A fast clinical reference to typical management patterns for common adult and pediatric fractures, organized by age group, body region, and operative status.
These protocols are intended as a practical reference and do not replace patient-specific clinical judgment. Management may vary based on fracture pattern, stability, soft-tissue condition, age, comorbidities, associated injuries, fixation method, and radiographic healing.
Click any row for motion, follow-up/imaging, hardware removal, and clinical notes. Straightforward entries use the shorthand below; entries with a conditional (diabetic status, joint involvement, bone quality, etc.) are spelled out in full so the branch isn't lost in translation.
| Injury | Body Region | Initial Immobilization | Weight-Bearing / Limb Use | |
|---|---|---|---|---|
| Buckle (Torus) Fracture of the Distal Radius Pediatric Nonoperative | Wrist and Hand | Short-arm splint ~3wk | NWB (arm) ~4wk | |
MotionNRM ~4wk; gentle finger/hand use OK Follow-Up / ImagingA 1-week alignment X-ray to confirm the bone is healing in a good position, then a 4-week X-ray to confirm healing and clear the weight-bearing restriction. Clinical NotesA buckle (torus) fracture is a stable, minor bend or buckle in the bone rather than a full break — one of the mildest and most common childhood wrist injuries. Full Patient Page | ||||
| Greenstick or Metaphyseal Fracture of the Distal Radius Pediatric Nonoperative | Wrist and Hand | SAC ~4wk | NWB (arm) ~6wk | |
MotionNRM ~6wk Follow-Up / ImagingWeekly alignment X-rays for the first 2 weeks to confirm the bone is healing in good position, then a 6-week X-ray to confirm healing and clear the weight-bearing restriction. Clinical NotesA greenstick fracture is a partial break where the bone bends and cracks on one side, similar to a green tree branch — common in growing bones because they are more flexible than adult bone. Full Patient Page | ||||
| Physeal (Growth Plate) Fracture of the Distal Radius Pediatric Nonoperative | Wrist and Hand | SAC ~4wk, then DC and gentle mobilization | NWB (arm) ~6wk | |
MotionNRM ~6wk Follow-Up / ImagingWeekly alignment X-rays for the first 3 weeks to confirm the bone is healing in good position. After that, your child's growth plate is monitored periodically (roughly every 3 months) until it's clear the growth plate is developing normally — this is sometimes tracked using markers on X-ray called Park-Harris lines. Clinical NotesThis fracture involves the growth plate — the area of developing cartilage near the end of a child's bone. Growth plate injuries are watched extra closely because, in rare cases, they can affect how the bone continues to grow. This is why your child's surgeon may recommend follow-up over several months. Full Patient Page | ||||
| Pediatric Galeazzi Fracture Pediatric Nonoperative | Elbow and Forearm | LAC in supination ~4wk | NWB (arm) ~6wk | |
MotionNRM ~6wk Follow-Up / ImagingWeekly alignment X-rays for the first 2 weeks to confirm the bone is healing in good position, then a 6-week X-ray to confirm healing and clear the weight-bearing restriction. Clinical NotesA Galeazzi fracture involves a break in the forearm bone (radius) along with an injury to the joint where the forearm bones meet the wrist. If your child develops new pain on the pinky side of the wrist, tell your surgeon — this can be a sign that the small cartilage cushion in the wrist (the TFCC) needs a closer look. Full Patient Page | ||||
| Pediatric Both-Bone Forearm Fracture (Age Under 10) Pediatric Nonoperative | Elbow and Forearm | LAS 2wk → SAC 6wk | NWB (arm) ~6-8wk | |
MotionNRM ~8wk total Follow-Up / ImagingWeekly alignment X-rays for the first 3 weeks to confirm the bones are staying in a good position for your child's age, then a 6-week X-ray to confirm healing and clear the weight-bearing restriction. Clinical NotesThis describes a fracture of both forearm bones (radius and ulna) together. Because younger bones remodel and straighten as they grow, surgeons can accept slightly more angulation in younger children than in older children or adults — your surgeon will confirm whether your child's X-ray alignment is acceptable. Full Patient Page | ||||
| Pediatric Both-Bone Forearm Fracture (Age 10 and Older) Pediatric Nonoperative | Elbow and Forearm | LAS 2wk → SAC 6wk | NWB (arm) ~6wk | |
