Bone Tear (Avulsion Fracture): What Is It? A Physiotherapist’s Guide

You’ve been diagnosed with a “bone tear“. In “official” medical terms, we say “avulsion fracture”.

I’m just trying to explain what it is and what the consequences are!

Summary: A bone tear occurs when a ligament or tendon pulls too hard on the bone, detaching a fragment.

♻️ Last update: September 15, 2025
Written by Nelly Darbois, physiotherapist and scientific editor

What happens when you have a bone tear? Definition

First of all, you need to know that bone tearing is synonymous with bone stripping. These 2 terms refer to the same thing from an anatomical point of view. And there’s another synonym: fracture-avulsion.

So what happens to the bone when you have this?

In fact, one is a particular type of fracture.

Part of your bone is broken.

In a typical fracture: the bone itself breaks into two or more pieces.

In a bone tear : a ligament, tendon or other soft tissue that fits over the bone has pulled too hard on it and “torn” a small fragment of bone. Or as a result of years of repetitive stress.

This diagram shows the differences:

How can you be sure that a bone has been torn out?

Bone tears are difficult to diagnose without X-rays. Depending on the part of the body involved, other imaging tests are sometimes performed to get a clear view.

The symptoms of a bone tear are not very characteristic. You can have the same symptoms with a “simple” sprain or contusion, or a fracture:

• very severe pain ;
• difficulty using the injured limb;
• swelling, redness, appearance of a hematoma.

X-rays are generally the best way to diagnose a bone tear.

See also: Ankle fracture or sprain, how to know?

What are the most common bone tears?

In adolescents and children, bone tears occur most frequently:

• at the basin ;
• knee.

Adults:

• to the ankle malleolus;
• at the foot ;
• knee ;
• at the hip;
• shoulders;
• at the elbow ;
• on the wrist
• hand and fingers (especially the thumb).

Source : Choi 2021

This diagram of the human body shows the most common locations of bone loss:

How long does it take to recover from a bone tear?

Several factors are involved in the healing time of a bone tear:

• your general state of health ;
• smoking or drinking alcohol (these 2 things slow healing and consolidation);
• whether or not you had a significant displacement of the broken fragment;
• of the tear site;
• Genetic predisposition to more or less successful recovery;
• if you have already had other sprains with or without tearing on this ankle.

But even taking all these factors into account, it’s very difficult to say to yourself: you’re going to consolidate completely in X weeks, and do it all over again in X months.

Here’s an idea, based on experience with my patients:

Activity	Deadlines
You can drive your car back	A few days to a few weeks or even months
You have much less pain	A few days.
Less swelling and edema	A few weeks, even a few months
Damaged soft tissue heals, bone fragment consolidates	Several months. But the healing of the ligament is well advanced after a month, and the consolidation of the bone after 1? months.
Removing the cast, walking boot or splint	After 3 to 6 weeks, often after a follow-up x-ray
You can start cycling again	2-3 to 6 weeks
You walk on crutches	Immediately, often with support, sometimes without support
You start your rehabilitation	Immediately, or when you remove the cast, splint or walking boot
You stop physical therapy	Very variable: some people don’t need it and do their own rehabilitation. Others have physiotherapy sessions lasting several months.
You can resume your other sporting activities	Usually several weeks minimum, sometimes several months
You are totally cured	A few weeks to a few months

How is a bone tear treated?

Here again, treatment will vary greatly depending on all the factors I’ve listed above. But also according to the habits of the medical team you come across!

Basically, there are 2 main types of treatment.

Surgical treatment.

You undergo surgery because it is felt that consolidation and healing will not be sufficient without assistance.

Material is used to stabilize the bone fragment to the bone. This surgical material is removed at a distance from the operation if it causes any discomfort.

Surgical treatment is uncommon.

Orthopedic treatment.

It can be used in addition to surgical treatment, or can replace it altogether.

In the latter case, your medical team has decided that you can heal and consolidate without surgical assistance.

Depending on the location of the bone tear, you may be fitted with a cast, splint or walking boot.Partial or total immobilization can facilitate healing and consolidation.

You’ll probably also be asked to put less strain on the current joint while it heals or consolidates. For example, by avoiding sport, or movements that are too intense and repeated.

Rehabilitation.

Depending on the “severity” of your tear and how well you’re recovering on your own, physiotherapy sessions may also be prescribed.

The main aim of physiotherapy sessions is to help you regain your former independence!

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That’s all I wanted to say on the subject! Any questions or comments? See you in comments!

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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