Surgery to fix a broken bone

What is surgery to fix a broken bone (fracture fixation)?

Fracture fixation is surgery to put a broken bone back into the correct position (called reduction) and hold it steady while it heals. Many breaks heal well in a plaster cast or splint without any operation, but some need surgery — for example when the pieces are badly out of line, when the break goes into a joint, when the bone is unstable, or when the skin over the bone is broken (an open fracture).

Most often the surgeon makes a cut over the bone, lines the pieces up directly and fixes them with metal implants. This is called open reduction and internal fixation (ORIF). The metalwork — plates and screws, a nail down the middle of the bone, wires or pins — holds the bone still so it can knit together. Sometimes the bone can be lined up without a large cut and held with wires or a frame on the outside (external fixation).

Fixing a bone does not make it heal faster than nature; it holds the pieces in a good position so that healing happens straight and stable. The bone still has to heal on its own, which takes weeks to months. The aim is the best possible alignment and function, not a guarantee of a perfect or pain-free result.

This guide is about the principle of fixing a broken bone. Because there are hundreds of different bones and types of break, your own operation, recovery time and weight-bearing rules will be specific to your injury, and your surgeon and physiotherapist will give you instructions tailored to you.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your surgery

• Most fracture surgery is done urgently after an injury, so preparation is often quick; you will be asked when you last ate and drank.
• Tell the team about all your medicines, especially blood thinners, and any allergies, diabetes or other health conditions.
• Stop smoking if you possibly can — smoking markedly slows bone healing and raises the risk of the bone not joining.
• Expect blood tests, an X-ray and sometimes a CT scan to plan the operation, plus a check by the anaesthetist.
• Ask which anaesthetic is planned, whether you will be able to put weight on the limb afterwards, and how long you may be in hospital.
• Arrange help at home, transport, and time off work, as you may have a cast, crutches or a sling and limited use of the limb.
• If your operation is planned rather than emergency, you may be asked to fast and to pause certain medicines beforehand.

What happens

After anaesthetic (usually a general anaesthetic, sometimes a regional block that numbs the limb), the surgeon brings the broken pieces back into position. In open fixation, this is done through a cut over the bone; in some cases the bone can be lined up without a large cut.

The pieces are then held with the chosen metalwork — a plate and screws, a nail inside the bone, wires, or an external frame. The position is usually checked with an X-ray during the operation. The wound is closed with stitches or clips, and a dressing, and sometimes a cast, splint or sling, is applied.

How long it takes depends on the bone and the complexity of the break. Afterwards you are monitored in recovery, given pain relief, and told whether you can put weight on the limb. Some small-bone operations are done as a day case; larger operations, leg fractures, or injuries needing close monitoring usually mean a hospital stay.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

The biggest specific worries are infection, the bone not healing (non-union or delayed union), and the position not being perfect. These are more likely with open (skin-breaking) fractures, smoking, diabetes, poor circulation, certain medicines, and high-energy injuries. Ask your surgeon about your particular break, whether you can bear weight, what the plan is if healing is slow, and what signs of infection or clots to watch for.

Published figures to discuss

Outcomes after fracture fixation vary enormously with the bone, the type and energy of the injury, whether the fracture was open, and the patient's health and habits (especially smoking and diabetes). Reliable single figures for “fracture surgery” as a whole do not exist, because each fracture type has its own risk profile. The figures below are illustrative ranges from studies of specific fractures and should not be read as your personal risk; your surgeon can give a more individual estimate.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery after fracture surgery is gradual and depends heavily on which bone is broken, how bad the break was, and whether you can put weight through the limb. Bone typically takes around 6–12 weeks to heal, and regaining full strength, movement and confidence usually takes longer. Follow the specific instructions your surgeon and physiotherapist give you, as these matter more than any general timeline.

• Pain, swelling and bruising that improve over the first weeks
• Stiffness in nearby joints that eases with movement and physiotherapy
• Aching around the metalwork, especially in cold weather or with activity
• Tiredness, as healing a fracture takes energy
• Gradual rather than sudden progress, with good and bad days

Aftercare

• Follow your weight-bearing instructions exactly — too much, too soon can disturb healing.
• Keep the wound clean and dry and look out for redness, increasing pain, heat or discharge.
• Elevate the limb when resting in the early days to reduce swelling.
• Take pain relief as advised and do the movement or physiotherapy exercises you are given.
• Do not smoke; smoking slows bone healing and increases the chance of non-union.
• Eat well and stay active within your limits to support healing and reduce clot risk.
• Keep all follow-up and X-ray appointments so healing can be checked.
• Know who to contact, and how, if you have concerns out of hours.

