'Fracture Blisters' A Commonly Asked Patient Question

What Are Fracture Blisters?
By Dr. Randall Thomas, Foot & Ankle Surgeon

If you or someone you know has suffered a foot or ankle injury—or recently had surgery—you may notice the skin around the site start to swell or even blister. A rare but important condition we commonly see is called a fracture blister. These are not your everyday skin blisters. They can affect how and when we treat your injury or perform surgery.

In this article, I’ll explain what fracture blisters are, how they form, how we treat them, and what you can do to help your recovery. I’ve divided this into two common situations:
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1. After elective surgeries involving bone cuts (osteotomies) or reconstructions in which realignment of the foot and/or ankle is performed leading to skin moving and stress 
2. After injuries or traumatic fractures especially crush type injuries

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Overview

Fracture blisters are fluid-filled pockets that form under the skin, usually near a broken bone or surgical site. They affect about 3% of all fractures, most often in areas like the ankle or forefoot, where the bone lies close to the surface and there isn’t much soft tissue or muscle for padding.
These blisters can form within hours to days after an injury or surgery—sometimes even weeks later—and take several weeks to fully heal.

1. Fracture Blisters After Elective Foot & Ankle Surgery

If you’ve had surgery for a bunion, flatfoot, or ankle realignment, your surgeon may have made bone cuts (osteotomies). These procedures naturally cause swelling, which in rare cases, can lead to fracture blisters.

Symptoms

• Clear (serous) or blood-filled (hemorrhagic) blisters near the surgical site
• Tight or loose skin covering the blister
• The blister itself is often painless, but the surgical site may be sore
• Usually appears 2–5 days after surgery

Causes

• Swelling puts pressure under the skin, separating its layers
• The fluid builds up and creates a blister
• These are more likely if elevation or icing isn’t done consistently
• ​​If swelling occurs and there is any bandage or splint/cast trauma

Treatment

• Do not pop the blister
• We often allow them to heal naturally
• In some cases, we drain the blister using sterile techniques
• We apply protective dressings to prevent infection
• If from a fracture and surgery is planned we may have to delay the surgery until the skin heals
• The fluid is from inside your body and skin and therefore it's typically sterile and does not need to be drained.

Complications

• Increased risk of infection if the blister breaks near a surgical incision
• Delayed wound healing
• Scarring if the blister is large or blood-filled

2. Fracture Blisters After Traumatic Injuries

Fracture blisters are more common after injuries like ankle fractures, crush injuries, or high-impact trauma to the foot.
Symptoms

• Blisters forming on or near the injured bone
• Can contain clear fluid (serous) or red blood (hemorrhagic)
• May occur within 6 hours or take up to 3 weeks to show up
• Common in the ankle, foot, and lower leg

Causes

• Sudden trauma triggers major swelling and inflammation
• Skin can’t stretch enough and separates internally
• Fluid fills the space, creating a blister

Treatment

• Elevation and immobilization to reduce swelling
• Blisters are left alone unless they pose a risk
• In some cases, as above, we must delay surgery until blisters resolve
• If drained, a sterile dressing and antibiotics may be used

Complications

• If untreated or popped, blisters can become infected
• Blisters can delay fracture repair or reconstructive surgery
• May result in skin scarring or wound dehiscence (wound reopening)

How to Help Prevent Fracture Blisters

• Elevate your leg above heart level as much as possible
• Use ice to control swelling in the first 48–72 hours
• Avoid walking or standing on the injured foot without permission
• Follow your surgeon’s post-op instructions carefully
• Call your doctor right away if you notice any blisters, redness, or drainage

What’s the Outlook?

Most fracture blisters will heal on their own within 2 to 3 weeks, although hemorrhagic blisters may take longer. If you do not need surgery, these can often be managed without any procedures. If you do need surgery, your care team may need to wait until your skin is healthy and safe enough for an incision. 

Many times fracture blister are an expected outcome of surgery and they most commoblty resolve without scars or complications. However, this can be a lengthy process for healing, require local wound care, have a slight discoloration. 

What do Patients say?

Any time in the first several weeks after surgery at one of their post op dressing changes or with dressing changes at home a patient can see a fracture blister(s) and become alarmed. Usually these are normal and nothing to be concerned about as they resolve quickly and do not cause pain. Recommend contact your surgeon and likely will reinforce the above however you would rather your surgeon know than not about anything going on that you are concerned about so they can make the best decision for each individual 

Final Thoughts:

While fracture blisters are rare, they are a sign that your body is under stress. As your foot and ankle surgeon, I want you to know that these blisters are manageable and, in most cases, not dangerous--if we catch and treat them properly. Communication and early care are key. patient. This blog entry is not a substitute for medical care between the patient and their provider. ​If you notice a blister after an injury or surgery, please reach out to your doctor or surgical team for guidance.

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For More Information See below PDF from Podiatry Institute Files

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