Every day the bones are subject to various forms of force and pressure. While bones are made up of very strong compounds, the amount of force may overwhelm the capacity of the bones leading to injuries. Fractures are some of the most common injuries to bones and joints. These injuries are most frequently seen in sports or athletic activities, motor vehicle accidents, occupation, and even in daily activities; with slip and fall as the leading causes of fractures, especially for older adults. For you to be able to help in such emergency situations, you should first know the basics of fracture.
Disclaimer: the information posted on this page on open and closed fractures is for learning purposes only. To learn to differentiate between the two and recognize and manage emergencies related to broken bones enrol in first aid courses through St Mark James.
What is a fracture?
A fracture is any break in the continuity of a bone, including splintering, cracks, chips, and complete breaks. Fractures are generally classified into two:
- A closed fracture occurs when a bone is broken but does not penetrate into the skin. The bones remain inside the muscle and skin tissue, and do not rip through the skin. It may involve soft tissue injuries but are usually minimal. In some cases, the bone splinters or the bone ends are displaced causing great damage to surrounding soft tissues. The damage is usually hidden beneath the skin and is often difficult to detect visually. This type of fracture may cause profuse internal bleeding.
- An open fracture occurs when a penetrating wound produces fractures or when the broken bones are forced out and pierced through the skin.
General Principles for Care of Fracture
Although the care for fractures may vary depending on the affected bones, its severity and type of fracture, the general care for skeletal injuries are the same.
- Assess the injury by gathering symptoms.
- tenderness and pain
- crepitus or cracking sound of bones
- numbness or tingling sensation
- loss of sensation, function or pulse below the site of injury
- muscle spasms
- exposed bones or open wound (for open fractures)
- Control serious bleeding by applying dressing and bandage on open wounds.
- Immobilize affected part. Avoid moving the victim until all fractures have been immobilized.
- Watch out for signs of shock and be ready to care for shock.
- Check the pulse below the affected limb or extremity.
- Check nerve function.
- Apply pressure at the distal part of the extremity and ask if victim is able to feel it.
- Instruct the victim to move toes or fingers at the affected side.
- Instruct the victim to perform slight hand or foot movement.
- Cut away or remove clothing around the injured site. Remove jewelry and other constricting accessories on injured limb.
- When necessary, attempt to splint the injured limb. However, if there is resistance or severe pain, do not force applying a splint.
- When applying splint, apply traction to straighten the fractured bone throughout the process. Immobilize fractured or dislocated joints but do not attempt to manipulate dislocation.
- Make sure splint is snugly fit but not too tight that it impairs circulation. Immobilize joints above and below the fracture to minimize movement.
- Leave toes and fingers exposed when splinting. Continuously monitor circulation and nerve function.
While the general principles for the care of fractures are the same, open fractures require additional care of the wound.
To learn more about differentiating between various fractures and how to recognize and manage broken bones sign up for first aid training through St Mark James Training.