Broken Bones and Fractures in Los Angeles County: Why Not All Fractures Are Equal and What the Type, Location, and Complications Mean for Your Claim 

A broken bone is not a broken bone is not a broken bone. That phrase may sound unusual, but it captures one of the most important concepts in understanding fracture injuries in personal injury cases. Not all broken bones are alike, and the medical and legal consequences can vary dramatically depending on the type, location, and severity of the fracture.

Not All Fractures Are the Same

A hairline crack in a metatarsal — the long bone in the foot — treated with a walking boot and fully healed in six weeks is a broken bone. A shattered tibial plateau — the top of the shin bone that forms the lower half of the knee joint — requiring complex orthopedic surgery and leading to post-traumatic arthritis and a total knee replacement a decade later is also a broken bone.

Both injuries are technically “fractures,” but they are worlds apart in terms of their impact on health, daily life, and a personal injury claim. The first may involve a short period of inconvenience, limited time off work, and minimal long-term consequences. The second can involve:

• Multiple surgeries and hospitalizations
• Permanent hardware in the bone
• Chronic pain and stiffness
• Reduced mobility and altered gait
• Long-term changes in daily activities and recreation
• Ongoing medical follow-up and future procedures

In other words, both are fractures, but they are not remotely the same in how they affect a life, a career, or a future.

Why Fractures Matter in Personal Injury Claims

Fractures have one significant advantage over soft tissue injuries in the personal injury context: they are objective. The break is visible on imaging. The surgery is documented in an operative report. The healing — or failure to heal — is tracked on serial X-rays and follow-up visits.

An insurance company cannot look at an imaging report showing a displaced fracture and claim there is nothing objective to support an injury claim. Unlike sprains, strains, or whiplash-type injuries that may rely heavily on reported symptoms, fractures leave a clear trail of medical evidence, including:

• Emergency room and urgent care records
• Radiology reports and X-ray, CT, or MRI images
• Orthopedic and surgical consultations
• Physical therapy and rehabilitation notes
• Documentation of hardware placement and removal

This objective record can be critical in proving that an injury occurred, how severe it was, what treatment was required, and how it may affect long-term function and quality of life.

How Insurance Companies Minimize Fracture Claims

Insurance companies often accept that a fracture occurred but work hard to minimize its consequences. They may argue that a person has fully recovered once the bone appears healed on X-ray and ignore the long-term complications that may not fully manifest for months or years after the accident.

Adjusters frequently focus narrowly on the initial fracture, cast, or surgery, while overlooking issues such as:

• Stiffness and loss of range of motion
• Nerve damage, numbness, or tingling
• Altered gait and difficulty walking
• Increased risk of post-traumatic arthritis
• Need for future injections, hardware removal, or joint replacement
• Limitations on work duties, hobbies, and family activities
• Emotional distress and anxiety related to chronic pain or disability

They may also point to pre-existing degenerative changes or prior injuries to suggest that ongoing problems are unrelated to the accident. Understanding these complications — and making sure they are addressed in medical care and in any personal injury claim — is essential.

Long-Term Impact and Future Needs After a Fracture

Serious orthopedic injuries can have lasting effects that go far beyond the initial healing period. A comprehensive evaluation of a fracture case often includes:

• Future medical needs, including possible surgeries or joint replacements
• Potential work limitations and reduced earning capacity
• Impact on hobbies, sports, and family responsibilities
• Need for assistive devices or home modifications
• The emotional toll of living with chronic pain or permanent impairment

Both minor and severe fractures can change the course of a life, but high-impact, complex, or joint-involving fractures are especially likely to create long-term orthopedic and functional problems. Nothing here is legal advice. A free case evaluation is available to discuss a specific situation.

Understanding Your Fracture: What the Terms in Your Medical Report Mean

If you have received an imaging report or a discharge summary after a fracture, it is probably full of terms that mean nothing to you. Here is a plain-English translation of the most important ones. 

Displaced vs. Non-Displaced: The First Question That Matters

When a bone breaks, the two pieces may stay in their normal position relative to each other — or they may shift out of alignment. This shift, called displacement, can be very subtle or quite dramatic. It plays a major role in how the fracture is treated, how long it takes to heal, and what the long-term outcome looks like for bone health, mobility, and function.

A non-displaced fracture means the broken pieces of bone stayed in place. The bone is cracked, but the crack has not shifted. It is similar to a crack in a windshield that has not yet spread — the glass is compromised, but everything is still where it belongs. In the same way, the bone’s overall shape and alignment are preserved, even though the surface has been damaged.

Non-displaced fractures in many locations can often be managed conservatively — with a cast, a brace, or protective weight bearing — without surgery. Treatment typically focuses on:

• Immobilizing the injured area
• Controlling pain and swelling
• Allowing the body’s natural healing process to knit the bone back together

Follow-up X-rays are usually taken to make sure the fracture has not shifted over time and that bone healing is progressing as expected. Proper monitoring helps reduce the risk of complications and supports a full recovery.

A displaced fracture means the broken pieces of bone have moved apart. The bone has broken and shifted — like a windshield crack that has suddenly spread across the entire glass. Sometimes the ends of the bone overlap, twist, or angle away from their normal position, which can change the shape of the limb or joint and affect normal movement.

Displaced fractures typically require reduction — putting the pieces back together — and fixation — holding them in place while they heal. Depending on the bone involved and the degree of displacement, this may be possible by manipulation alone under anesthesia, or it may require surgery to open the area, align the pieces under direct vision, and hold them with plates, screws, rods, or other orthopedic hardware.

In more complex injuries, multiple pieces of bone may need to be reconstructed like a puzzle. After surgical treatment, patients often need physical therapy to restore strength, motion, and function, and to reduce the risk of long-term stiffness or weakness.

From a legal and insurance standpoint, displacement matters because it typically means surgery — and surgery usually leads to higher medical costs, a longer recovery, and a more significant impact on daily life and the ability to work. A displaced fracture can result in:

• More time away from employment and lost wages
• Greater need for assistance with daily activities
• More extensive medical treatment and rehabilitation
• A higher risk of long-term complications such as stiffness, chronic pain, or arthritis in the affected joint

These factors can influence the overall value of a personal injury claim, the extent of damages, and the documentation needed to fully capture the impact of the fracture over both the short and long term. Detailed medical records, imaging, and treatment notes are often essential to demonstrate how a displaced fracture has affected health, function, and quality of life.

