Fracture Blisters

Sign of Soft-Tissue Trauma Associated With Broken Bones

Blisters of the skin three days after an ankle fracture.. Jonathan Cluett, M.D.

Fracture blisters are blisters that form around the area of a broken bone.  Fracture blisters are a sign of significant soft-tissue injury.  They most often occur over fractures of bones that are near the skin surface.  Therefore, fracture blisters are most common with:

Fracture blisters usually develop within days of a fracture.  Most commonly, a broken bone is temporarily splinted after an injury, and the blisters are then seen when the splint is removed a few days or a week after the injury.

  The likelihood of blistering can be minimized by preventing any further trauma to the soft-tissues by rigidly immobilizing the fracture, protecting the skin with a well-molded splint, and elevating the broken extremity.  Fracture blisters tend to worsen when the fracture fragments are able to move, causing further soft-tissue damage.

Inside the Blister

Blisters are filled with either clear fluid or blood.  The fluid inside the blister depends on the depth of skin involvement.  While the treatment is similar whether or not there is blood or clear fluid in the blister, the likelihood of scarring of the skin is higher with a blood-filled blister.

The fluid inside the blister is sterile, and therefore the blister should be left intact and not broken.  If the blister does rupture, as they sometimes do, the roof of the blister should be left alone as the skin heals underneath.  Popping the blisters and removing the skin is not the proper way to heal a fracture blister.

  Some topical treatments, such as Silvadene cream, has been shown to be effective in aiding the healing of ruptured blisters.

Having Surgery

The most important aspect of fracture blisters is their implication for surgical repair of broken bones.  If a patient has developed fracture blisters, surgery should not be performed through the blistered skin.

  Doing surgery through a fracture blister significantly increases the chance of wound complications, including infection.

If surgery needs to be performed, and fracture blisters are present, the surgery should be modified to avoid the blistered skin.  For example, if an ankle fracture has fracture blisters in the ankle region, then rather than using plates and screws, an external fixator may be used to stabilize the bone.

Treatment of Blisters

As stated, blisters should be left alone if unruptured.  If you have a broken bone that requires surgery, and there are fracture blisters in that area, the following should take place:

  • The broken bone should be immobilized.  This can be accomplished with a splint or an external fixator.  The advantage of the external fixator is the immobilization is often better, and your doctor can see the skin.  In complicated cases, this method is often preferred.
  • The extremity should be elevated.  The extremity should be elevated as much as possible.  If the ankle or tibia is the bone involved, the only way to elevate above the heart is by lying down.  Propping the ankle up while sitting is not elevating!
  • Surgery should be delayed.  Surgery should not be performed through a fracture blister.  The chance of wound complications, including infection, is too high, and surgery should be altered or delayed.

Complete healing of a fracture blister may take several weeks.  Ideally with prompt, effective treatment, the chance of developing a fracture blister will be lessened, but when they develop, patience is necessary to allow the blister to resolve before proceeding with surgical treatment.


Strauss EJ, et al. "Blisters associated with lower-extremity fracture: results of a prospective treatment protocol" J Orthop Trauma. 2006 Oct;20(9):618-22.

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