Typical Fracture Healing Time
Most fractures in healthy adults heal within 6 to 12 weeks, with the majority showing clinical union by 8 weeks, though complete remodeling continues for months thereafter. 1, 2
Healing Timeline by Phase
Inflammatory Phase (Days 1-7)
- Immediate inflammatory response begins at the fracture site, involving immune cells and molecular factors that initiate the repair cascade 3
- This phase is critical for setting up the subsequent healing process 4
Repair Phase (Weeks 2-8)
- Most symptomatic improvement occurs during weeks 2-12, with the majority of fractures achieving clinical stability by 6-8 weeks 1, 2
- Bone marrow edema visible on MRI typically resolves within 1-3 months, indicating active healing 1
- Bony bridging of fracture fragments occurs during this period 3
Remodeling Phase (Months 3-12+)
- Slow remodeling continues after initial union, eventually reconstituting the original bone structure 3
- Complete remodeling can take many months beyond clinical healing 4
Site-Specific Healing Times
Vertebral Compression Fractures
- Pain gradually improves over 2-12 weeks with variable return of function 1
- Most patients show significant improvement within 6-8 weeks of conservative management 2, 5
Hip and Femoral Fractures
- Immediate full weight-bearing is typically allowed after surgical fixation with intramedullary nailing 6
- Clinical healing occurs within the standard 6-12 week timeframe 6
Proximal Humerus Fractures
- Acute symptoms subside over 6-8 weeks as the fracture heals 5
- Most can be managed conservatively with good functional outcomes 1
Factors That Influence Healing Time
Local Factors
- Degree of local trauma and bone loss significantly affects healing duration 4
- Type of bone affected (cortical vs. cancellous) influences timeline 4
- Degree of immobilization and fracture stability are critical determinants 4, 3
Systemic Factors
- Systemic inflammation from conditions like rheumatoid arthritis, diabetes, or sepsis can increase healing time and complication rates 3
- Age affects healing speed, though healthy adults generally heal predictably 4
Delayed Union vs. Nonunion
Definitions
- Delayed union refers to fractures not healing within the expected timeframe (typically beyond 12 weeks), though healing is still progressing 7
- Old fractures are generally defined as those present for more than 3 weeks without appropriate healing 7
Key Warning Signs
- Fractures failing to show progressive healing by 12 weeks require reassessment 7
- Unstable fixation and compromised blood supply are the most important factors causing delayed or nonunion 7
Clinical Implications
Early Mobilization Benefits
- Limited bed rest (less than 2 weeks) prevents complications including bone mass loss and muscle strength loss 2
- Early mobilization as soon as pain allows prevents deconditioning and associated complications 1, 2
Monitoring Progress
- Regular clinical and radiographic assessment ensures healing is progressing appropriately 6
- Persistent pain beyond 8-12 weeks warrants investigation for delayed union or other complications 1, 2
Common Pitfalls to Avoid
- Excessive immobilization beyond what is necessary can lead to muscle atrophy, bone loss, and cardiovascular deconditioning 1, 2, 5
- Assuming all fractures heal at the same rate—site-specific and patient-specific factors must be considered 4, 3
- Failing to address underlying conditions (osteoporosis, vitamin D deficiency) that may impair healing 1