What is a Comminuted Fracture?

Mary McMahon
Mary McMahon

A comminuted fracture is a fracture in which the bone involved in the fracture is broken into several pieces. At least three separate pieces of bone must be present for a fracture to be classified as comminuted. This type of fracture can be challenging to treat due to the complexity of the break, and it can be especially complicated if the fracture is open, meaning that the bone is protruding outside the skin. Open fractures are at a very high risk of infection and they typically take longer to heal.

Comminuted fractures are common among the elderly.
Comminuted fractures are common among the elderly.

Comminuted fractures are also sometimes known as multi-fragmentary fractures. This type of fracture often involves crushing or splintering of the bone, and it can occur anywhere along the length of the bone. This type of fracture is most common in elderly people or in people with conditions which weaken the bones, such as osteogenesis imperfecta or cancer. A comminuted fracture can also occur as the result of tremendous force, such as a car accident or a severe fall.

An X-ray may be performed to diagnose a comminuted fracture.
An X-ray may be performed to diagnose a comminuted fracture.

Like many other types of fracture, comminuted fractures are associated with very distinctive symptoms which usually lead people to seek medical treatment. The patient usually experiences tremendous pain at the site of the fracture, and he or she may even pass out at the time that the break occurs as a result of the pain. The area around the break will also swell, and it may become warm to the touch. Typically the patient cannot bear any weight on the fracture without experiencing significant pain.

A person with a comminuted fracture.
A person with a comminuted fracture.

This type of fracture is usually easy to diagnose with an X-ray to look at the site of the suspected fracture. When the fracture is X-rayed, the doctor can use the image to gather more about the orientation of the pieces of bone and the location of the fracture to determine the best possible treatment. It may be necessary to pin the fracture with surgery so that the pieces will have a chance to knit together.

A car accident can cause a comminuted fracture.
A car accident can cause a comminuted fracture.

Complications of comminuted fractures can include infection, compartment syndrome, vascular necrosis, and nonunion, in which the pieces of bone fail to join together. Usually someone with a comminuted fracture will need to attend several follow up appointments at the office of an orthopedic doctor to confirm that the fracture has been set properly, and that it is healing appropriately. If the healing does not appear to be progressing as desired, the doctor can intervene to address the issue.

Severe comminuted fractures that have other complications may necessitate amputation.
Severe comminuted fractures that have other complications may necessitate amputation.
Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a wiseGEEK researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

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Discussion Comments


My cousin had a comminuted fracture in his left femur. His fracture has been operated on and more than 15 days have passed. But still he is suffering from severe pain and swelling around his knee. He is worrying about unexpected swelling. Can anybody help regarding this?


My nephew had a severe fall and consequently had a comminuted fracture of his femur below his knee. This happened last week (Tuesday). His orthopedic surgeon however sent him home with heavy duty pain meds and has had him wait until tomorrow for the surgery.

This has been a ten day waiting period while his surgeon went literally to Disneyland.

Other local hospitals in the Florida area said that he would have to wait for two weeks before they could do the surgery.

I don't understand why the surgeons can ignore this extremely painful condition. I bet if it was their son or daughter in pain they would not wait.


A drunk hit me head on, but I only remember parts of the accident, as I was knocked out cold. The hospital I was rushed to did the most horrible care with me, leaving me for days in excruciating pain.

I will never again will go to an Aurora care center. Even my complaints of horrible care, in writing letters, emails, phone calls, etc, to this day, went unanswered!

I suffered a crushed heel bone, and a broken wrist. I had to beg for care to care my wrist, and receive pain meds, as I found that I was allergic to morphine. I never knew what my crushed foot was called, nor did any doctor talk to me regarding the issues, while I was hospitalized for four days. They never looked into the reason why I kept passing out either.

I went to a doctor a month after my accident, because no doctor would treat me, for an accident. That doctor was horrible, kept me in pain constantly, where I had to beg for results. I was in a wheelchair for almost 1-1/2 years, as I could not even stand. I requested to go to therapy, and was told it would not help me.

I had to threatened to file a complaint with the AMA, in order to get therapy. On my therapy prescription, it was stated, Rsd?

I was never told of the fracture or of rsds, and did not know what it was. I was told that my foot was too far gone, and there was nothing that they could do for me. I've seen doctor after doctor, with the same answers, but no explanations.

My therapist is the only one, who finally told me about my foot and what Rsds was. Thank God for her. She is my angel! I pushed myself, and with her love and tons of help, I progressed to a walker.

Today, I do walk now, not good, but I do walk, with tons of pain, and suffer with a rare nerve disease called, "rsds." There is no cure for this disease, which is very sad. It took me, tons of doctors, a wonderful therapist, determination, much pain, and three years, just to walk! It is very sad when no medical field really gives a crap about their patient, or their care!

Today, I work for "Rsds Hope of Wisconsin, Inc," helping patients and myself, with the rare nerve disease, support, suicide support, knowledge, and financial support, with love and friendship that is needed!

Push your determination, and complain to the AMA, if you have to, for your care! It is your body and your lif, that they are playing with, and ignoring! Praise God for health care!


A good friend of mine received one these fractures as the result of a soccer injury. He had to undergo intensive surgery to set the break. After surgery, he wore a cast on the injured leg for six months. Luckily, he recovered nicely and does not limp. However, he claims that he can feel the injury ache a bit right before a large storm.


In younger people, comminuted fractures are often caused by road accidents. However, these severe breaks are frequently caused by brittle bone disease or bone cancer in the elderly.

Regardless of age, it is important to treat these fractures immediately to prevent infection which can lead to complications and even amputation.


Bad breaks like a comminuted fracture are frequently open fractures. This makes significantly more dangerous than other types of breaks.


A couple of months ago, my dog disappeared for a couple of days. When he came home, he was limping, whining, and one of his back legs seemed to appear a bit crooked. I put him in the car and took him to the vet. After x-raying the leg, the vet told me that he had a comminuted fracture. She said that it often happens after an animal gets struck by a car. At first, she suggested euthanizing him because of the severity of the break, but that wasn’t an option for us. We opted for any possible treatment.

He required surgical intervention to repair the bone. He was put under general anesthesia. They had to insert a pin in the leg. He wore a cast on his leg for a couple of months for stabilization purposes. We were given pain medication to give him when he got home.

He is now doing very well. You can hardly tell he ever had a surgery!

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