Simple, Comminuted, and Segmental: How Many Pieces?

Simple Fracture

A simple fracture has one clean fracture line, meaning the bone breaks in a single place and produces two main pieces. This type of bone fracture is usually easier to align and stabilize because there are only two primary fragments to manage, and the surrounding soft tissues are often less severely damaged.

Simple fractures are commonly seen after lower-energy injuries, such as twisting an ankle, a fall from standing height, or a direct blow during sports. With proper fracture treatment and immobilization, these breaks often heal predictably, especially when the bone ends are well aligned and the blood supply to the area is preserved.

Comminuted Fracture

A comminuted fracture occurs when the bone shatters into three or more pieces. It is similar to the difference between snapping a dry twig in two versus slamming it against a hard surface: one produces a clean break, while the other creates multiple fragments.

In a comminuted fracture, the bone fragments can be large or very small, and they may be displaced, overlapping, or rotated. This makes restoring the normal shape and length of the bone more challenging. Comminuted fractures typically result from high-energy impacts, such as major vehicle accidents, falls from significant height, or crushing injuries.

These complex fractures are more difficult to surgically repair because every fragment needs to be addressed, and the bone quality at the fracture site may be poor. Orthopedic surgeons may need to use plates, screws, rods, or even bone grafts to rebuild the bone, restore alignment, and support healing. Recovery is often longer and carries a higher risk of stiffness, infection, or delayed union.

Segmental Fracture

A segmental fracture has two separate fracture lines, creating a free-floating middle segment of bone that has lost its blood supply from both ends. This fracture pattern is most often seen in long bones such as the femur, tibia, or humerus, usually after a strong, direct force applied along the length of the bone.

This loss of blood supply is important because bone segments without adequate circulation can die, a complication called avascular necrosis. Avascular necrosis significantly affects fracture healing, bone strength, and the long-term outcome for the affected limb.

Segmental fractures usually require careful surgical stabilization to reconnect all bone segments, protect and restore blood supply as much as possible, and allow early, controlled movement. This approach helps reduce the risk of joint stiffness, muscle wasting, and long-term functional limitations.

Open Fractures: When the Bone Comes Through the Skin

What Is an Open (Compound) Fracture?

An open fracture — sometimes still called a compound fracture — occurs when a broken bone pierces through the overlying skin and is exposed to the outside environment. In this type of traumatic injury, there is not only a fracture of the bone, but also a break in the skin and soft tissues, creating a direct pathway from the outside world to the bone and deeper structures.

This combination of a broken bone and an open wound is a surgical emergency for one primary reason: the high risk of bone infection.

Under normal circumstances, bone is sterile. Once exposed to bacteria in the outside world — particularly in a dirty environment such as a road surface, farmyard, construction site, or industrial setting — the risk of osteomyelitis (bone infection) becomes very high. Osteomyelitis is one of the most serious complications in orthopedic trauma. It is difficult to treat, prone to becoming chronic, and in severe cases can lead to loss of the infected limb. In the most extreme situations, uncontrolled infection can spread to the bloodstream, become life-threatening, and result in sepsis.

Treatment of an Open Fracture

Treatment of an open fracture requires emergency surgical irrigation and debridement — washing out the wound and removing contaminated or dead tissue — followed by fracture stabilization. Prompt treatment in a hospital or trauma center is critical to reduce the risk of infection and long-term complications.

This procedure usually takes place in an operating room under anesthesia, where large volumes of sterile fluid are used to flush the wound and any dead, damaged, or heavily contaminated tissue is carefully removed. After the wound is cleaned, the broken bone must be stabilized so it can heal in the correct position.

Fracture stabilization can involve:

• Metal plates and screws
• Intramedullary rods or nails
• An external fixator frame to hold the bone in alignment from outside the body

The wound may be left open initially to reduce infection risk and then closed in a second procedure once the risk of infection has been controlled. In some cases, temporary dressings or vacuum-assisted wound therapy (negative pressure wound therapy) are used between surgeries to help control swelling, remove fluid, and promote healthy tissue growth and wound healing.

Severity, Classification, and Complications of Open Fractures

Open fractures are classified by severity — from relatively limited soft tissue injury to extensive tissue loss requiring complex plastic surgical reconstruction. This open fracture classification system takes into account:

• The size of the wound
• The amount and type of contamination (dirt, debris, foreign material)
• The degree of soft tissue damage, including muscle, skin, and tendons
• Whether blood supply to the limb has been compromised

Higher-grade open fractures carry correspondingly higher risks of infection, delayed healing, and long-term complications. These complications can include:

• Nonunion of the fracture (failure of the bone to heal)
• Chronic pain and ongoing inflammation
• Joint stiffness and reduced range of motion
• Significant scarring and cosmetic deformity
• Repeated surgeries and revision procedures
• Prolonged rehabilitation and physical therapy
• Permanent loss of function or disability

These long-term effects often result in a significant impact on work, daily activities, independence, and overall quality of life, and can be associated with substantial medical costs and long-term damages.

Intra-Articular Fractures: When the Break Goes Into the Joint

This fracture type carries the most serious long-term consequences and is the one most likely to lead to post-traumatic arthritis, which often becomes the dominant future damages issue in a personal injury or accident case.

What Is an Intra-Articular Fracture?

An intra-articular fracture occurs when the fracture line extends into the surface of a joint — the smooth, cartilage-covered area where two bones meet to allow movement. That joint surface can be compared to a perfectly smooth tile floor. When a fracture cuts through it, the result is an uneven surface — a “step-off” — that alters how the joint bears and distributes load during movement.

How Intra-Articular Fractures Lead to Post-Traumatic Arthritis

Even when a surgeon achieves excellent alignment — reducing the step-off to within two millimeters of normal — the cartilage disrupted by the fracture has already been damaged at the cellular level. Cartilage cells do not regenerate. Over time, the damaged cartilage begins to break down under the mechanical stress of daily use, the degeneration spreads to adjacent cartilage, and the joint progressively develops post-traumatic arthritis.

High-Risk Joints and Long-Term Damages

The most significant intra-articular fractures in accident and trauma cases — tibial plateau fractures at the knee, acetabular fractures at the hip, ankle fractures involving the joint surface, and wrist fractures involving the radiocarpal joint — all carry a substantial long-term arthritis risk. This elevated risk of post-traumatic arthritis must be specifically evaluated and addressed in any comprehensive damages analysis and future medical needs assessment.