• Crutches, sling or walking aid set up at home as advised
• Pain relief obtained and a plan for taking it
• Time off work arranged and someone to help at home early on
• Wound-care advice and dressings understood
• Weight-bearing and exercise instructions written down
• Transport arranged for follow-up appointments
• The trauma team or ward's contact number saved

Scars and how they heal

Open fixation leaves a scar over the operation site, and sometimes more than one if several cuts or an external frame were used. Scars are usually pink and firm at first and fade over months. Wires or pins that stick out through the skin leave small marks when removed. The size and position of the scar depend on the bone and the approach the surgeon needed to use.

⚠ Get urgent help if…

• Increasing redness, swelling, heat or discharge from the wound, or a fever — possible infection
• Pain that is getting worse rather than better, or that is not controlled by your pain relief
• Numbness, severe pins and needles, coldness or a pale or blue colour in the limb
• Calf pain, swelling or tenderness, or sudden breathlessness or chest pain — possible blood clot, call 999 if breathless
• A cast or dressing that feels too tight, or a wound that gapes open
• A sudden change in the shape of the limb, or a feeling that something has shifted or given way

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result is a bone that heals in a good position, with a limb that works well and as little pain and stiffness as possible. Whether this is achieved depends on the bone, the severity of the break, your general health, and how well healing goes.

Surgery cannot guarantee a perfect or completely pain-free outcome. Some people are left with stiffness, occasional aching, weather-related discomfort, or visible metalwork that can be felt under the skin. Breaks that go into a joint carry a higher chance of arthritis later, even after good surgery. Your surgeon should be clear about what to expect for your particular injury.

Once a bone has fully healed it is generally as functional as before, though it may ache at times and a joint involved in the break can develop arthritis years later. Internal metalwork is usually left in place permanently and causes no problems for most people; it is removed only if it becomes painful, prominent, infected or, in children, may interfere with growth. Wires and external frames are temporary and are removed once the bone has healed.

Combining with other procedures

Fracture surgery is sometimes combined with treatment of other injuries from the same accident, with bone grafting if there is a gap in the bone, or with repair of damaged ligaments, tendons or skin. In open fractures, surgery to clean and cover the wound is an important part of the treatment and may involve plastic as well as orthopaedic surgeons.

Follow-up & long-term care

You will usually be reviewed in a fracture clinic, with X-rays to check that the bone is healing and in a good position. Physiotherapy is often arranged to restore movement and strength. The number and timing of appointments depend on the bone and how recovery goes; serious concerns such as infection or a clot should be reported straight away rather than left until the next appointment.

• Keeping up physiotherapy exercises to regain and maintain movement and strength
• Protecting the limb from re-injury while the bone is still healing
• Attending review X-rays so healing and metalwork position can be checked
• Discussing whether any metalwork needs removing if it becomes painful or prominent
• Not smoking and managing conditions such as diabetes that affect bone healing

Revision and secondary surgery reality

• Some fractures need further surgery if healing is slow or fails (for example bone grafting for non-union).
• Metalwork is sometimes removed in a second operation if it is painful, prominent or infected.
• An imperfect position (malunion) occasionally needs correcting if it affects function.
• Wires and external frames are removed as a planned step once the bone has healed.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• Clear written weight-bearing and exercise instructions, plus a named contact for problems.
• Planned fracture-clinic review with X-rays to confirm the bone is healing.
• Access to physiotherapy to restore movement and strength.
• A clear plan and route to help if healing is slow, or if infection or a clot is suspected.
• Support to stop smoking and manage conditions that affect bone healing.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Which bone is broken and how complex the break is
• The type of surgery and metalwork used (plate and screws, nail, wires or external frame)
• The anaesthetic used and the length of the operation
• Length of hospital stay and level of monitoring needed
• Imaging such as X-rays and CT scans before and after surgery
• Physiotherapy and the number of follow-up appointments
• Whether any further surgery, such as metalwork removal, is needed later

• The surgeon's fee and the anaesthetist's fee
• The hospital or theatre and facility fee, and likely length of stay
• The cost of implants (plates, screws, nails or wires) and imaging
• Physiotherapy and follow-up appointments, and what is included
• What happens, and what it costs, if healing is slow or further surgery is needed
• The policy if a complication such as infection occurs
• The cancellation policy for planned procedures

On the NHS? Surgery to fix a broken bone is core NHS emergency and trauma care, provided free when clinically needed; private treatment is uncommon and mainly relevant to planned cases or choice of surgeon rather than because the operation is unavailable.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• Which bone is broken, what type of break is it, and why do I need surgery rather than a cast?
• What metalwork will you use, and will it need to be removed later?
• Will I be able to put weight on the limb afterwards, and when?
• What is the plan if the bone heals slowly or does not join?
• Given my health, smoking or medicines, what is my personal risk of infection or non-union?
• What signs of infection, clots or problems should I watch for, and who do I contact?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for surgery to fix a broken bone

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Broken leg NHS — Broken arm or wrist NICE NG38 — Fractures (non-complex): assessment and management British Orthopaedic Association Oxford University Hospitals NHS — Non-healing fractures (non-union) ORIF complications review — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.