Bone Healing Timeline: Weeks to Recovery

What does bone healing mean?

In everyday language, when we break a bone, we wonder how long it will take to heal. This means that we are aware that there are one or more cracks in the bone, seeing that bone fragments are separated or spaced.

We know that they need to reconnect, come back together for our bone to regain strength and resume its usual functions.

In medical terms, we refer to it as:

• Fracture of a bone = a broken bone in everyday language.
• Bone healing time = bone knitting or mending in everyday language.

New bone tissue needs to form to replace what has disappeared or been damaged. Our body is naturally capable of spontaneously implementing mechanisms to facilitate this!

Why is healing important when you’ve broken a bone?

Here are the 5 main reasons why it is beneficial for a bone to “heal” after a fracture:

1. Regain full functionality: The ultimate goal of healing is to restore the normal function of the fractured bone, allowing you to resume your daily activities and mobility. Once your bone is healed, it can regain its ability to bear weight and resist applied forces.
2. Prevent complications: A broken bone can be unstable and cause pain, swelling, and even deformities. Healing prevents permanent deformities, reduced mobility, or poor joint functionality.
3. Prevent infections (in the case of an open fracture, where the bone pierces the skin): Healing helps seal the fracture, reducing potential entry points for microbes and bacteria that could cause infection.
4. Reduce pain and discomfort: Non-healed fractures can cause continuous pain and discomfort, as unstable bone fragments may rub against each other or surrounding tissues.
5. Maintain your body structure: Healing ensures the structural integrity of the skeleton, maintaining your posture, gait, and overall physical fitness.

Good healing allows you to regain, in the majority of cases, 100% of your pre-fracture abilities and avoid complications.

How do we know how long it takes for a bone to mend?

For hundreds of years, efforts have been made to better understand how a bone reforms after being damaged and how long it takes. Here are the main types of research that help estimate this:

• In-vitro studies on corpses, animals, or human-derived cells, observing cell behavior.
• Imaging exams (X-rays, MRI, CT scans, etc.) performed before/during and after a bone is broken to observe the process.
• Clinical studies that follow individuals who have broken something, evaluating how long it takes for them to recover certain capacities.

Some research teams publish their findings in scientific journals. Therefore, one can rely on this data to estimate bone healing times, in addition to the direct experience of doctors, surgeons, physiotherapists, and patients who follow or are victims of fractures.

What is the bone healing time based on the fracture location?

So, what do these different types of data tell us about bone healing? Here’s a summary with:

• The 4 typical phases of bone healing.
• Concrete average healing times based on the type of fracture.

The 4 Phases of Bone Healing

In a very theoretical sense, bone healing is divided into four phases. These phases can overlap and may last more or less time depending on the type of fracture, its location, the individual’s health, and genetic predispositions to heal more or less effectively.

Phase	Duration	What happens?
Formation of a hematoma: inflammation	Few days to a week	Right after the fracture, blood vessels in the damaged area are injured, causing a hematoma (bleeding) and resulting in reduced blood circulation. This improves over hours and days after the fracture, reaching its peak at two weeks, then returning to normal between 3 and 5 months. Your immune system reacts automatically, inducing inflammation. This inflammation brings all the necessary substances to the damaged area to aid the natural healing of the injured structures.
Formation of a soft callus: repair	Several weeks	Specialized cells in bone consolidation, osteoblasts, create new bone tissue. This is called a soft bone callus. It is composed of connective tissue and cartilage, connecting the fragments of the broken bone.
Formation of a hard callus: strengthening	Several months	Gradually, minerals (calcium, phosphorus) accumulate in the soft callus to transform it into hard bone tissue. This stabilizes the fracture, making it stronger.
Bone remodeling: maturation	Several months to several years	Over time, the new hard callus further transforms to increasingly resemble “real bone.”

As you can see, it often takes several months (or even years!) for your bone to fully return to its original state. However, your bone becomes sufficiently strong before that: you can gradually resume all your activities before the “ultimate” consolidation.

Source: Sheen 2023

The overall healing time

From how long do we estimate that the consolidation is sufficiently established to gradually resume all activities that still stress the fractured bone?

Here are some estimates, based on the fractured bone. As we will see later, other factors will also impact this duration, regardless of the fractured bone: the type of fracture, overall health, etc.

Bone Type	Approximate Healing Time	Why it Takes More or Less Time
Long Bones (e.g., femur, tibia, humerus)	6 weeks to several months	Fractures in long bones take longer because these bones are more complex and require more extensive bone regeneration.
Short Bones (e.g., wrist, ankle)	About 4 to 8 weeks	Fractures in short bones heal faster due to their small size and the proximity of fracture fragments.
End Extremities (fingers, toes)	About 4 to 6 weeks	Fractures in the end extremities heal quickly due to the small size of the bones and a higher healing capacity.
Spine, Pelvis, Face, Skull Bones	More variable: several weeks to months	In these locations, the consolidation time is even more variable.