The Fractures That Matter Most in Los Angeles County Accident Cases

Los Angeles County produces a distinct pattern of fracture injuries based on its unique accident demographics — high-speed freeway collisions, pedestrian accidents on busy surface streets, slip and fall accidents at commercial properties, motorcycle accidents on canyon roads, and workplace accidents in the county's large industrial and construction economy. These incidents often occur in densely populated urban areas, during heavy commute hours, or in locations where vehicles, cyclists, and pedestrians are forced to share limited space, creating a higher risk of serious impact injuries and traumatic fractures.

The combination of heavy traffic, tourism, nightlife, and ongoing development projects throughout Los Angeles means that fractures can result from a wide range of accident scenarios, from multi-car pileups on the freeway to falls on poorly maintained sidewalks, parking lots, or stairways, as well as scaffolding accidents and other construction site incidents. These conditions contribute to a high volume of orthopedic injuries and broken bones across the region.

Here are the fracture types that appear most frequently in personal injury cases in this market, especially in claims involving medical treatment, emergency care, surgery, lost wages, and long-term rehabilitation needs. 

Hip Fractures: The Most Dangerous Fracture for Older Adults

Hip Fractures in Older Adults: Serious Injuries and High-Value Injury Cases

Hip fractures in older adults are among the most serious injuries in the entire personal injury spectrum — and they are often among the highest-value cases when they result from someone else's negligence. These injuries frequently arise in premises liability cases and can lead to substantial compensation in clear-liability claims.

Medical Severity of Hip Fractures in Elderly Patients

Hip fractures are a major public health concern in the United States. Approximately 300,000 hip fractures occur nationwide each year, and the vast majority involve adults over age 65. The one-year mortality rate after a hip fracture in elderly patients runs from 20 to 30 percent in published medical literature. This means that up to one in four older adults who sustain a hip fracture does not survive the following year.

The causes of this high mortality rate are multifactorial. Death may result from the fracture itself, from hip surgery, from complications of prolonged immobility, or from the cascade of medical events that a hip fracture can trigger in a body with limited physiological reserve.

Long-Term Consequences and Loss of Independence

For those who survive a hip fracture, the long-term consequences can be profound and life-changing. Many older adults never fully regain their pre-injury level of independence or mobility. Common outcomes include:

• Permanent need for skilled nursing facility care
• Ongoing in-home assistance with daily activities
• Loss of the ability to live independently
• Inability to resume driving or community activities

These functional losses significantly affect quality of life and are central to the damages analysis in serious personal injury and slip and fall cases.

Femoral Neck Fractures and Avascular Necrosis

The most common hip fracture in this older population — a femoral neck fracture, where the ball of the hip breaks off from the shaft — is particularly serious. The blood supply to the femoral head runs through the femoral neck. When the neck fractures, that blood supply is disrupted, which is why these fractures carry a significant risk of avascular necrosis, the death of the femoral head from loss of blood supply.

In elderly patients, the standard treatment for displaced femoral neck fractures is immediate hip replacement surgery — either partial (hemiarthroplasty) or total (total hip arthroplasty). Because of the high risk of fixation failure and avascular necrosis, internal fixation of the original bone is often unreliable in this population and is generally not the preferred treatment.

Hip Fractures and Premises Liability in Los Angeles County

In the legal context, hip fractures from premises liability accidents — such as a wet floor at a Burbank supermarket, an uneven parking lot surface at a Van Nuys shopping center, or inadequate lighting in a Glendale restaurant — are among the most significant personal injury cases in Los Angeles County.

These cases often involve substantial damages, including:

• Hospital and surgical costs for hip fracture repair or hip replacement
• Skilled nursing facility rehabilitation and physical therapy
• In-home assistance during recovery and beyond
• Permanent changes in function, mobility, and independence
• Profound non-economic damages from pain, suffering, and loss of enjoyment of life

When a life-altering hip fracture results from a preventable slip and fall or other dangerous property condition, the economic and non-economic damages in clear-liability cases can be significant.

Eggshell Plaintiff Doctrine and Osteoporosis in Elderly Victims

The eggshell plaintiff doctrine under California Civil Jury Instruction CACI 3927 is particularly important in hip fracture cases involving elderly victims with osteoporosis — the age-related reduction in bone density that makes older adults vulnerable to fractures from forces that would not fracture a young adult's bone.

Under this doctrine, a property owner is not excused from liability because a visitor's bones were more fragile or because the victim had pre-existing conditions such as osteoporosis. The negligent party must take every visitor as they find them, including those who are more susceptible to serious injury from a fall or other premises liability accident.

Tibial Plateau Fracture: Knee Fracture From Vehicle Impacts

What Is the Tibial Plateau?

The tibial plateau is the top surface of the shin bone — the flat, load-bearing area that forms the lower half of the knee joint and supports the femur above. This critical part of the knee joint helps absorb weight and allows smooth motion during walking, running, and other activities.

The tibial plateau is divided into medial (inner) and lateral (outer) compartments, both of which are covered with smooth articular cartilage. This cartilage allows the knee to bend and straighten with minimal friction and protects the underlying bone.

How Tibial Plateau Fractures Occur

In vehicle accidents — particularly pedestrian accidents where the vehicle bumper strikes the lateral knee — and in high-energy falls from a height, sports collisions, or crush injuries, this surface can fracture. These tibial plateau fractures may range from simple cracks to complex, multi-fragment breaks that depress or shatter the joint surface.

Severe tibial plateau fractures can also injure surrounding ligaments, menisci, and soft tissues, increasing the risk of long-term knee instability, pain, and disability.

Risks and Long-Term Effects of Tibial Plateau Fractures

Tibial plateau fractures are intra-articular — they run through the joint surface — which means they carry a significant risk of post-traumatic knee arthritis. Because the fracture line crosses the cartilage-bearing portion of the joint, even small irregularities in the surface can alter how forces are transmitted through the knee with every step.

Over time, this abnormal loading accelerates wear of the cartilage, leading to stiffness, chronic knee pain, swelling, and loss of motion. Even with excellent surgical reduction, the articular cartilage damage from the fracture itself sets the clock ticking toward progressive joint degeneration and osteoarthritis.

