Is It “Fractured” or “Broken”? A Patient Survey Study to Assess Injury Comprehension after Orthopedic Trauma

Document Type: RESEARCH PAPER

Authors

1 Harvard Medical School, BIDMC, Carl J. Shapiro, Department of Orthopaedics, Boston, MA, USA

2 Harvard Combined Orthopaedic Surgery Program, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA

3 McLean Hospital, Harvard Medical School, Boston, MA, USA

4 Department of Orthopaedic Surgery, Harvard Medical School, Division of Foot and Ankle Surgery, BIDMC, Department of Orthopaedic Surgery, Boston, MA, USA

Abstract

the bone is “fractured” or “broken”. While orthopaedic surgeons consider these terms synonymous, patients appear to
comprehend the terms as having different meanings. Given the commonality of this frequently posed question, it may be
important for providers to assess patients’ level of understanding in order to provide optimal care. The purpose of this
study is to evaluate patients’ comprehension and understanding regarding the use of the terms fractured and broken.
Methods: A survey was administered as a patient-quality measure to patients, family members and/or other non-patients
presenting to an orthopaedic outpatient clinic at an academic teaching hospital.
Results: 200 responders met inclusion criteria. Only 45% of responders understood the terms fractured and broken
to be synonymous. Age, gender, nor ethnicity correlated with understanding of terminology. Responders described a
“fractured” bone using synonyms of less severe characteristics for 55.7% of their answers and chose more severe
characteristics 44.3% of the time, whereas responders chose synonyms to describe a "broken” bone with more severe
characteristics as an answer in 62.1% of cases and chose less severe characteristics 37.9% of the time. The difference
for each group was statistically significant (P=0.0458 and P ≤0.00001, respectively).There was no correlation between
level of education nor having a personal orthopaedic history of a previous fracture with understanding the terms
fracture and broken as synonymous. Having an occupation in the medical field (i.e. physician or physical/occupational
therapist) significantly improved understanding of terminology.
Conclusion: The majority of people, regardless of the age, gender, race, education or history of previous fracture, may
not understand that fractured and broken are synonymous terms. Providers need to be cognizant of the terminology they
use when describing a patient’s injury in order to optimize patient understanding and care.

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