MotionNRM ~8wk total Follow-Up / ImagingWeekly alignment X-rays for the first 3 weeks. Older children have less remaining growth to correct angulation, so your surgeon allows less angulation on X-ray than for a younger child with the same injury. A 6-week X-ray then confirms healing and clears the weight-bearing restriction. Clinical NotesThis describes a fracture of both forearm bones (radius and ulna) together in an older child or pre-teen, who has less remaining growth to naturally correct any residual angulation compared with a younger child. Full Patient Page | ||||
| Recovery After Elastic Nail Fixation of a Forearm Fracture Pediatric Operative | Elbow and Forearm | LAS ~3wk, then DC for elbow ROM | NWB (arm) ~6wk | |
MotionNRM ~6wk; elbow ROM begins ~3wk (at splint DC) Follow-Up / ImagingAn X-ray at 6 weeks to confirm healing and clear the weight-bearing restriction. A return visit around 6–9 months is planned for hardware removal, once your child's surgeon confirms healing (a bridging callus across all three visible sides of the bone on X-ray). Hardware RemovalThe elastic nail (flexible rod placed inside the bone during surgery) is typically removed in a short outpatient surgery around 6–9 months, once X-rays confirm solid healing across all three cortices (sides) of the bone. Clinical NotesAn elastic (flexible) nail is a smooth, bendable metal rod placed inside the bone to hold a forearm fracture in good position while it heals. It is designed to be removed once healing is confirmed. Full Patient PageRecovery After Elastic Nail Fixation of a Forearm Fracture → | ||||
| Recovery After Elastic Nail Fixation of a Tibia Fracture Pediatric Operative | Leg and Ankle | SLC or fracture boot | NWB ~4wk | |
MotionNRM ~6wk; ROM ~2wk once skin healed Follow-Up / ImagingAn X-ray at 6 weeks to confirm healing and clear the weight-bearing restriction. A return visit around 6–9 months is planned for hardware removal, once your child's surgeon confirms healing (a bridging callus across all three visible sides of the bone on X-ray). Hardware RemovalThe elastic nail (flexible rod placed inside the bone during surgery) is typically removed in a short outpatient surgery around 6–9 months, once X-rays confirm solid healing across all three cortices (sides) of the bone. Clinical NotesAn elastic (flexible) nail is a smooth, bendable metal rod placed inside the bone to hold a shinbone (tibia) fracture in good position while it heals. It is designed to be removed once healing is confirmed. Full Patient Page | ||||
| Ankle Fracture (Without Syndesmotic Injury) Adult Variable | Leg and Ankle | SLS 2wk → CAM boot | NWB ~2wk | |
MotionNRM ~6wk; ROM ~2wk (skin healed), transition to CAM boot; WB restriction continues Follow-Up / ImagingA 6–8 week X-ray to confirm healing and clear the weight-bearing restriction. An optional 3–6 month X-ray may be used to monitor final healing. Clinical NotesThis protocol applies to ankle fractures that do not involve the syndesmosis (the strong ligament complex connecting the two lower leg bones just above the ankle). Patients with diabetes may be kept non-weight-bearing longer — see your surgeon's specific instructions. Full Patient Page | ||||
| Ankle Fracture With Syndesmotic Injury Adult Variable | Leg and Ankle | SLS 2wk → CAM boot | No weight bearing (NWB) for about 6 weeks. Patients with diabetes are generally kept non-weight-bearing longer — about 12 weeks — given the higher risk of bone-healing complications. | |
MotionNo resistance or strengthening (NRM) for about 6 weeks (12 weeks for patients with diabetes). If treated with surgery, motion (ROM) may begin around 2 weeks once the skin has healed, as you transition to a CAM boot while weight-bearing restrictions continue. Follow-Up / ImagingA 6–8 week X-ray to confirm healing and clear the weight-bearing restriction. An optional 3–6 month X-ray may be used to monitor final healing. Clinical NotesThe syndesmosis is the strong ligament complex holding the two lower leg bones together just above the ankle joint. An injury here typically requires a longer non-weight-bearing period than an ankle fracture without this involvement, to protect healing. Full Patient Page | ||||
| Bimalleolar or Trimalleolar Ankle Fracture Adult Variable | Leg and Ankle | SLS 2wk → CAM boot | No weight bearing (NWB) for about 2 weeks; patients with diabetes are typically kept non-weight-bearing for about 6–12 weeks. | |