In many cases, patients experience increasing symptoms years after the initial injury, requiring ongoing medical care, pain management, activity modification, and eventually total knee replacement surgery. These long-term consequences are a key factor in evaluating future medical needs and life care planning after a tibial plateau fracture.

Surgical Treatment and Recovery After Tibial Plateau Fracture

Surgery for tibial plateau fractures typically involves open reduction and internal fixation — plates and screws placed to hold the joint surface in proper alignment while it heals. In more complex injuries, bone graft or bone substitute may be used to support depressed areas of the plateau, and staged procedures may be required to address soft-tissue swelling before definitive fixation.

Rehabilitation and Functional Impact

Recovery requires a prolonged period of non-weight bearing — typically six to twelve weeks of not putting weight on the leg — followed by a gradual rehabilitation process that can take six months to a year before full function is restored. During this time, patients often need assistive devices such as walkers, crutches, or wheelchairs, as well as structured physical therapy to restore strength, balance, and range of motion.

Some individuals never return to their prior level of activity or employment and may face permanent restrictions on standing, walking, climbing, or heavy labor. These functional limitations can significantly affect long-term mobility, independence, and earning capacity.

Life Care Planning for Tibial Plateau Fractures

The life care plan for a significant tibial plateau fracture must specifically project the expected timeline for the development of post-traumatic knee arthritis — based on the severity of the fracture pattern — and the cost of total knee replacement and potential revision surgery over the claimant's life expectancy.

This projection should also account for interim care needs, including orthopedic follow-up, imaging studies, periodic injections, bracing, medications, and ongoing physical therapy or exercise programs to manage symptoms and preserve function as long as possible.

Without that projection, the economic damages in these cases are substantially undervalued, because they fail to capture the long-term impact of progressive joint deterioration, future surgical interventions, extended rehabilitation, and the associated loss of earning capacity and quality of life over decades after the initial injury.

Vertebral Fractures: When the Spine Itself Breaks

Vertebral fractures are breaks in the bones that form the spine. These spinal fractures most often occur in high-energy motor vehicle accidents, falls from height, and in older adults with osteoporosis, where even relatively minor forces can cause serious injury. Vertebral fractures are a common cause of severe back pain and can lead to long-term spinal deformity and disability if not properly diagnosed and treated.

Compression Fractures of the Spine

A compression fracture occurs when the front of a vertebral body collapses under compressive loading, similar to a marshmallow being pushed down from above. In older adults with osteoporosis, compression fractures can result from the force of a rear-end collision, a slip and fall landing on the buttocks, or even a severe cough. These osteoporotic compression fractures are a frequent source of acute and chronic back pain.

Compression fractures can cause:

• Significant, often sudden-onset back pain
• Loss of height over time
• Progressive spinal deformity, including a hunched-forward posture (kyphosis), especially when multiple adjacent vertebrae fracture

Burst Fractures and Spinal Canal Compromise

A burst fracture is a more severe type of vertebral fracture in which the entire vertebral body fails. Bone fragments can be driven into the spinal canal, threatening the spinal cord or nerve roots and creating a high risk of spinal cord injury. Because of this instability and the danger to the nervous system, burst fractures typically require surgical stabilization and, in many cases, decompression of the spinal canal.

The risk of neurological deficit — including paralysis, weakness, numbness, and other nerve damage similar to that described on the spinal cord injury page — is a major concern with burst fractures of the spine.

Spinal Fractures, Back Injury, and Neurological Risk

The back and spine injury page covers spinal fractures in the context of their relationship to the spinal cord and nerve roots in greater detail. The key point is that a vertebral fracture is not simply a “broken back.” It represents a structural failure of the protective column surrounding the spinal cord, with immediate and potentially permanent neurological implications if the injury is not promptly recognized and appropriately managed.

Pelvic Fractures: When the Foundation Breaks

Pelvic Fractures After High-Energy Accidents

The pelvis is the bony basin that connects the spine to the legs and supports the abdominal organs and major blood vessels. In high-energy vehicle accidents, pelvic fractures can be life-threatening — not primarily because of the broken bones themselves, but because of the damage the fracture can cause to the vital structures within the pelvis.

Life-Threatening Pelvic Bleeding and Emergency Care

The pelvic venous plexus — the dense network of veins within the pelvis — can bleed massively when the bony ring is disrupted. Blood loss into the pelvis can approach or exceed two liters, which is enough to cause life-threatening hemorrhage and shock.

Emergency management of unstable pelvic fractures focuses first on controlling that internal bleeding. Common interventions include:

• Pelvic binders to stabilize the pelvic ring
• Emergency surgery to control hemorrhage
• Additional trauma care to support blood pressure and organ function

Long-Term Consequences of Major Pelvic Fractures

For accident victims who survive a major pelvic fracture, recovery is often prolonged, and the long-term consequences can be significant. The bladder, urethra, rectum, and pelvic nerves are all at risk from both the fracture and the surgical interventions required to treat it.

Serious complications from pelvic fractures and their treatment can include:

• Bladder and bowel dysfunction
• Sexual dysfunction
• Lower extremity nerve damage and weakness
• Chronic pain and mobility limitations

Pelvic Fractures and Personal Injury Damages

From a damages standpoint, major pelvic fractures are among the most complex personal injury presentations. They combine:

• Significant immediate medical costs and trauma care
• Potential neurological consequences and nerve damage
• Long-term functional limitations and disability
• Profound non-economic impact, including pain, suffering, and loss of quality of life

This combination of medical, functional, and non-economic harms creates a damages framework that typically requires a comprehensive life care plan to address fully.

Wrist Fractures: The Protective Reflex That Backfires

Wrist fractures are among the most common injuries in slip and fall accidents. The most frequent type is a wrist fracture of the distal radius, sometimes called a Colles fracture. During a fall, the natural reflex is to reach out and break the fall with the hands. This protective reaction sends enormous compressive force through the wrist at the moment of impact, and the distal radius—the end of the forearm bone closest to the wrist—absorbs most of that force.

Simple, non-displaced distal radius fractures are typically treated with a cast and usually heal well with conservative care. More serious injuries, such as displaced or comminuted distal radius fractures, especially those that extend into the wrist joint (intra-articular fractures), may require surgical fixation. This often involves a plate and screws placed through an incision on the front of the wrist to restore alignment, stability, and function.

