Compound Fracture is an unlockable passive item added in The Binding of Isaac: Afterbirth †.
- Tears turn into bones, which shatter into 1-3 shards upon hitting an obstacle or enemy.
- Shards deal 50% of Isaac's normal tear damage.
- Unlike
The Parasite, there is no damage minimum on splitting, but the tears can also split only once.
- +1.5 range.
- +1.0 tear height.
Bob's Rotten Head: The bomb will break into 1-3 more bombs which are launched in random directions from the point of impact.
Cricket's Body/ The Parasite: Each tear splits into more tears, which will all shatter.
Haemolacria: Tears will sometimes burst into smaller tears when hitting obstacles or enemies. These smaller tears are miniature versions of Haemolacria tears, which will burst when hitting the ground.
Ipecac: If the bone tear hits a wall or an obstacle, it will split into explosive half-damage shards. Hits on enemies and the floor behave as normal Ipecac.
The Ludovico Technique: Tear turns into a spinning bone that rapidly spews out smaller bone shots on contact with enemies.- Spectral tears: Bones pass through obstacles and generate shards for each obstacle they pass through, which can result in many shards being generated from a single bone.
Anti-Gravity: Bone tears will hover until released but bone shards will travel normally.
Brimstone: Overrides Compound Fracture.
Dr. Fetus: Overrides Compound Fracture.
Epic Fetus: Overrides Compound Fracture.
Flat Stone: Bone tears will bounce when they are fired, however, bone shards will not bounce when they travel.
Lachryphagy: Bone tears can be fed and will burst into split tears. Bone tears will burst into bone shards when hitting obstacles or enemies which can also be fed and burst into split tears and bone shards yet again. When bone shards are fed, they turn back into bone tears which can repeat this process again and again.
Mom's Knife: Overrides Compound Fracture.
Technology/
Tech X: Overrides Compound Fracture.
Technology 2: The laser is not affected, but bone tears still shoot from Isaac's left eye.
Tractor Beam: Bone tears will not burst into bone shards when fired at obstacles, however, bone tears will burst into bone shards when fired at enemies.
Trisagion: Beams will only burst when hitting obstacles.
- The item is a reference to a compound fracture, a medical condition where a bone breaks and is exposed through the skin.
Defeat Delirium as Lazarus
Lazarus Unlocks 
The Binding of Isaac: Rebirth 
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