MotionNo resistance or strengthening (NRM) for about 6 weeks (12 weeks for patients with diabetes). If treated with surgery, motion (ROM) may begin around 2 weeks once the skin has healed, as you transition to a CAM boot. Follow-Up / ImagingA 6–8 week X-ray to confirm healing and clear the weight-bearing restriction. An optional 3–6 month X-ray may be used to monitor final healing. Clinical NotesA bimalleolar fracture involves two of the bony prominences around the ankle joint; a trimalleolar fracture involves three. These are more complex ankle fracture patterns that often benefit from surgical stabilization. Full Patient Page | ||||
| Nonoperative Calcaneus (Heel Bone) Fracture Adult Nonoperative | Foot | Bulky Jones splint ~2-4wk | NWB ~12wk | |
MotionNRM ~12wk Follow-Up / ImagingA 6–8 week X-ray to check healing, then a 12-week X-ray to confirm healing and clear the weight-bearing restriction. An optional 6–9 month X-ray may be used to monitor final healing. Clinical NotesThe calcaneus (heel bone) bears significant weight with every step, which is why non-weight-bearing periods for this fracture tend to be longer than for many other fractures. Full Patient Page | ||||
| Operative Calcaneus (Heel Bone) Fracture Adult Operative | Foot | Short-leg splint 2wk → CAM boot | NWB ~12wk | |
MotionNRM ~12wk; ROM ~2wk once skin healed Follow-Up / ImagingA 6–8 week X-ray to check healing, then a 12-week X-ray to confirm further healing and clear the weight-bearing restriction. An optional 6–9 month X-ray may be used to monitor final healing. Clinical NotesThe calcaneus (heel bone) bears significant weight with every step, which is why non-weight-bearing periods for this fracture tend to be longer than for many other fractures, whether treated with or without surgery. Full Patient Page | ||||
| Femoral Neck Fracture — Fixation (Screws) Adult Operative | Pelvis and Hip | Walker/cane until baseline ambulation | WBAT (walker/cane for balance PRN) | |
MotionLE ROM postop; light exercise ~2-4wk Follow-Up / ImagingA 6–8 week X-ray to confirm healing. An optional 3–6 month X-ray may be used to monitor final healing. Clinical NotesThis describes a fracture near the top of the thighbone, close to the hip joint, stabilized with screws. Weight-bearing status after femoral neck fixation can vary based on the specific fracture pattern and bone quality — always follow your surgeon's individual instructions. Full Patient Page | ||||
| Intertrochanteric Hip Fracture Adult Operative | Pelvis and Hip | Walker/cane until baseline ambulation | Weight bearing as tolerated (WBAT) — you may put as much weight on the leg as feels comfortable, using a walker or cane for balance as needed. If bone loss was severe, your surgeon may instead start you at partial or touch-down weight bearing. | |
MotionLE ROM postop; light exercise ~2-4wk Follow-Up / ImagingA 6–8 week X-ray to confirm healing. An optional 3–6 month X-ray may be used to monitor final healing. Clinical NotesAn intertrochanteric fracture occurs in the upper thighbone just below the hip joint, and is typically stabilized with a plate/screw or rod construct. Getting up and moving safely (often with physical therapy) soon after surgery is an important part of recovery for this fracture. Full Patient Page | ||||
| Patella (Kneecap) Fracture After Surgery Adult Operative | Thigh and Knee | KI x6wk (ambulatory) | WBAT from start | |
MotionKI locked in extension x6wk → HKB locked in extension (ambulatory); unlock 0–30°, increasing ~20°/wk Follow-Up / ImagingA 2-week skin check with suture removal, then a 6–8 week X-ray to confirm healing. An optional 3–6 month X-ray may be used to monitor final healing. Clinical NotesThe patella (kneecap) helps the thigh muscles straighten the knee, so protecting the repair while it heals — before allowing bending — is an important early step. Full Patient Page | ||||
| Nonoperative Patella (Kneecap) Fracture Adult Nonoperative | Thigh and Knee | KI ~6wk | WBAT from start | |
MotionKI x3-4wk → HKB locked 0–50°, increase 10–20°/wk to 90° flexion, then DC Follow-Up / ImagingA 6–8 week X-ray to confirm healing. An optional 3–6 month X-ray may be used to monitor final healing. Clinical NotesSome patella (kneecap) fractures that remain in good alignment can be treated without surgery, protecting the knee in a straight position while the bone heals. Full Patient Page | ||||
| Tibial Plateau Fracture Adult Variable | Thigh and Knee | KI | NWB ~12wk | |
