Determining whether or not a fracture requires surgical repair depends on the nature of the injury. "I see everything from shoulders to fingertips and hips to toes, and whether or not a fracture requires surgery really depends upon the degree to which the bone pieces are separated," says Dr. Matthew S. Grunkemeyer, a board-certified orthopaedic surgeon who treats both pediatric and adult patients.
Sometimes the location of the break matters as well. In general, if you break one of the body's large, weight-bearing bones, such as your thigh bone (femur), you will likely need surgery. "You really can't properly cast a major bone like the femur, so very often healing requires surgical placement of a rod to support the bone and allow the patient to bear weight."
Further, fractures that involve a joint often require surgical repair. "When a bone crack protrudes into a joint, we use surgery to return that joint to its normal anatomical position and function," Dr. Grunkemeyer notes. "This helps prevent later development of arthritis in the joint - a painful, sometimes debilitating inflammation."