How long does Bone healing take after a fracture?

The process of bone healing is complex and during medical school we all have to study the different stages that take part in a biological cellular level. 

 

Broadly speaking all bones would have healed after 6 to 12 weeks from a fracture. This can vary depending on multiple factors. Children’s bones heal much faster than adults. Smoking or certain medication will have a detrimental effect on bone healing. Lastly, the type of treatment provided will also play a role.

 

If a fracture takes twice as long to heal than expected for a specific bone and patient age,  we talk about “delayed union”. When a fracture does not heal even past that delayed time and after 6 or 9 months, the term used is “non-union” or “pseudo-arthrosis”.

 

As early as 3 weeks from the fracture, there is a bridging callus made of calcified cartilage which represents a degree of healing that stabilises the bone. The secondary callus which is stronger than the bridging one and of a similar consistency of mature bone will appear between 4 and 8 weeks in most cases. However, a radiological callus which is clearly visible on an X-ray is not present at least until 12 weeks from the fracture. This is why a fracture line will still show on x-rays for the first 3 months without this necessarily representing any abnormality or delay in the healing process.

 

Delay in bone healing can be caused by many factors but the most notorious one is smoking. The detrimental effects of smoking have been well described and these not only involve delayed healing but also increased risk of developing other types of complications. Smoking reduces blood flow to the fracture site and impairs the healing process. Even though smoking cessation strategies are not easy to implement I always warn my patients that they must try hard given the clear benefits towards an uneventful recovery from a foot or ankle fracture. Some adverse effects persist for a prolonged period of time but it is never too late to quit smoking!

 

There are some strategies to enhance bone healing when it is not following its usual course. An innovative bone healing stimulator that uses low intensity pulsed ultrasound waves is available through our clinic and has shown excellent results. It is a device that can be taken home and applied on a daily basis with a risk- and pain- free profile. It is approved by the National Institute for Clinical Excellence (NICE) which is the public body of the Department of Health in the UK that publishes guidelines on healthcare topics.