Fractures and Broken Bones:
Recognising and Treating Bone Injuries
Fractures, commonly known as broken bones, occur when a bone is cracked or broken due to trauma, such as a fall, direct blow, or accident. While some fractures are minor and heal with time, others require immediate medical attention to prevent complications. Knowing how to provide first aid for fractures can help reduce pain, prevent further injury, and support healing.
What is a Fracture?
A fracture is a break in the bone, ranging from a small crack to a complete break. There are different types of fractures, including:
- Closed (Simple) Fracture: The bone is broken but the skin remains intact.
- Open (Compound) Fracture: The broken bone pierces through the skin, creating an open wound and increasing the risk of infection.
- Greenstick Fracture: A partial fracture where the bone bends and cracks, common in children whose bones are more flexible.
- Comminuted Fracture: The bone is shattered into multiple pieces.
- Stress Fracture: A hairline crack caused by repeated stress or overuse, common in athletes.
Causes of Fractures
Fractures are typically caused by:
- Trauma: Falls, car accidents, sports injuries, or direct blows to the body.
- Overuse: Repeated stress on a bone, such as from running or jumping, can lead to stress fractures.
- Osteoporosis: Weakened bones due to osteoporosis make people more prone to fractures, even with minor falls or injuries.
Signs and Symptoms of Fractures
The symptoms of a fracture depend on the severity and location of the injury, but common signs include:
- Pain: Severe pain at the site of the injury, especially when trying to move or put weight on the affected area.
- Swelling and Bruising: The area around the fracture may become swollen, tender, and discoloured.
- Deformity: The limb or affected area may appear deformed or out of place.
- Inability to Move: The person may be unable to move the injured limb or put weight on the affected bone.
- Grinding Sensation: The person may feel or hear a grating or grinding sensation when moving the bone.
- Protruding Bone: In the case of an open (compound) fracture, the bone may be visible through the skin.
First Aid for Fractures
Providing proper first aid for fractures can help stabilise the injury and prevent further damage. Here’s how to respond:
- Immobilise the Injury:
- Keep the person still: Encourage the person not to move the injured area to prevent further injury. Any movement could cause the bones to shift or damage surrounding tissues.
- Support the injured limb: If the injury is to an arm or leg, immobilise the affected limb by using a sling or splint. Use items like a folded newspaper, a piece of wood, or a rolled-up towel to create a splint, and secure it in place with bandages or cloth strips. Avoid moving the injured area while applying the splint.
- Do not attempt to realign the bone: If the limb appears deformed or the bone is out of place, do not try to push it back into position. Leave this to medical professionals.
- Apply Ice:
- Reduce swelling and pain: Apply an ice pack or a bag of frozen peas (wrapped in a cloth) to the injury to help reduce swelling and pain. Ice should never be applied directly to the skin, as this can cause frostbite.
- Avoid using heat: Do not use heat packs, as this can increase swelling.
- Stop Any Bleeding:
- Apply pressure to open wounds: If the fracture is an open (compound) fracture, where the bone has pierced the skin, cover the wound with a sterile dressing or clean cloth and apply gentle pressure to stop the bleeding. Avoid pressing directly on the protruding bone.
- Treat for Shock:
- Monitor for signs of shock: Fractures, especially those involving heavy bleeding or severe pain, can lead to shock. Symptoms of shock include pale, cold, clammy skin, rapid breathing, and confusion. Keep the person warm by covering them with a blanket and lying them down with their legs slightly elevated if possible.
- Do not give food or drink: Avoid giving the person anything to eat or drink in case they need surgery.
- Seek Medical Help:
- Call 999 for emergency help: Call for emergency services if the fracture is severe, such as an open fracture, a fracture to the head, neck, back, pelvis, or major joints, or if the person is in severe pain.
- Take the person to A&E: For less severe fractures, arrange transport to the hospital or A&E for further assessment and treatment.
First Aid for Specific Types of Fractures
- Arm or Wrist Fractures:
- Support the arm with a sling: Create a makeshift sling using a triangular bandage or a cloth to support the arm. Tie the sling behind the neck to immobilise the arm and prevent further movement.
- Leg Fractures:
- Keep the leg still: If the leg is fractured, avoid moving the person unless absolutely necessary. If you must move them, splint the leg by using a long, rigid object (such as a board or stick) to immobilise the limb. Secure it in place with bandages or cloth strips.
- Rib Fractures:
- Encourage shallow breathing: Rib fractures can be painful, especially when breathing. Encourage the person to take shallow breaths to minimise pain. They may hold a cushion or pillow against their chest to support the injury.
- Seek medical attention: Always seek medical advice for suspected rib fractures, as complications like punctured lungs (pneumothorax) can occur.
- Hip Fractures:
- Do not move the person: If you suspect a hip fracture, do not attempt to move the person. Call 999 and keep them as still and comfortable as possible until emergency services arrive.
When to Seek Medical Help
You should always seek medical attention for fractures, but call 999 immediately if:
- The bone is visible through the skin (open fracture).
- There is heavy bleeding from the wound.
- The person shows signs of shock (pale, cold skin, confusion, rapid breathing).
- The injury involves the head, neck, spine, or pelvis.
- The limb or joint appears deformed or out of place.
- The person is in severe pain and cannot move the injured area.
Prevention of Fractures
- Wear Protective Gear: Use helmets, padding, or other protective equipment during sports and activities with a high risk of falls or impact.
- Strengthen Bones: Maintain strong bones through a healthy diet rich in calcium and vitamin D, and engage in regular weight-bearing exercises like walking or lifting weights.
- Prevent Falls: Remove hazards from the home, such as loose rugs or clutter, and install handrails or grab bars in areas where falls are likely, especially for elderly people.
- Drive Safely: Always wear a seatbelt and follow road safety guidelines to reduce the risk of fractures in car accidents.
Key Points to Remember
- Immobilise the injured area using a sling or splint and avoid moving the person if the injury is severe.
- Apply ice to reduce swelling and pain, and cover any open wounds with a sterile dressing.
- Monitor for signs of shock and seek medical attention as soon as possible, especially for severe fractures or open wounds.
- Never attempt to realign a bone or push it back into place.