If you want more information based on the specific type of broken bone, I provide details in my articles dedicated to each fracture. Here’s a summary of these articles:

On average, it takes around 6 weeks for a bone to be on track for healing. A follow-up X-ray usually confirms the progress of consolidation.

Other Factors Influencing Fracture Healing Time

Here are the factors that influence bone healing time:

1. Displaced vs. non-displaced fracture – greater space between broken bone ends can lengthen consolidation.
2. Complications: secondary displacement, infection.
3. Advanced age, especially over 65, weakens the immune response and delays bone healing mechanisms.
4. Obesity.
5. Anemia.
6. Hormonal disorders like diabetes, hyperthyroidism, and menopause.
7. Malnutrition, especially vitamin D and calcium deficiencies.
8. Prolonged use of certain medications: NSAIDs, corticosteroids, bisphosphonates, quinolones.
9. Tobacco or alcohol consumption (past or present).

Source: Sheen 2023

Can the duration of bone healing be shortened?

Some factors influencing the consolidation time are unchangeable, and there’s no specific medication or substance significantly accelerating the bone consolidation process.

However, here are factors that can be influenced:

1. Limit tobacco consumption as much as possible: Tobacco slows down the consolidation process.
2. Limit alcohol consumption as much as possible: Alcohol slows down the consolidation process.
3. Stay active as much as possible: Ideally, engage in at least 150 minutes per week of moderate-intensity physical activity that makes you breathe harder. Find an activity suitable for your fracture location: stationary biking, seated cycling, walking, swimming, etc.

How does activity “speed up bone consolidation”? It stimulates bone cells to produce new cells, especially by accelerating blood circulation. In addition to the general positive effects of physical activity on physical and mental health.

4. If you have osteoporosis and/or are over 65: Take vitamin D and calcium (or ensure sufficient intake through diet and sun exposure, which can be challenging to quantify): 800 to 1000 IU (International Units) of vitamin D per day and 1000 to 1200 mg of calcium per day (see on Amazon the one that appears to be the best value for money with rational doses relative to what you already consume in calcium through your diet).

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Here’s what I wanted to tell you about this! I wish you a very good recovery! Do you have any comments or questions? Your comments are welcome 🙂 !

If you feel the need to learn more about the recovery period after an injury, I wrote this guide in eBook format:

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You may also like:

• When Can You Drive after a Broken Bone?
• Home Remedies for Bone Healing
• What to do with a nonunion fracture?

 📚 SOURCES

Sheen JR, Mabrouk A, Garla VV. Fracture Healing Overview. [Updated 2023 Apr 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551678/

Roberts, C. S., & Falls, T. D. (2012). Talking turkey: Fracture care and smoking cessation. Injury, 43(3), 257–258. doi:10.1016/j.injury.2012.01.018 

Dey D, Jingar P, Agrawal S, Shrivastava V, Bhattacharya A, Manhas J, Garg B, Ansari MT, Mridha AR, Sreenivas V, Khurana A, Sen S. Symphytum officinale augments osteogenesis in human bone marrow-derived mesenchymal stem cells in vitro as they differentiate into osteoblasts. J Ethnopharmacol. 2020 Feb 10;248:112329. doi: 10.1016/j.jep.2019.112329. Epub 2019 Oct 28. PMID: 31672526.

Prieto-Alhambra D, Turkiewicz A, Reyes C, Timpka S, Rosengren B, Englund M. Smoking and Alcohol Intake but Not Muscle Strength in Young Men Increase Fracture Risk at Middle Age: A Cohort Study Linked to the Swedish National Patient Registry. J Bone Miner Res. 2020 Mar;35(3):498-504. doi: 10.1002/jbmr.3917. Epub 2019 Dec 4. PMID: 31714618.

Howe TE, Shea B, Dawson LJ, Downie F, Murray A, Ross C, Harbour RT, Caldwell LM, Creed G. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD000333. DOI: 10.1002/14651858.CD000333.pub2

Avenell A, Mak JCS, O’Connell DL. Vitamin D and vitamin D analogues for preventing fractures in post‐menopausal women and older men. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD000227. DOI: 10.1002/14651858.CD000227.pub4. Accessed 25 August 2023.

Image : Ghiasi MS, Chen J, Vaziri A, Rodriguez EK, Nazarian A. Bone fracture healing in mechanobiological modeling: A review of principles and methods. Bone Rep. 2017 Mar 16;6:87-100. doi: 10.1016/j.bonr.2017.03.002. PMID: 28377988; PMCID: PMC5365304.