Untreated fractures increase mortality risk due to a combination of direct physical complications, systemic physiological effects, and secondary health problems that arise when broken bones are not properly managed. When a fracture is left untreated, the body faces ongoing instability, pain, and impaired function, which can cascade into life-threatening conditions.
First, untreated fractures often lead to **impaired mobility**. When a bone is broken and not stabilized, the affected limb or body part cannot support normal movement. This immobility can cause muscle wasting, joint stiffness, and loss of independence. In older adults especially, prolonged immobility increases the risk of serious complications such as **deep vein thrombosis (DVT)**—blood clots forming in deep veins, usually in the legs. These clots can dislodge and travel to the lungs, causing a **pulmonary embolism**, which can be fatal. This risk is particularly high with fractures of large bones like the femur or pelvis, where blood vessel injury and immobility combine to promote clot formation.
Second, untreated fractures can cause **fat embolism syndrome**, especially with long bone fractures such as the femur. Fat globules from the bone marrow may enter the bloodstream and block small blood vessels in the lungs, brain, or other organs, leading to respiratory distress, neurological symptoms, and even death if not promptly treated.
Third, fractures that are not properly aligned or immobilized can lead to **nonunion or malunion**, where the bone either fails to heal or heals incorrectly. This can cause chronic pain, deformity, and ongoing disability, which further reduce a person’s ability to care for themselves and maintain adequate nutrition and hygiene, indirectly increasing mortality risk.
Fourth, fractures, particularly in the elderly or those with osteoporosis, are often associated with **secondary infections**. For example, hip fractures can lead to prolonged bed rest, increasing the risk of pneumonia and urinary tract infections. Pneumonia is a leading cause of death in older adults after hip fractures because the weakened state and immobility impair lung function and immune response.
Fifth, untreated fractures can cause **internal bleeding and damage to surrounding tissues**. Some fractures, especially pelvic or rib fractures, can injure blood vessels or internal organs, leading to hemorrhage or organ failure if not addressed. This internal damage can be life-threatening without timely medical intervention.
Sixth, the **pain and stress response** from untreated fractures can trigger systemic effects such as increased heart rate, elevated blood pressure, and release of stress hormones. In vulnerable populations, such as the elderly or those with cardiovascular disease, this physiological stress can precipitate heart attacks, strokes, or other fatal events.
Seventh, fractures involving the spine or skull can cause **neurological damage** if untreated. Spinal fractures may lead to paralysis or loss of autonomic functions, while skull fractures can cause brain injury, bleeding, or infection. These neurological complications significantly increase mortality risk.
Eighth, untreated fractures often reflect or contribute to **underlying health problems** such as osteoporosis, malnutrition, or chronic diseases that themselves increase mortality risk. For example, a hip fracture in an osteoporotic patient is not just a broken bone but a marker of frailty and systemic bone weakness, which correlates with higher death rates.
Finally, the social and psychological consequences of untreated fractures—such as loss of independence, depression, and social isolation—can indirectly increase mortality by reducing a person’s ability to seek care, maintain nutrition, or adhere to treatments for other conditions.
In summary, untreated fractures increase mortality risk through a complex interplay of physical complications (like embolism, infection, and internal injury), systemic physiological stress, impaired mobility leading to secondary problems, neurological damage, and the exacerbation of underlying health vulnerabilities. Proper and timely treatment of fractures is critical to stabilize the injury, prevent complications, and reduce the risk of death.
