Fractures of the upper and lower extremities usually heal with restoration of bony architecture and function, yet many individuals also develop measurable impairment or significant disability. Fractures may be associated with other injuries or complications, including infection or nonunion or malunion, which can lead to increased disability. Through several case reports, this article reviews the anatomy and function of the human skeleton, the process and expected timeframe for fracture healing, methods of measuring permanent impairment, and disability evaluation concepts for extremity fractures.