How do you know if you’ve broken a bone?
Sometimes, with major bone trauma, the signs are obvious. A limb may look out of place or even puncture through the skin.
But other times, the signs aren’t so obvious. You can also have a bone bruise (called a contusion). Bone bruises can hurt almost as much as some bone breaks.
How can you tell if a bone has fractured or bruised? And what are the treatments for each?
Below is a guide to bone fractures versus bone bruises, and what to do for each.
What Is a Bone Bruise?
Just as your skin can bruise, so can your bones.
We think of a bone as a solid mass, but it’s actually made up of tissue and blood. When a hit or a fall traumatizes a bone, it can bleed.
A bone bruise essentially involves bleeding that gets trapped under the bone surface. The same happens to soft tissue, leading to bruising under the skin.
Bone bruises can occur alongside other injuries, such as sprains or ligament tears. For example, you can sprain your ankle, bruise an ankle bone, or bruise some ribs and break others.
Trauma is usually what causes both bone bruises and bone fractures, although repetitive motion can sometimes also lead to bone problems.
Bone bruises can happen along with other injuries. For example, you can sprain your ankle and bruise an ankle bone. Or, you can bruise some ribs and break others.
Doctors can’t always diagnose bone bruises because x-rays cannot show them. More sensitive technology, like MRI, is why we can now see bone bruises, along with other soft-tissue damage.
Is a Bone Bruise as Severe as a Fracture?
A bone bruise or contusion isn’t as severe an injury as a bone fracture.
A bruise causes tissue damage to the bone, which can show up as super tiny cracks. If the bruise is severe, the damage might affect multiple layers of the bone.
Unlike a fracture, a bone bruise doesn’t make the bone less stable. But these bruises can hurt as much as minor fractures and take several weeks to heal.
What Are the Symptoms of Bone Bruises and Bone Fractures?
Bone contusions and bone fractures share some of the same symptoms including:
- Pain in the bone itself.
- Skin bruising.
- Tenderness and swelling around the injury.
Whereas a bone bruise may feel like a dull ache, bone fracture pain is often sharper. With a bone bruise, you may feel tenderness mostly when you touch the area. With a bone break, the pain is usually more constant.
With a bone break, you may notice the bone looking out of place or twisting at an odd angle. Bone bruises don’t affect the integrity of the bone in this way.
How Are Bone Bruises Diagnosed?
Getting severe trauma checked out by a doctor is always a good idea. Seeing a doctor about bone bruises can involve the following:
- An examination of the area of swelling and bruising.
- An expert may start by ordering x-rays. If there is inability to put weight on the limb after time has passed or symptoms of pain and swelling worsen, additional imaging studies may be ordered.
They may diagnose the bone bruise with a physical exam if no breaks are visible. However, if they suspect more serious soft-tissue damage, they may order more imaging tests.
How Are Bone Bruises Treated?
For bone bruises, your doctor will most likely prescribe RICE, which stands for:
- Rest, meaning you should rest the injury.
- Ice to reduce swelling. Ice the bone bruise for 20 minutes on, 20 minutes off, as much as possible for the first 24 to 48 hours.
- Compression, such as tape or an ACE bandage, to help with swelling.
- Elevation means keeping the injury above your heart (if possible) or off the ground.
Depending on the severity of your bone bruise, your doctor may suggest a brace. For example, a brace may help with a bruised knee.
How Are Bone Fractures Treated?
Bones can break evenly, diagonally, or in multiple places. With open fractures, the bone can pierce through the skin.
After a doctor assesses the degree and type of your fracture, they may treat it in one of several ways, including:
- A plaster cast, or a traditional cast that immobilizes the injury.
- A splint or brace to hold the injury in place.
- A wet waterproof cast (a waterproof cast isn’t suitable for all fractures).
- A walking boot is often a treatment for more minor breaks in the foot.
Some bone breaks will need surgery to repair and realign the bones. Depending on the break’s severity, you may need screws, pins, or rods to fix the fracture.
Fractures may heal independently as long as you keep the bone in the right place. For minor breaks in your foot, for example, RICE plus wearing a boot can help them heal. That’s why it’s important to always see a doctor if you suspect a break or have worsening pain.
How Long Does a Fracture Take to Heal?
Your bones have a fantastic ability to heal fractures and grow back together. On both sides of the fracture, bone cells grow toward each other. Eventually, the fracture closes.
This is why it’s so important to align the ends of the bone. If they grow back together crookedly, it’s called a malunion.
Fracture healing time can take as much as a year for some breaks. But you can often resume activity within a few months. Your doctor will give you specifics about recovery and restrictions.
You can help your bones heal by taking in some key nutrients, including:
- Calcium
- Vitamin D
- Vitamin K
- Protein
If you’ve had a cast, the area may feel stiff after removing it. You may continue to have swelling and bruising for several weeks. Physical therapy can help you regain range of motion.
UPMC orthopaedic experts have treated thousands of bone injuries, including bruises and compound fractures. If you’ve had an orthopaedic trauma, find a health care provider near you.