MotionKnee ROM ~2wk Follow-Up / ImagingA 6–8 week X-ray to check healing, then a 12-week X-ray to confirm healing and clear the weight-bearing restriction. An optional 6–9 month X-ray may be used to monitor final healing. Clinical NotesThe tibial plateau is the top surface of the shinbone that forms part of the knee joint. Protecting this weight-bearing surface while it heals — while still working on knee motion early — helps preserve knee function. Full Patient Page | ||||
| Tibial Shaft Fracture — Mid-Shaft (IM Nail) Adult Operative | Leg and Ankle | Walker/cane until baseline ambulation | WBAT, soon postop | |
MotionKnee ROM postop; light exercise ~2wk Follow-Up / ImagingA 2-week skin check with suture removal, then a 6–8 week X-ray to confirm healing. An optional 3–6 month X-ray may be used to monitor final healing. Clinical NotesThis describes a fracture in the middle portion of the shinbone (tibia) stabilized with an intramedullary nail (IMN) — a rod placed inside the bone's central canal. Mid-shaft fractures fixed this way are often able to bear weight sooner than fractures nearer the ends of the bone. Full Patient Page | ||||
| Tibial Shaft Fracture — Proximal or Distal Adult Operative | Leg and Ankle | Walker/cane until baseline ambulation | Weight bearing as tolerated (WBAT), typically starting soon after surgery — if the fracture doesn't extend into the joint. If it does extend into the joint, no weight bearing (NWB) for about 8–12 weeks. | |
MotionKnee/ankle ROM ~2wk Clinical NotesFractures near the ends of the shinbone (tibia) — closer to the knee or ankle — are generally protected with a longer non-weight-bearing period than fractures in the middle of the shaft, because the bone has less surrounding support at these locations. Full Patient Page | ||||
| Clavicle (Collarbone) Fracture Adult Variable | Shoulder and Upper Arm | Sling | No push/pull/lift ~6wk | |
MotionNRM ~6wk; pendulum exercises ~2wk Follow-Up / ImagingFollow-up visits with X-rays at 2 weeks and 6–8 weeks. Clinical NotesThis protocol applies whether your clavicle (collarbone) fracture is being treated with or without surgery — the emphasis in the early weeks is protecting the shoulder from load-bearing activity while it heals. Full Patient Page | ||||
| Scapula (Shoulder Blade) Fracture Adult Variable | Shoulder and Upper Arm | Sling | Weight bearing as tolerated (WBAT) on the arm for most scapula fractures. If the fracture involves the socket (glenoid) or the neck of the shoulder blade, a more cautious approach is used instead — see Motion below. | |
MotionNo resistance or strengthening (NRM) is advised for about 6 weeks for fractures involving the glenoid or neck of the shoulder blade. Gentle pendulum exercises (letting the arm hang and gently swing) typically begin around 2 weeks. Follow-Up / ImagingFollow-up visits with X-rays at 2 weeks and 6–8 weeks. Clinical NotesThe scapula (shoulder blade) is surrounded by muscle, so many fractures here heal well without surgery. Fractures that extend into the shoulder socket (glenoid) or the neck of the shoulder blade are treated more cautiously in the early weeks. Full Patient Page | ||||
| Operative Proximal Humerus Fracture Adult Operative | Shoulder and Upper Arm | Sling | NWB ~6wk | |
MotionNRM ~6wk; pendulum exercises ~2wk Follow-Up / ImagingA 2-week skin check with suture removal, then a 6–8 week X-ray to confirm healing. An optional 3–6 month X-ray may be used to monitor final healing. Clinical NotesThe proximal humerus is the upper part of the arm bone, near the shoulder. After surgical repair, early gentle motion (like pendulum exercises) is balanced against protecting the repair from load and resistance. Full Patient Page | ||||
| Nonoperative Proximal Humerus Fracture Adult Nonoperative | Shoulder and Upper Arm | Sling | NWB ~6wk | |
MotionNRM ~6wk Follow-Up / ImagingA follow-up visit around 1–2 weeks to recheck alignment on X-ray, then a 6–8 week X-ray to confirm healing. An optional 6–9 month X-ray may be used to monitor final healing. Clinical NotesMany proximal humerus (upper arm, near the shoulder) fractures that are well-aligned can be treated without surgery, with the shoulder protected from resistance while the bone heals. Full Patient Page | ||||
| Distal Humerus Fracture Adult Variable | Elbow and Forearm | LAS ~3wk | NWB (arm) ~12wk | |
