How Long Does a Fracture Take to Heal?

When a child breaks a bone, parents go into emergency mode—get treatment and make the child comfortable. But once the immediate concern passes, thoughts quickly turn to, “How long until we can get back to normal?”

While it’s understandable to want a clear timeline, the reality is that healing is unique to every child and every injury.

“Six weeks, three months—they're all just rules of thumb,” says Gleeson Rebello, MD, MBBS, a Mass General Brigham pediatric orthopedic surgeon. “It's very hard to put it into a box, so we just have some rough guidelines.”

Not having a hard-and-fast answer can be frustrating, but knowing what to expect—and what healing factors you can control—can help.

How a broken bone heals

Bone healing is a complex process that happens in stages, as the body heals and rebuilds the bone:

• Inflammatory phase (hours to days): Immediately after a break, the injured area becomes red, swollen, and painful. This inflammatory response starts the healing process. In addition, broken blood vessels form a clot and a hematoma (seen as a bruise). The hematoma will become the foundation for new bone.
• Reparative phase (days to weeks): The blood clot transforms into a soft callus made up of cartilage and other tissue. The soft callus provides some stability to the fractured area, but is not strong. Over several weeks, the soft callus turns into a hard callus that’s weaker than regular bone but strong enough for the broken area to be used.
• Remodeling phase (months to years): During this long phase, the hard callus transforms into new bone. Using the affected area during this phase helps new bone grow.

Most kids with a broken bone need to wear a cast, brace, or splint for one to three months to get through the reparative phase, but the bone and nearby muscles continue to heal after that. Healing time is also affected by the type of fracture and location.

Factors that affect healing time of a fracture

No two kids are alike, and neither are any two broken bones. One child might bounce back and be back on the field in a few weeks, while another needs more rest. Even the same types of breaks can heal differently in different children.

Understanding the factors that affect bone healing can help you have realistic expectations and support your child for the best outcomes.

Location of the fracture

Bones that have a rich blood supply, like bones in the hand, or soft tissue envelope (the skin, fat, and muscle that surround the bone), like femurs, or thigh bones, are likely to heal quicker. On the other hand, bony areas like the shin take longer to heal.

Severity of the injury

More complicated broken bones—ones that have multiple fractures, bones that have shifted out of place (displaced), damage to surrounding muscle or nerves, or involve a joint—may take longer to heal.

Age of the child

In children, bone healing happens much faster than in adults. Young kids have a thick layer of blood-rich connective tissue around their bones called the periosteum that speeds bone healing. As kids get older, the periosteum thins out, resulting in less blood supply.

Physical therapy

Although it seems like kids bounce back and recover easily, exercise through physical therapy (PT) may help children regain strength and range of motion in the injured area.

“When they come out of the cast, you'll see some healing bone [on x-rays], but the fracture line may not have disappeared,” says Dr. Rebello. “Before they return to any kind of sporting activity, range of motion exercises and gradual, controlled stress on the bone will facilitate healing.”

If your child needs PT, their physical therapist will tailor exercises to the injury and recovery stage. They may start with exercises that increase range of motion and progress to more challenging moves that build bone and muscle strength necessary to prevent re-injury. “It’s imperative to not just do it in a physical therapist’s office, but also at home, to get optimum results and the soonest possible return to all activity,” says Dr. Rebello.

Although you can’t precisely control how fast your child’s broken bone heals, supporting them with good nutrition and safe and appropriate exercise makes a big difference. “Your healing time is going to be dependent on what you do, how often you do it, and how motivated you are,” says Dr. Rebello.