Fractures

If more pressure is put on a bone than it can stand, it will split or break.

A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.

Symptoms of a fracture are

  • Intense pain
  • Deformity - the limb looks out of place
  • Swelling, bruising, or tenderness around the injury
  • Numbness and tingling
  • Problems moving a limb

You need to get medical care right away for any fracture. An x-ray can tell if your bone is broken. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.

It is hard to tell a dislocated joint from a broken bone. However, both are emergency situations, and the basic first aid steps are the same.

Call 911 if:

  • The person is not responding or is losing consciousness.
  • There is a suspected broken bone in the head, neck, or back.
  • There is a suspected broken bone in the hip, pelvis, or upper leg.
  • You cannot completely immobilize the injury at the scene by yourself.
  • There is severe bleeding.
  • An area below the injured joint is pale, cold, clammy, or blue.
  • There is a bone projecting through the skin.

Even though other broken bones may not be medical emergencies, they still deserve medical attention. Call your health care provider to find out where and when to be seen.

If a young child refuses to put weight on an arm or leg after an accident, won't move the arm or leg, or you can clearly see a deformity, assume the child has a broken bone and get medical help.

The following are common causes of broken bones:

  • Fall from a height
  • Motor vehicle accidents
  • Direct blow
  • Child abuse
  • Repetitive forces, such as those caused by running, can cause stress fractures of the foot, ankle, tibia, or hip

Symptoms of a broken bone include:

  • A visibly out-of-place or misshapen limb or joint
  • Swelling, bruising, or bleeding
  • Intense pain
  • Numbness and tingling
  • Broken skin with bone protruding
  • Limited mobility or inability to move a limb

First aid steps include:

  • Check the person's airway and breathing. If necessary, call 911 and begin rescue breathing, CPR, or bleeding control.
  • Keep the person still and calm.
  • Examine the person closely for other injuries.
  • In most cases, if medical help responds quickly, allow the medical personnel to take further action.
  • If the skin is broken, it should be treated immediately to prevent infection. Call emergency help right away. DO NOT breathe on the wound or probe it. If possible, lightly rinse the wound to remove visible dirt or other contamination, but do not vigorously scrub or flush the wound. Cover with sterile dressings.
  • If needed, immobilize the broken bone with a splint or sling. Possible splints include a rolled up newspaper or strips of wood. Immobilize the area both above and below the injured bone.
  • Apply ice packs to reduce pain and swelling.
  • Take steps to prevent shock. Lay the person flat, elevate the feet about 12 inches (30 centimeters) above the head, and cover the person with a coat or blanket. However, DO NOT move the person if a head, neck, or back injury is suspected.

CHECK BLOOD CIRCULATION

Check the person's blood circulation. Press firmly over the skin beyond the fracture site. (For example, if the fracture is in the leg, press on the foot). It should first blanch white and then "pink up" in about two seconds. Signs that circulation is inadequate include pale or blue skin, numbness or tingling, and loss of pulse.

If circulation is poor and trained personnel are NOT quickly available, try to realign the limb into a normal resting position. This will reduce swelling, pain, and damage to the tissues from lack of blood.

TREAT BLEEDING

Place a dry, clean cloth over the wound to dress it.

If the bleeding continues, apply direct pressure to the site of bleeding. DO NOT apply a tourniquet to the extremity to stop the bleeding unless it is life-threatening.