A diagnosis can be made using clinical examination, laryngoscope examination, and/or radiographic studies.

An X-ray is essential for the proper diagnosis of a malunion. The doctor will look into the patient’s history and the treatment process for the bone fracture. Oftentimes a CT scan and probably a MRI are also used in diagnosis. MRI are used to check of cartilage and ligament issues that developed due to the malunion and misalignment. CT scans are used to locate normal or abnormal structures within the body and to help during procedures to guide the placement of instruments and/or treatments.

The indication to surgically stabilize a cervical fracture can be estimated from the "Subaxial Injury Classification" (SLIC). In this system, a score of 3 or less indicates that conservative management is appropriate, a score of 5 or more indicates that surgery is needed, and a score of 4 is equivocal. The score is the sum from 3 different categories: morphology, discs and ligaments, and neurology:

Typically, radiographs are taken of the hip from the front (AP view), and side (lateral view). Frog leg views are to be avoided, as they may cause severe pain and further displace the fracture. In situations where a hip fracture is suspected but not obvious on x-ray, an MRI is the next test of choice. If an MRI is not available or the patient can not be placed into the scanner a CT may be used as a substitute. MRI sensitivity for radiographically occult fracture is greater than CT. Bone scan is another useful alternative however substantial drawbacks include decreased sensitivity, early false negative results, and decreased conspicuity of findings due to age related metabolic changes in the elderly.

As the patients most often require an operation, full pre-operative general investigation is required. This would normally include blood tests, ECG and chest x-ray.

Computed tomography is the most sensitive and specific of the imaging techniques. The facial bones can be visualized as slices through the skeletal in either the axial, coronal or sagittal planes. Images can be reconstructed into a 3-dimensional view, to give a better sense of the displacement of various fragments. 3D reconstruction, however, can mask smaller fractures owing to volume averaging, scatter artifact and surrounding structures simply blocking the view of underlying areas.

Research has shown that panoramic radiography is similar to computed tomography in its diagnostic accuracy for mandible fractures and both are more accurate than plain film radiograph. The indications to use CT for mandible fracture vary by region, but it does not seem to add to diagnosis or treatment planning except for comminuted or avulsive type fractures, although, there is better clinician agreement on the location and absence of fractures with CT compared to panoramic radiography.

X-ray of the affected wrist is required if a fracture is suspected. Anteroposterior (AP), lateral, and oblique views can be used together to describe the fracture. X-ray of the uninjured wrist should also be taken to determine if there are any normal anatomic variations. Investigation of a potential distal radial fracture includes assessment of the angle of the joint surface on lateral X-ray (volar/dorsal tilt), the loss of length of the radius from the collapse of the fracture (radial length), and congruency of the distal radioulnar joint (DRUJ). Displacement of the articular surface is the most important factor affecting prognosis and treatment. CT scan is often performed to further investigate the articular anatomy of the fracture, especially if surgery is considered. MRI can be considered to evaluate for soft tissue injuries, including damage to the TFCC and the interosseous ligaments.

To assess an olecranon fracture, a careful skin exam is performed to ensure there is no open fracture. Then a complete neurological exam of the upper limb should be documented. Frontal and lateral X-ray views of the elbow are typically done to investigate the possibility of an olecranon fracture. A true lateral x-ray is essential to determine the fracture pattern, degree of displacement, comminution, and the degree of articular involvement.

X-ray is seldom helpful, but a CT scan and an MRI study may help in diagnosis.

Bone scans are positive early on. Dual energy X-ray absorptiometry is also helpful to rule out comorbid osteoporosis.

Segond and reverse Segond fractures are characterized by a small avulsion, or "chip", fragment of characteristic size that is best seen on plain radiography in the anterior-posterior plane. The chip of bone may be very difficult to see on the plain x-ray exam, and may be better seen on computed tomography. MRI may be useful for visualization of the associated bone marrow edema of the underlying tibial plateau on fat- saturated T2W and STIR images, as well as the associated findings of ligamentous and/or meniscal injury.

Nasal fractures are usually identified visually and through physical examination. Medical imaging is generally not recommended. A priority is to distinguish simple fractures limited to the nasal bones (Type 1) from fractures that also involve other facial bones and/or the nasal septum (Types 2 and 3). In simple Type 1 fractures X-Rays supply surprisingly little information beyond clinical examination. However, diagnosis may be confirmed with X-rays or CT scans, and these are required if other facial injuries are suspected.

A fracture that runs horizontally across the septum is sometimes called a "Jarjavay fracture", and a vertical one, a "Chevallet fracture".

Although treatment of an uncomplicated fracture of nasal bones is not urgent—a referral for specific treatment in five to seven days usually suffices—an associated injury, nasal septal hematoma, occurs in about 5% of cases and does require urgent treatment and should be looked for during the assessment of nasal injuries.

Diagnosis may be evident clinically when the distal radius is deformed but should be confirmed by X-ray.

