Avulsion Fracture

An avulsion fracture has symptoms that are similar to bone breaks in other parts of the body. These symptoms can include:

Swelling, bruising, or bleeding 
Intense pain 
Numbness and tingling 
Difficulty walking or moving a limb

Usually, these symptoms will be worst near the bone that is broken, but you might also feel pain or other symptoms in nearby areas of the body (for instance, joints near the bone that is broken). 

When to See a Doctor

Most avulsion fractures aren’t medical emergencies, but they are still a serious medical condition. See a healthcare provider if you have pain, swelling, numbness, or difficulty moving a limb. If you don’t get medical attention, your broken bone might take longer to heal or it might not heal in the right way. Even if your bone isn’t broken, similar problems like dislocations or sprained joints can cause serious problems if they aren’t treated.

Find a Provider

There are many causes for a bone fracture. Anything that puts too much stress on a bone can cause a fracture. Common causes include: 

Falling from a height (out of a window, off of a tree) 
Car accidents 
A direct hit to the bone (common in contact sports like football) 
Long-term impact from forces like running or other forms of exercise

The most common types of avulsion fracture come from putting too much stress on the bones in the ankle, hip, or elbow, especially during sports or exercise. Avulsion fractures are more common in children or if your bones are already weakened or under pressure from training, repetitive tasks, or other intense physical activity. 

Diagnosis & Tests, Treatments, & Prevention

Diagnosis & Tests

If your doctor thinks that you have an avulsion fracture, they will do a physical exam and ask you questions. Some of these questions can include: 

What are your symptoms? How long have you had them? 
What were you doing when the symptoms started? 
Is there anything that makes them better or worse? 
Are you having trouble moving your joints?

Your doctor will also look at and press on the part of your body that might be injured. 

Sometimes, the exam will be enough to diagnose your avulsion fracture, but your doctor might want to do imaging tests like x-rays to look at the injured area more closely and decide on the best treatment for you. An x-ray can also show that you have a broken bone, and not a similar problem like a sprain or dislocation. 

If your doctor thinks that your avulsion fracture might require surgery, they might refer you to a foot and ankle surgeon who will do additional tests and can start more treatment for your injury. 

Treatments

Treatment for an avulsion fracture starts with simple first aid that you can do yourself or with the help of someone else. 

First Aid

First aid steps include: 

If you were exercising or playing sports when the injury happened, stop. Don’t use the part of the body that hurts. 
Check for other injuries near the bone fracture and on other parts of your body. 
Stop the bone from moving by using a splint or sling.
Before you see your doctor, you can use the RICE method to help relieve pain and reduce swelling:
- Rest:  Avoid putting weight on the injured bone, and avoid participating in normal activities until you get better. If your ankle or hip is hurt, you shouldn’t walk. 
- Ice:   Use an ice pack (you can also use a bag of frozen vegetables if you do not have an ice pack) for 15 to 20 minutes, 3 times a day. 
- Compression:   You can use a compression bandage or compression brace to help put pressure on the bone and reduce swelling. 
- Elevation:   To keep swelling down, elevate (raise) the affected area above the level of your heart. You can do this by sitting or lying down on a couch or floor and placing pillows under the injured foot, leg, or arm until it is higher than your chest.

Medical Treatment 

Your healthcare provider might treat your avulsion fracture in different ways depending on the kind of break you have and how serious it is. Some treatments include: 

Rest.  Even if you don’t need surgery or reduction (setting a broken bone), you will probably need to stay off of the injury while it heals. Your doctor might use a cast or splint to keep the bone from moving during this period. 
Medicine.  Anti-inflammatory medicines like ibuprofen can help decrease pain, swelling, and inflammation around the fracture. 
Immobilization.  Your doctor might put a cast or walking boot around the injured bone to stop it from moving while it heals. If your avulsion fracture is in your ankle or metatarsal bone, your doctor might use a cast or stiff-soled shoe to do the same thing. 
Exercises.  Your healthcare provider may recommend controlled exercises to restore ranged of motion and promote bone healing. 
If your injury involves multiple breaks that don’t heal properly, surgery may be required. Your healthcare provider may recommend you visit a foot and ankle surgeon.

Healing time for an avulsion fracture might take several weeks or months. Seeing a healthcare provider right away and getting the right treatment can help you heal faster. 

Prevention

An avulsion fracture happens when you pull too hard on the bones in your ankle, hip, or elbow. You can take several steps to minimize the chance that you will have a bone fracture, such as: 

Use protective gear while exercising or playing sports. Protective gear includes helmets, elbow pads, knee pads, shin pads, and other sports equipment. 
Warm up and stretch before you exercise. 
Wear the right shoes for the kind of exercise or sports you are doing. 
Replace athletic shoes every year, and replace running shoes every 300 to 400 miles. 
Try not to run or walk on uneven surfaces. 
Take breaks and don’t exercise more than you are in shape for.

Symptoms