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.
Kidney Stone: First bullet shatters into smaller kidney stone bullets
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.
Technology Zero: The bone fragments will be connected by the electric current.
Interactions
Anti-Gravity: Bone tears will hover until released but bone shards will travel normally.
Flat Stone: Bone tears will bounce when they are fired, however, bone shards will not bounce when they travel.
The Forgotten: Smaller bone shots appear whenever an enemy is hit with the melee attack. The bone toss is unaffected.
Bone toss attack also creates bone tears.
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.
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.
Unlike The Parasite and Cricket's Body, Compound Fracture is overriden by most tear replacing items instead of having a synergy, making the item less versatile than those.
The Parasite, there is no damage minimum on splitting, but the tears can also split only once.
+1.0 Tear Falling Speed.
Bob's Rotten Head: The bomb will break into 1-3 more bombs which are launched in random directions from the point of impact.
C Section: Fetuses are skeletons that shoot splitting bone fragments when in contact with an enemy.
Cricket's Body/
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.
Kidney Stone: First bullet shatters into smaller kidney stone bullets
Technology Zero: The bone fragments will be connected by the electric current.
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.
The Forgotten: Smaller bone shots appear whenever an enemy is hit with the melee attack. 
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.
Rubber Cement: Tears turn to bones, but bones do not shatter.
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.
Bones 
Lazarus Unlocks 
Delirium Unlocks 
The Binding of Isaac: Rebirth