The differential diagnosis includes scaphoid fractures and wrist dislocations, which can also co-exist with a distal radius fracture. Occasionally, fractures may not be seen on X-rays immediately after the injury. Delayed X-rays, X-ray computed tomography (CT scan), or Magnetic resonance imaging (MRI) will confirm the diagnosis.

X-rays of the affected hip usually make the diagnosis obvious; AP (anteroposterior) and lateral views should be obtained.

Trochanteric fractures are subdivided into either intertrochanteric (between the greater and lesser trochanter) or pertrochanteric (through the trochanters) by the Müller AO Classification of fractures. Practically, the difference between these types is minor. The terms are often used synonymously. An "isolated trochanteric fracture" involves one of the trochanters without going through the anatomical axis of the femur, and may occur in young individuals due to forceful muscle contraction. Yet, an "isolated trochanteric fracture" may not be regarded as a true hip fracture because it is not cross-sectional.

A bone fracture may be diagnosed based on the history given and the physical examination performed. Radiographic imaging often is performed to confirm the diagnosis. Under certain circumstances, radiographic examination of the nearby joints is indicated in order to exclude dislocations and fracture-dislocations. In situations where projectional radiography alone is insufficient, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) may be indicated.

Severe pain will usually be present at the point of injury. Pressure on a nerve may also cause pain from the neck down the shoulders and/or arms. Bruising and swelling may be present at the back of the neck. A neurological exam will be performed to assess for spinal cord injury. X-rays will be ordered to determine the severity and location of the fracture. CT (computed tomography) scans may be ordered to assess for gross abnormalities not visible by regular X-ray. MRI (magnetic resonance imaging) tests may be ordered to provide high resolution images of soft tissue and determine whether there has been damage to the spinal cord, although such damage is usually obvious in the conscious patient because of the immediate functional consequences of numbness and paralysis in much of the body.

It is also common for imaging (either a plain film X-ray or CT scan) to be completed when assessing a cervical injury. This is the most common way to diagnose the location and severity of the fracture. To decrease the use C-spine scans yielding negative findings for fracture, thus unnecessarily exposing people to radiation and increase time in the hospital and cost of the visit, multiple clinical decision support rules have been developed to help clinicians weigh the option to scan a patient with a neck injury. Among these are the Canadian C-spine rule and the NEXUS criteria for C-Spine imaging, which both help make these decisions from easily obtained information. Both rules are widely used in emergency departments and by paramedics.

Anterior-posterior (AP) and lateral radiographs are typically obtained. In order to rule out other injuries, hip, pelvis, and knee radiographs are also obtained. The hip radiograph is of particular importance, because femoral neck fractures can lead to osteonecrosis of the femoral head.

The basic method to check for a clavicle fracture is by an X-ray of the clavicle to determine the fracture type and extent of injury. In former times, X-rays were taken of both clavicle bones for comparison purposes. Due to the curved shape in a tilted plane X-rays are typically oriented with ~15° upwards facing tilt from the front. In more severe cases, a computerized tomography (CT) or magnetic resonance imaging (MRI) scan is taken.

However, the standard method of diagnosis through ultrasound imaging performed in the emergency room may be equally accurate in children.

There are various classification systems of mandibular fractures in use.

X-rays are usually necessary, but this is not always the case. A physical examination will be carried out, which sometimes involves a rectal examination and/or neurologic examination.

Diagnosis by a doctor’s examination is the most common, often confirmed by x-rays. X-ray is used to display the fracture and the angulations of the fracture. A CT scan may be done in very rare cases to provide a more detailed picture.

Bone stability after a fracture occurs between 3 and 4 weeks. Some experts suggest not wearing glasses or blowing the nose during this time as it can affect the bone alignment. Full bone fusion occurs between 4 and 8 weeks. General activity is fine after 1–2 weeks, but contact sports are not advisable for at least 2–3 months, depending on the extent of injury. It is recommended that when participating in sports a face guard should be worn for at least 6 weeks post-injury.

Anteroposterior (AP) and lateral radiographs the include the entire length of the lower leg (knee to ankle) are highly sensitive and specific for tibial shaft fractures.

Two systems of fracture classification are commonly used to aid diagnosis and management of tibia shaft fractures:

- Oestern and Tscherne Classification

- Gustilo-Anderson Classification

Management is dependent on the determination of whether the fracture is open or closed.

X-rays usually do not show evidence of new stress fractures, but can be used 3 weeks after onset of pain when the bone begins to remodel. A CT scan, MRI, or 3-phase bone scan may be more effective for early diagnosis.

MRI appears to be the most accurate test.

Several precautions may decrease the risk of getting a pelvic fracture. One study that examined the effectiveness of vitamin D supplementation found that oral vitamin D supplements reduced the risk of hip and nonvertebral fractures in older people. Certain types of equipment may help prevent pelvic fractures for the groups which are most at risk.

The diagnosis of nonunion is generally done when there is no progress between to occasions of medical imaging such as X-ray. This is generally the case after 6-8 months.