Angulated fractures involve a broken bone that tilts at an angle. Most cases require some form of realignment using a cast or other measures for proper healing.
An angulated fracture occurs when a bone breaks, comes out of alignment, and tilts at an angle. It may be visually obvious or not, depending on the angle of the tilt.
They’re a type of displacement fracture that typically requires medical treatment for proper healing. It requires diagnosis and treatment from a doctor.
Angulated fractures are usually evaluated based on the amount of tilt between the broken bone. This angle will be measured in degrees. For example, a 45-degree tilt means that your bone is angled halfway between perfectly aligned and completely perpendicular.
The angle of the broken bone may also be described as apex posterior, apex anterior, apex lateral, or apex medial, depending on where it’s positioned in relation to the other part of the bone.
An angulated fracture is a type of displaced fracture.
A displaced fracture occurs when the broken bone no longer aligns. Other types of displaced fractures include when the bones have shifted slightly but don’t tilt, when the bones rotate, and when a single side of the bone breaks and bends the nonbroken side.
Nondisplaced fractures generally are less severe and involve a smaller break or crack but not a complete severing of the bone at the injury site.
There are a few other fracture classifications:
- Open fractures: The fracture breaks the skin.
- Closed fractures: The fracture does not break the skin.
- Comminuted fractures: The bone breaks or shatters in more than three places.
Treatment for fractures varies by their severity, but an angulated fracture may require more treatment than a less severe fracture. Most fractures will heal with the right treatment, as bones are tissues that can repair themselves.
The tilt from the fracture will need to be realigned to heal properly. This can be done with a reduction or surgery.
Realigning the bones with a reduction
This is a nonsurgical procedure. It occurs when your doctor manually realigns the broken bone by manipulating the bones externally. You may receive pain-reducing medications or sedation during a reduction.
Realigning the bones with surgery
A severely angulated fracture could require surgery. A surgeon fixes the alignment by entering the fracture site internally.
This realignment could require implants or devices like pins, screws, wires, and plates to set the bone into place. These may be metal, ceramic, or polymer, and they may be temporary or permanent. You’ll likely receive general anesthesia for surgery.
Healing in a cast, splint, brace, or boot
Your realigned bones will need to heal over time. Your doctor will recommend a method to stabilize the fracture. These include:
- Casts: These protect the bone from external forces. They’re very hard on the outside and generally made with plaster or fiberglass. They have a second internal layer that is softer and more cushioned.
- Splints and braces: These can be removed if needed and might be good for temporary use if your fracture causes a lot of swelling initially. You may also wear a splint or brace if your fracture is not severe or if you’re nearing the end of the healing process and require physical therapy or strengthening exercises.
- Boots: These are for broken bones in your foot or ankle. You can walk on them if your injury is stable enough and take them off for showering or bathing if your doctor allows it.
It may take up to 3 months for a fracture to heal after realignment. It may take an additional few weeks or months to regain strength in the injured area. You may no longer feel pain from the fracture, but that doesn’t mean the bone has healed completely.
Discuss rehabilitation with your doctor to make sure you don’t reinjure or strain the healed fracture. They may recommend certain exercises to build up strength at the weakened injury site.
You may encounter complications after an angular fracture, including:
- the bone is not properly aligning after a procedure
- infections at the fracture site
- improper healing due to the cast, brace, splint, or boot not fitting correctly.
While most bones will repair themselves following a fracture, sometimes a condition called nonunion occurs. This is when the bone does not fully heal.
An angulated fracture is when your bone breaks and one piece of the bone tilts off its axis and points in a new direction.
This type of fracture will require resetting by a doctor, followed by a few months of healing. Bones regrow with time, and you should be able to use the bone normally after treatment.