Sprain vs. Fracture: What’s the difference?

Sprains and fractures are common conditions we see in our office. These are often the result of sporting injuries, but can also result from a misstep while walking as in the case of an ankle sprain. A sprain means one or more ligaments, the tough bands that hold the bones together, have been injured. The injury to the ligament may be mild stretching of the ligament causing only pain and swelling or it can be more severe, resulting in a complete tear of the ligament. The good news is most sprains are mild and can be treated adequately with RICE. RICE is a pneumonic to remember the treatment of sprains and involves rest, ice, compression and elevation. If a sprain is severe, a splint or cast may be applied for a short period of time to minimize pain and allow the ligament to heal. Sprains are most often diagnosed with a clinical exam. There is typically an incident causing the injury (fall, collision) and localized swelling and pain overlying a joint. With time, bruising often develops and gradually resolves. In some cases it may be difficult to distinguish a fracture from a sprain. In those cases X-rays supplement our clinical evaluation to arrive at the correct diagnosis. Most sprains about the ankle and wrist can be treated without surgery. The ligamentous injury that most often warrants surgery is when the ACL (anterior cruciate ligament) is torn. This ligament is important for stability of the knee joint and is the ligament most commonly injured while participating in sports. After sustaining an injury to their ankle, many people are curious how to distinguish an ankle sprain from an ankle fracture. One way is that a person is often able to walk, although with a limp, following an ankle sprain but if that same person sustains an ankle fracture they are unable to bear any weight on their foot. A fracture occurs when one or more of the bones are broken. A fracture can be a simple break in one bone or can be several fractures. The extent and severity of the fracture is best evaluated with X-rays.  Whereas many sprains do not require immobilization, most fractures need to be treated in a cast or splint. The most common fracture we treat are fractures to the radius and ulna (forearm). In children theses fractures are typically in a cast for 4 to 6 weeks and children are able to return to their prior activity level within a few months. To learn more about splinting a lower extremity, watch the video below.