The legal significance of wrist fractures in accident and personal injury cases often arises from long-term consequences that are not apparent on the initial X-rays or imaging studies. Intra-articular wrist fractures carry a substantial risk of developing post-traumatic wrist arthritis, which can lead to chronic pain, stiffness, and reduced function over time.

In addition, injuries to the triangular fibrocartilage complex (TFCC)—the key stabilizing structure on the pinky side of the wrist—frequently occur along with wrist fractures. If TFCC injuries are not specifically identified and treated, they can cause ongoing wrist pain, instability, and difficulty with weight-bearing or rotational activities.

For individuals whose occupations demand fine manual dexterity and precise hand function—such as musicians, surgeons, craftspeople, and carpenters—even a moderate loss of grip strength or reduced wrist range of motion after a fracture can have a significant vocational impact. These long-term functional limitations can affect earning capacity, job performance, and overall quality of life following a slip and fall accident.

Facial Fractures: Function and Appearance

Facial fractures are common injuries in motor vehicle accidents, where the face can strike an airbag, steering wheel, or dashboard. They also occur in pedestrian accidents from face-to-ground impact and in any incident involving direct facial trauma. These injuries range from simple nasal fractures to complex midface fractures that require multi-specialty surgical reconstruction by experienced trauma surgeons.

Nasal fractures are the most common type of facial fracture — and often the most overlooked. From the outside, the nose may appear to heal and the injury can look minor. However, a displaced nasal fracture that is not properly reduced can lead to permanent nasal deformity and chronic nasal obstruction that affects breathing for life. The functional and cosmetic consequences of inadequately treated nasal fractures are real and compensable in a personal injury claim.

Permanent visible facial deformity from a nasal fracture or other facial fracture can result in significant cosmetic damages. These issues, including scarring, disfigurement, and long-term changes in appearance, are discussed in more detail on the scarring and disfigurement page of this site.

More complex facial fractures — including orbital fractures involving the eye socket, midface fractures, and jaw fractures — typically require surgical reduction and fixation by oral and maxillofacial surgeons or craniofacial surgeons. These procedures often involve significant postoperative swelling and discomfort and may require a lengthy recovery period.

In some cases, complex facial fractures produce permanent changes in bite alignment, facial symmetry, or vision. These lasting functional consequences can affect chewing, speaking, facial expression, and eyesight, and may require ongoing medical care, revision surgery, or rehabilitative treatment. 

Rib Fractures: Why Your Breathing Hurts and Why It Matters

Rib fractures turn every breath into an exercise in pain management. Breathing cannot be avoided, and with each inhale and exhale the fractured rib moves, triggering sharp pain. Every cough, every laugh, and every deep breath becomes a vivid reminder that something inside the chest is broken.

Pain, Shallow Breathing, and Lung Complications

The intense pain from rib fractures often causes people to breathe shallowly, either consciously or unconsciously, to avoid the deep breaths that hurt. This pattern of shallow breathing can lead to the collapse of small segments of the lung, a condition known as atelectasis. Atelectasis significantly increases the risk of developing pneumonia.

For elderly patients, pneumonia following rib fractures is a leading cause of mortality. This is why rib fractures in older adults are treated far more seriously in medical and legal settings than the general public typically realizes.

Multiple Rib Fractures and Flail Chest

Multiple rib fractures, usually defined as three or more broken ribs, create more serious respiratory compromise. These injuries often require hospitalization for advanced pain management, continuous respiratory monitoring, and prevention of complications such as pneumonia or respiratory failure.

Flail chest is an especially severe and life-threatening form of rib injury. It occurs when three or more adjacent ribs are each broken in two places, creating a free-floating segment of the chest wall. This unstable segment moves paradoxically with breathing, severely impairing ventilation and oxygenation. Flail chest typically requires ICU-level care and may necessitate mechanical ventilation and other intensive interventions.

Rib Fractures in the Legal Context

In personal injury and medical-legal cases, rib fracture claims often involve more significant damages than the initial emergency room presentation suggests. The risk of respiratory complications, the prolonged period of pain with every breath, and the substantial limitations on physical activity during the extended healing process all contribute to a damages profile that extends far beyond the fracture itself.

When Fractures Get Complicated: Long-Term Consequences That Increase Damages

The initial fracture is only the beginning of the medical story in many personal injury cases. What happens during the healing process — and what the joint looks like years after the bone has healed — often determines more of the total damages picture than the acute injury itself.

These long-term complications after a fracture are not rare or unpredictable. They are well documented in the orthopedic and medical literature, specific to particular fracture types, and entirely expected in a meaningful proportion of cases. For this reason, they must be included in a comprehensive damages analysis in any personal injury or medical-legal claim.

A detailed life care plan that anticipates and projects these expected future consequences — including chronic pain, loss of function, post-traumatic arthritis, and the need for future treatment — is essential to any significant fracture case. 

Non-Union: When the Bone Refuses to Heal

Bone Healing and Non-Union Fractures

Bone normally heals by forming new bone tissue that bridges the gap between fracture fragments. In most fractures this healing process is reliable and predictable. However, in some patients and with certain fracture types, this process fails and the bone does not unite as expected.

What Is a Non-Union Fracture?

Non-union is the diagnosis when a fracture has not healed within the expected timeframe, generally six to nine months after the initial injury. In a non-union fracture, the broken bone ends remain separated instead of joining together with solid new bone.

Non-union can be compared to two ends of a bridge that were supposed to connect in the middle but never did. The gap remains open. The two sides move relative to each other with activity, producing ongoing pain, instability, and preventing the return of normal function.

Treatment of Non-Union Fractures

Treatment of non-union usually requires revision surgery. This typically involves returning to the fracture site, removing the failed or fibrous healing tissue, and stimulating the bone ends to restart the healing process. In most cases, bone graft is added — bone tissue harvested from elsewhere in the patient's body or from a donor — to provide the biological material and growth factors the healing process needs.