MotionElbow ROM immediate postop Follow-Up / ImagingA follow-up visit around 1–2 weeks to recheck alignment on X-ray, then a 6–8 week X-ray to confirm healing. An optional 6–9 month X-ray may be used to monitor final healing. Clinical NotesThe distal humerus is the lower end of the upper arm bone, forming the top of the elbow joint. Even though weight bearing through the arm is restricted for an extended period, early elbow motion is prioritized to help prevent stiffness. Full Patient Page | ||||
| Olecranon Fracture After Surgery Adult Operative | Elbow and Forearm | LAS/cast ~3wk (if comminuted) | NWB (arm) ~6wk | |
MotionROM begins ~3wk; NRM (arm) ~6wk Follow-Up / ImagingA follow-up visit around 1–2 weeks to recheck alignment on X-ray, then a 6–8 week X-ray to confirm healing. An optional 6–9 month X-ray may be used to monitor final healing. Clinical NotesThe olecranon is the bony point of the elbow, where the triceps tendon attaches. Fractures that are broken into several pieces (comminuted) are typically protected in a splint or cast for longer than simpler fracture patterns. Full Patient Page | ||||
| Radius and Ulna Shaft Fracture Adult Operative | Elbow and Forearm | LAS 2wk → SAC 4wk | NWB (arm) ~6wk | |
MotionNRM (arm) ~6wk Follow-Up / ImagingA follow-up visit around 1–2 weeks to recheck alignment on X-ray, then a 6–8 week X-ray to confirm healing. An optional 6–9 month X-ray may be used to monitor final healing. Clinical NotesThis describes a fracture of both forearm bones (radius and ulna) together in an adult, typically stabilized with surgery given the load these two bones share with everyday arm rotation. Full Patient Page | ||||
| Nonoperative Distal Radius Fracture Adult Nonoperative | Wrist and Hand | LAS 2wk → SAC 4wk | NWB (arm) ~6wk | |
MotionNRM (wrist) ~6wk Follow-Up / ImagingA follow-up visit around 1–2 weeks to recheck alignment on X-ray, then a 6–8 week X-ray to confirm healing. An optional 6–9 month X-ray may be used to monitor final healing. Clinical NotesDistal radius (wrist) fractures that remain in good alignment can often be treated without surgery, protecting the wrist from resistance and strengthening while the bone heals. Full Patient Page | ||||
| Distal Radius Fracture After Surgery — Simple Pattern Adult Operative | Wrist and Hand | Volar cock-up splint 2wk → wrist brace 6wk | NWB (wrist) ~6wk | |
MotionNRM (wrist) ~6wk Follow-Up / ImagingA follow-up visit around 1–2 weeks to recheck alignment on X-ray, then a 6–8 week X-ray to confirm healing. An optional 6–9 month X-ray may be used to monitor final healing. Clinical NotesThis protocol applies to a straightforward (simple) fracture pattern treated with surgery — generally a more predictable recovery course than a severely comminuted fracture. Full Patient Page | ||||
| Distal Radius Fracture After Surgery — Severe/Comminuted Pattern Adult Operative | Wrist and Hand | LAS → SAC, ~8wk total | NWB (wrist) ~8wk | |
MotionNRM (wrist) ~8wk Follow-Up / ImagingA follow-up visit around 2 weeks for a skin check and suture removal, then a 6–8 week X-ray to confirm healing. If a dorsal spanning plate was used, a return visit around 2 months is generally planned for hardware removal. An optional 6–9 month X-ray may be used to monitor final healing. Hardware RemovalIf a dorsal spanning plate was used to stabilize a severely broken (comminuted) fracture, hardware removal is typically planned around 2 months after surgery. Clinical NotesA severely comminuted distal radius fracture — broken into several pieces — sometimes requires a spanning plate for extra stability, which is generally removed once the bone has healed enough to no longer need it. Full Patient PageDistal Radius Fracture After Surgery — Severe/Comminuted Pattern → | ||||
| Abbreviation | Meaning |
|---|---|
| NWB | No weight bearing |
| TDWB | Touch-down weight bearing |
| PWB | Partial weight bearing |
| WBAT | Weight bearing as tolerated |
| FWB | Full weight bearing |
| ROM | Range of motion |
| NRM | No resistance or strengthening |
| SAC | Short-arm cast |
| LAC | Long-arm cast |
| LAS | Long-arm splint |
| SLC | Short-leg cast |
| SLS | Short-leg splint |
| CAM boot | Controlled ankle motion boot |
| KI | Knee immobilizer |
| HKB | Hinged knee brace |
| ORIF | Open reduction and internal fixation |
| IMN | Intramedullary nail |
| HWR | Hardware removal |
| Fu | Follow-up |
| DC | Discontinue |
| PRN | As needed |
| XR | X-ray |
For questions about a specific patient or to make a referral, contact the office directly.