Perkin’s Timetable for Fracture Healing

One needs to understand the difference between bone union and consolidation first

DefinitionPartial/Incomplete repairFull/Complete repair
Attempted angulationPainfulPainless
Fracture line in X-rayStill visibleObliterated and crossed by bony trabeculae
Full weight bearingCannot be undertakenCan be undertaken
Reference: Physiotherapy in Orthopaedics: A Problem-Solving Approach by Karen Atkinson, Fiona J. Coutts, Anne-Marie Hassenkamp
bone healing
Bill Rhodes from Asheville, CC BY 2.0, via Wikimedia Commons

Perkin’s rule

Named after: George Perkins

According to Oxford handbook of clinical surgery:

1. Fractures of cancellous (metaphyseal) bone will take 6 weeks to unite.

2. Fracture of cortical (diaphyseal) bone will take 12 weeks to unite.

3. Fracture of tibia (because of poor blood supply) will take 24 weeks to unite.

4. Time to union for children equals the age of child in years plus 1. Common sense needs to be applied when applying the rule to fracture of cancellous bone in older children.

Reference: Oxford Handbook of Clinical Surgery, 5e by Anil Agarwal, Santhini Jeyarajah, Rhiannon Harries, Greg McLatchie, Ruwan Weerakkody

Other versions:

  1. Spiral or oblique fracture in upper limbs unite in 3 weeks.
  2. For lower limbs: multiply by 2
  3. For transverse fractures: multiply by 2
  4. For consolidation: multiply by 2
  5. Full remodeling: Double the time of consolidation
Upper limb3 weeks6 weeks6 weeks12 weeks
Lower limb6 weeks12 weeks12 weeks24 weeks
Reference: Fracture – Long Bones (

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