• Removal of non-viable tissue at the fracture site
• Stimulation of the bone ends to encourage new bone growth
• Use of bone graft from the patient or a donor to support healing
• Stabilization of the fracture to allow solid bone union

Legal Impact of Non-Union in Injury Cases

From a legal standpoint, non-union dramatically changes the damages calculation in a personal injury or medical malpractice case. A non-union fracture often means:

• A second surgical procedure
• A second, extended recovery period
• Additional lost wages and loss of earning capacity
• Increased medical expenses and rehabilitation costs
• An extended psychological burden from an injury that should have healed but has not

Non-union also raises the critical question of why the fracture failed to heal. This is an issue that must be carefully evaluated in the legal context. In some cases, patient factors such as smoking, diabetes, or poor nutrition contribute to non-union. In others, the fracture pattern, the severity of the trauma, or the adequacy of the initial treatment and fixation are the relevant factors. The answer affects how the non-union fracture is analyzed, documented, and presented in a legal claim or lawsuit.

Avascular Necrosis: When the Bone Loses Its Blood Supply

Avascular necrosis (AVN) and osteonecrosis after fractures occur when the blood supply to a segment of bone is disrupted by an injury. Without adequate blood flow, bone cells die. Over time, this dead bone gradually loses its structural integrity, and the weight-bearing surface above it begins to weaken and collapse.

It can be compared to a house built on a foundation that is quietly rotting away underneath. The house may look stable from the outside until the foundation can no longer support the weight above it and the floor begins to cave in. In avascular necrosis, the "floor" is the articular surface of the joint — the smooth, cartilage-covered surface that allows painless movement. When the subchondral bone supporting this surface collapses, the joint surface becomes irregular and painful, leading to progressive joint damage and eventual joint destruction.

The fractures most commonly associated with avascular necrosis are femoral neck fractures at the hip, where the blood supply to the femoral head runs through the neck that has just fractured. AVN is also a documented risk after scaphoid fractures at the wrist and talar fractures at the ankle, where similar vascular anatomy makes disruption of blood flow and subsequent osteonecrosis more likely.

In the legal and medico-legal context, avascular necrosis is a catastrophic complication that can convert a fracture that might otherwise have healed well into a condition that progresses toward joint replacement surgery. A comprehensive life care plan must address the expected progression of AVN through the stages of joint destruction, projecting when joint replacement is likely to be needed based on the current stage of disease and the published medical literature on progression rates and long-term outcomes.

Post-Traumatic Arthritis: The Slow Burn That Follows Joint Fractures

Articular cartilage — the smooth, protective surface covering the ends of bones in every joint — does not naturally regenerate after injury. Once cartilage cells are damaged by a fracture, by inflammation from the injury, or by altered joint mechanics after surgical repair, the damage is permanent and typically progressive.

Post-traumatic arthritis is the end result: a gradual breakdown of the already damaged cartilage under the daily mechanical stress of normal joint use. This form of arthritis after an accident or orthopedic injury may not cause noticeable symptoms for months or even years. A person may feel reasonably well, return to normal activities, and believe the joint has fully healed.

Over time, however — six months later, two years later, or even five years later — the affected joint can become increasingly painful, stiff, and limited in motion with activity. These delayed symptoms are classic signs of post-traumatic arthritis and long-term joint degeneration following an injury.

This long-term complication is one that insurance companies most aggressively try to exclude from a damages analysis in a personal injury or accident claim. Insurers often argue that the fracture has healed, that the joint appears acceptable on current imaging studies, and that any future arthritis is speculative and not clearly proven to be caused by the accident or trauma.

The appropriate response relies on the treating orthopedic surgeon’s specific medical opinion about the risk of post-traumatic arthritis, given the nature and location of the fracture. That opinion is supported by published medical literature on post-traumatic arthritis rates for that specific fracture type, as well as by a detailed life care plan that projects the expected progression of arthritis and the anticipated cost of future joint replacement surgery and related care.

This projection of future joint degeneration and arthritis-related treatment is not speculation. It is grounded in evidence-based medicine, supported by orthopedic research and clinical experience, and courts routinely accept it as a valid basis for future damages awards in serious joint injury and post-traumatic arthritis cases.

Osteomyelitis: Bone Infection After Open Fractures

Open fractures carry a high risk of osteomyelitis, a serious infection of the bone that can follow traumatic injuries and orthopedic surgery. Once established in bone, osteomyelitis becomes one of the most difficult infections in medicine to treat and can lead to long-term disability and chronic pain.

Bacteria involved in osteomyelitis form biofilms within the bone and around surgical hardware. These biofilms are highly resistant to standard antibiotic therapy, and the body’s normal infection-fighting tools cannot penetrate the bone well enough to fully clear the infection. As a result, chronic osteomyelitis often persists despite aggressive medical care.

Chronic osteomyelitis typically requires prolonged antibiotic treatment, often delivered through an IV line for weeks at a time, along with repeated surgical debridement to remove infected and dead tissue. In severe cases, surgeons may need to remove segments of infected bone. Many patients endure multiple hospitalizations and multiple surgeries over months to years, and even with comprehensive treatment, osteomyelitis may become a lifelong management challenge rather than an infection that is fully cured.

In the most severe cases—typically open fractures with significant contamination or delayed treatment—the bone infection cannot be controlled without amputation of the affected limb. Amputation and its consequences are addressed in more detail on a separate page in this section, which explains the long-term functional, emotional, and financial impact of losing a limb.

The damages framework for osteomyelitis following an open fracture reflects this extraordinary medical burden. It must account for:

• Multiple hospitalizations and extended inpatient stays
• Repeated surgical procedures and debridements
• Prolonged IV and oral antibiotic therapy
• Ongoing follow-up care and long-term monitoring for recurrent infection
• Chronic pain, reduced mobility, and loss of function from a persistent bone infection
• The possibility of amputation and the need for prosthetics and rehabilitation

Because osteomyelitis after an open fracture can alter every aspect of daily life and work, the resulting damages extend far beyond initial medical bills to include long-term medical care, loss of earning capacity, and the profound impact on quality of life.

Surgery for Fractures: What It Means for Your Recovery and Your Claim

When a bone fracture requires surgery — and many serious broken bones do — the damages calculation changes significantly compared to a case managed conservatively. Instead of only dealing with casts, splints, and physical therapy, the injury claim now involves operating room fees, anesthesia, and surgical hardware such as plates, screws, or rods, along with a longer and more complicated recovery process.

These additional medical needs often lead to more time off work, higher out-of-pocket medical expenses, and a greater impact on daily life, mobility, and long-term health. Surgical fractures can also increase the risk of complications, future procedures, and ongoing pain management.

