns are

Transverse Fracture

A fracture in which the break is across the bone, at a right angle to the long axis of the bone.

Oblique Fracture

In this fracture, instead of the break being at the right angle, it goes oblique to the long axis of the bone. The fracture is confined to one plane. In other words, the bone has broken at an angle.

Spiral Fracture

This fracture is easily confused with the oblique fracture. Instead of a straight break as in an oblique fracture that is only in one plane, the break, in this case, traverses both planes. To understand this you need to imagine a three-dimensional view of the bone.

If you take a stick and slice it at an angle to divide it into two, it is similar to the oblique fracture. But if you twist and break that stick it would result in a broken pattern that would start from one point, move obliquely in one direction, reach the other end, and then continue on another side of the stick in a spiral fashion to meet the original point.

Comminuted Fracture

If the injury results in multiple breaks in the bone, they are visible as different fragments. These kinds of fractures are called comminuted fractures.

Segmental Fracture

It is a type of comminuted fracture only.

The bone is fractured at two distinct levels. The reduction of this fracture is difficult and nonunion common as seen in the following x-ray. Segmental fracture is defined as a comminuted fracture where one fragment retains the complete cortex of the bone.

Impacted Fracture

This is a fracture in which the ends are driven into each other. Cancellous bone is typically involved, and union often occurs rapidly. A torus fracture or buckle fracture is a pediatric impaction fracture in which the cortex of long bone buckles, with no loss of cortices.

Compression Fracture

This occurs in the cancellous bone when an excessive axial load compresses the bone beyond its limits. It typically occurs in the vertebral bodies.

The type of compression fracture where the force depresses the fracture segment below the level of the surrounding bone is called a depressed fracture. it is seen in cancellous bones like the upper end tibia, the distal end of the radius.

Displaced Fractures

Depending on the displacement of fragments, there can be two types of fractures – displaced or undisplaced.

If bone fragments stay together maintaining structural alignment of the bone, it is called an undisplaced fracture. A hairline fracture is an example of an undisplaced fracture.  However, the fragments of the bone may move from their original position resulting in the separation of the fragments. Such a fracture is called a displaced fracture.

Incomplete Fractures – Torus and Greenstick Fractures

An incomplete fracture is one where the fracture has not involved the bony cortex on all sides. Torus fractures and greenstick fractures are examples of incomplete fractures.

Incomplete types of fractures are often seen in injuries in children. These type of fractures occur in children as their bones are more plaint than adults and the periosteum is thick.

In torus fracture, which is also called buckle fracture, there is an axial force that causes compression of the cortex and the periosteum buckle.

Greenstick fracture is named so as the bone breaks like a greenstick. One coretex bends and the other breaks.

Complicated Fracture

Complicated fractures are those in which there is significant soft tissue damage to major nearby structures (nerves, vessels, ligaments, and muscles).

There is minimal soft tissue damage.

There is always an amount of trauma to the surrounding soft tissue whenever a fracture occurs. The bone cannot break in isolation. The energy is dissipated to the soft tissue as well.

But the fracture becomes complicated only when there is significant trauma to the soft tissue that may alter the course of the treatment or prognosis of the injury.

Intraarticular fractures

Intraarticular fractures are those in which the fracture line extends into the joint space. Extraarticular fractures are those in which the fracture line does not enter the joint space. Intrarticular fractures typically involve fractures of the joint cartilage.

Open Fractures

A closed fracture is one in which the skin or other soft tissue envelope overlying the fracture site is intact. There is no wound that connects or potentially connects to the fracture.

A fracture that communicates with the external wound is called an open fracture. The fracture thus is not closed anymore but is open to the external environment.

In some injuries like pelvic injuries, if an internal visceral wound is present that communicates with the fracture, the fracture is also an open fracture [open from within].

Examples of open fractures are – When a bone fragment from within breaks out through the skin or when some outside force penetrates both the skin and bone.

Open fractures are surgical emergencies, and most require operative treatment.

[Read more on Open Fractures]

Osteoporotic Fractures

Most of the fractures are caused by significant trauma. However, there are types of fractures caused by insignificant trauma. There may be several reasons for this.

Fractures resulting from trivial trauma because the bone is weak, are called insufficiency fractures.

Osteoporosis is an age-related loss of bone mineral and microarchitectural change in the bone. As bone weakens, a trivial trauma can result in fractures. A simple fall in old age may result in fractures of the hip region whereas the same injury in young persons will just result in soft tissue injury.

Such fractures that occur in the osteoporotic skeleton are popularly also called osteoporotic fractures. Fractures of the hip, distal radius, and upper humerus are examples of osteoporotic fractures.

Pathological fractures

Pathological fractures are types of fractures that occur when a bone is weakened by a disease such as infection, malignancy, or lack of nutrition. Spontaneous fractures occur when the bone is so weakened that fracture may occur even by forces of daily use e.g., lifting of hand or simple movements of walking. This generally occurs when the disease is quite advanced.

Stress fractures

Types of fractures that occur with repetitive exposure of the normal bone to the forces to which it is not accustomed are called stress fractures. An example of this would be sudden jogging for a long distance without training.

A point to note is that bone is otherwise normal in these cases i.e. not weakened by any pathology. Stress fractures are common in athletes, gymnasts, dancers, etc. Metatarsals, tibia, neck of femur, spine are common locations of stress fractures.

[Read more on stress fractures]

Significance of Classification into Different Types of Fractures