Here is a plain-English overview of what fracture surgery involves, how it can affect healing, work, and overall quality of life, and why it matters legally when evaluating compensation for pain and suffering, lost wages, and future medical care in a personal injury or accident claim. 

Plates and Screws: Holding the Pieces Together From Outside the Bone

Open Reduction and Internal Fixation (ORIF) for Fractures is the most common surgical approach for displaced fractures that involve joint surfaces or occur in locations where a cast alone cannot maintain proper bone alignment. This orthopedic surgery technique is frequently used for complex fractures of the ankle, hip, wrist, elbow, and shoulder, as well as for certain long-bone fractures where precise positioning is essential for restoring normal joint function and mobility. 

During ORIF surgery, the orthopedic surgeon opens the fracture site through an incision, carefully exposes the broken bone, and reduces the fragments under direct vision, restoring them as closely as possible to their original anatomical position. The bone fragments are then held in place with metal plates and screws that usually remain in the body permanently, providing stable internal fixation so that the bone can heal in the correct alignment and allowing earlier, safer movement of the nearby joints.

This type of fracture surgery requires general or regional anesthesia and is usually performed in a hospital or specialized orthopedic surgical center. As with any surgical procedure, it carries risks, including infection, nerve injury, blood clots, bleeding, and anesthesia complications, along with specific risks related to the location, pattern, and severity of the fracture. 

After surgery, there is a recovery period during which activity is significantly restricted, often involving the use of crutches, slings, or braces, together with a structured rehabilitation program and physical therapy to restore strength, flexibility, range of motion, and overall function. The permanent presence of the metal hardware is not typically a problem—most people are unaware of it in daily life—but hardware failure, screw breakage, irritation, or hardware that becomes prominent or painful under the skin may require removal surgery in the future. 

Over time, some individuals may experience stiffness, residual pain, or post‑traumatic arthritis in the affected joint, especially after severe injuries, and may need ongoing follow-up and monitoring with an orthopedic specialist.

Intramedullary Nailing: Inserting a Metal Rod Through the Center of the Bone

For fractures of the long bones — such as the femur, tibia, and humerus — the standard orthopedic surgical treatment is intramedullary nailing. In this procedure, the surgeon inserts a metal rod through the center of the bone, advancing it across the fracture site and into the far fragment. Screws at each end lock the rod in place and prevent the bone from rotating or shortening. This internal splint runs along the bone’s natural axis, providing stable fixation while keeping the surrounding muscles, tendons, and soft tissues as undisturbed as possible compared with more invasive open plating techniques.

Intramedullary nailing is biomechanically elegant: the rod shares the mechanical load with the bone rather than acting as a rigid external splint. This load-sharing design allows early weight bearing in many fracture patterns and supports faster functional recovery. The nail remains in the bone permanently in most cases, although in some patients it may later be removed if it causes irritation, pain, or interferes with future surgery.

Because the implant sits within the medullary canal, close to the body’s natural weight-bearing line, it can tolerate substantial forces during walking, standing, and even more demanding activities once healing has progressed. This load sharing encourages callus formation and bone remodeling, supporting a more natural bone healing process and improving long-term fracture stability.

For accident victims with femoral shaft fractures requiring intramedullary (IM) nailing, the injury typically involves significant blood loss from the fracture itself — the femur alone can lose a liter or more of blood into the thigh — followed by hospitalization, surgery, and a prolonged recovery period. In many cases, patients are unable to return to full work and normal activity for three to six months.

During this time, patients often require intensive pain management, structured physical therapy, and a gradual progression from non–weight bearing to partial and then full weight bearing as the fracture consolidates. Even after radiographic healing, residual weakness, stiffness, and altered gait can persist. Some individuals experience long-term limitations in high-impact sports, heavy labor, or other physically demanding occupations due to the severity of the original long bone fracture and the demands placed on the repaired limb.

Joint Replacement: When the Joint Cannot Be Saved

In some fractures — particularly femoral neck fractures in elderly patients and severely comminuted joint fractures in patients of any age — the damaged joint cannot be reconstructed or reliably fixed. In these situations, the better surgical option is often to replace the joint with an artificial implant.

Joint Replacement After Severe Fractures

Hip replacement — either partial or total hip arthroplasty — is the standard treatment for displaced femoral neck fractures in older adults when the blood supply and bone quality are compromised. Knee replacement may be required for severe tibial plateau or distal femur fractures that destroy the joint surface beyond reconstruction with plates, screws, or other fixation. Ankle replacement or ankle fusion may be required for severe ankle fractures with joint destruction that cannot be restored with conventional fracture surgery.

Long-Term Implant Wear and Revision Surgery

Joint replacement surgery carries a specific long-term consideration that is critical to the damages analysis in serious injury cases: implants wear out over time. Every joint replacement has a finite lifespan — typically fifteen to twenty years in optimal circumstances — and when the implant wears out, revision surgery is required to replace the worn components. Revision joint replacement surgery is more complex, more risky, and more expensive than the primary replacement procedure.

Life Care Planning and Future Economic Damages

For a young accident victim who undergoes joint replacement surgery as a result of fracture complications — such as avascular necrosis, post-traumatic arthritis, or a fracture that cannot be reconstructed — the life care plan must project at least one revision surgery based on the expected implant lifespan and the patient's age. That future revision surgery cost, calculated at current medical rates and adjusted for medical cost inflation over the projection period, represents a significant component of future economic damages in an orthopedic injury case.

The Pre-Existing Condition Argument in Fracture Cases: Why It Is Different From Soft Tissue Injury Cases

In soft tissue personal injury cases, the pre-existing condition argument is often the insurance company's primary weapon — and it has real traction because imaging of soft tissue frequently shows changes that predate the accident. These radiology findings can include age-related degeneration, prior minor injuries, or normal wear and tear that appear on MRIs and X-rays long before the incident in question. Insurers seize on these images to argue that the pain, loss of function, and need for treatment are simply the natural progression of what was already there, rather than the result of a new trauma caused by a car accident, slip and fall, or other negligent act. This defense strategy is designed to minimize payouts by blurring the line between true pre-existing conditions and the aggravation or acceleration of those conditions caused by the accident.

In fracture and broken bone cases, the pre-existing condition argument takes a different form — and it is most commonly deployed against elderly victims with osteoporosis. Instead of focusing on degenerative changes in muscles, tendons, or discs, the focus shifts to bone density, overall skeletal health, and fall risk. Older adults, especially those with documented osteopenia or osteoporosis, become easy targets for this line of attack because their medical records often contain years of bone scans, medication lists, and notes about balance issues or prior falls. Insurers and defense attorneys attempt to turn this medical history into a shield against responsibility for the harm caused by a dangerous condition or a negligent act, arguing that the victim’s own health, rather than the unsafe property or careless conduct, is to blame.

The argument typically goes like this: the force involved in the fall or the accident was minor. A person with normal bone density would not have fractured. The fracture occurred because of the victim's osteoporosis — their pre-existing condition — not because of the defendant's negligence. In other words, the defense claims that the accident merely revealed an inevitable injury waiting to happen, rather than creating a new injury. This narrative is often supported by hired medical experts who testify that even a small twist, step, or bump could have caused the same fracture at any time. The goal is to shift the focus away from the unsafe step, the unmarked spill, or the careless driver, and place the blame squarely on the victim's medical vulnerability instead of the dangerous condition or negligent behavior that triggered the fall.

California personal injury law rejects this reasoning through the eggshell plaintiff doctrine under CACI 3927. The defendant takes the plaintiff as they find them. An elderly person with osteoporosis who slips on a wet floor at a Los Angeles business has the same right to walk on that floor safely as a young person with healthy bones. The fact that the plaintiff's bones were more fragile does not reduce the property owner's duty to maintain a safe surface — and it does not reduce their liability when a dangerous condition on their property causes a fracture. Under this doctrine, a negligent party is responsible for all harm legally caused by their conduct, even if the extent of the injury is greater because of a pre-existing condition. A minor fall that might have caused only a bruise in a younger person can legitimately result in a hip fracture, surgery, rehabilitation, and long-term loss of independence in an older adult — and the law recognizes that the negligent party remains fully accountable for those consequences.

Pre-accident activity level, independence, and the absence of prior hip or wrist fractures despite living with osteoporosis for years is powerful evidence that the pre-existing condition alone was not causing significant problems — and that the accident is what pushed the situation past the threshold. Medical records showing regular exercise, community involvement, and the ability to perform daily tasks without assistance help demonstrate that life was stable and manageable before the incident. When a single fall suddenly leads to surgery, hospitalization, assistive devices, or the need for in-home care, that sharp change in function strongly supports the conclusion that the accident — not the underlying osteoporosis — is the true cause of the current limitations. This contrast between life before and after the injury is often the most compelling proof in a personal injury claim that a negligent act transformed a manageable condition into a serious, life-altering problem.

What Fracture Cases Are Worth in Los Angeles County

How Fracture Injury Cases Are Valued in Los Angeles

This is a plain-English overview of how fracture and broken bone cases are typically valued in the Los Angeles personal injury market. Settlement and verdict values depend heavily on the type of fracture, the treatment required, the medical outcome, and the venue where the case is filed.

Non-Displaced Fractures Managed Conservatively

Non-displaced fractures that are treated conservatively, with complete healing and no complications, usually generate values that reflect:

• The immobilization period and time in a cast, boot, or brace
• Medical expenses during the healing process
• Temporary functional limitations and pain during recovery

These cases benefit from objective proof of injury because the fracture is clearly documented on imaging. However, the relatively modest treatment course and full recovery generally limit damages to the recovery period, with lower long-term non-economic damages.

Displaced Fractures Requiring Surgical Fixation

Displaced fractures that require surgical fixation typically produce significantly higher case values in Los Angeles County. The surgery itself adds substantial economic damages, including:

• High surgical costs in Los Angeles County hospitals
• Hospitalization charges and related facility fees
• Post-operative care, follow-up visits, and medications

The recovery period often involves activity restrictions, physical therapy, and in many cases a temporary inability to work, which adds lost wage damages and loss of earning capacity. The permanent presence of hardware in the body, while often not painful, is a lasting consequence of the accident that contributes to non-economic damages for pain, suffering, and loss of enjoyment of life.

Fractures With Serious Complications

Fractures complicated by non-union, avascular necrosis, or significant post-traumatic arthritis that ultimately require joint replacement tend to produce the highest values in the fracture case spectrum. These severe orthopedic injuries often involve:

• Additional surgeries and possible revision procedures
• Extended disability and prolonged recovery time
• A life care plan projecting future joint replacement and revision surgery over the person’s life expectancy
• Profound non-economic impact from progressive joint destruction on daily life, mobility, and physical activity

The combination of long-term medical needs, permanent impairment, and chronic pain can result in very substantial total damages in Los Angeles personal injury litigation.

Hip Fractures in Elderly Premises Liability Victims

Hip fractures in elderly victims arising from premises liability accidents are consistently among the highest-value fracture cases in Los Angeles County. As discussed above, these cases often involve:

• Major orthopedic surgery, such as hip replacement or internal fixation
• Prolonged hospitalization and intensive rehabilitation
• Permanent loss of independence for many victims, including the need for assisted living or nursing care
• A life-threatening mortality risk associated with hip fractures in older adults

This combination creates a damages framework that reflects the full human cost of what an unsafe property condition imposed on the injured person and their family, including both economic and non-economic losses.

Why Venue Matters in Los Angeles Fracture Cases

Venue plays a major role in fracture case valuation, as in all personal injury cases in Los Angeles County. Cases filed at Stanley Mosk Courthouse in downtown Los Angeles have historically produced higher settlement and verdict values than equivalent cases in more conservative venues such as Chatsworth or Lancaster.

Insurance adjusters and defense attorneys are aware of these venue differences, and their internal assessment of case value reflects the filing location from the very beginning of the claim. The courthouse and jury pool can significantly influence the ultimate outcome.

Every Fracture Case Is Unique

These are general observations about how fracture and broken bone cases are valued in the Los Angeles market. Every fracture case is different. Factors that influence the outcome include:

• The specific bone involved and whether it is weight-bearing or dominant
• The exact fracture type and pattern
• Any complications that develop during healing
• The person’s age, health, and occupation
• The liability picture, including fault, comparative negligence, and available insurance coverage

Only a case-specific evaluation that considers the medical records, imaging, prognosis, and liability facts can determine the likely settlement or verdict value of a particular fracture case in Los Angeles County.