Fractures (Broken Bones)

Overview

What are fractures?

A break or crack in a bone is called a fracture. In the case of an open fracture, it will present as an open wound or break in the skin near the site of a broken bone.  

But in a closed fracture the skin around the fracture is intact.

Broken bones may be unstable causing internal bleeding and the casualty may develop shock.

Signs and Symptoms

Signs of a fracture are:

• deformity, swelling and bruising around the fracture
• pain and/or difficulty moving the area
• a limb may look shorter, twisted or bent 
• a grating noise or feeling from the ends of the broken bones
• difficulty or being unable to move the limb normally (don't ask the casualty to attempt movement if they are unable to)
• a wound over the fracture when the bone is not visible or a wound where you can see the bone sticking out (known as an open fracture)
• signs of shock, particularly with a fracture of a thigh bone, hip or pelvis
  

Immediate First Aid Steps

It can be difficult to tell if a person has a broken bone or a joint, as opposed to a simple muscular injury. If you're in any doubt, treat the injury as a broken bone.

1. If the person is unconscious or is bleeding heavily, these must be dealt with first by controlling the bleeding with direct pressure and performing CPR. 
2. If it is an open fracture, or these is a visible wound, cover the wound with a sterile dressing or a clean non-fluffy cloth. Apply pressure around the wound and not over the protruding bone or suspected fracture site, to control any bleeding. Then secure the dressing with a bandage.
3. If the person is conscious, prevent any further pain or damage by keeping the fracture as still as possible until you get them safely to hospital. Do this by holding the joint above and below the injured area. Place padding around the injury for extra support.
4. Do not move the casualty until the injured part is secured, unless they are in immediate danger.
5. Once you have done this, decide whether the best way to get them to hospital is by ambulance or car.

If the pain isn't too severe, you could transport them to hospital by car. Get someone else to drive if possible so you can care for the person who is injured during the trip.

But call for an ambulance if:

• they're in a lot of pain and in need of strong painkilling medication – call an ambulance and do not move them
• it's obvious they have a broken leg – do not move them, but keep them in the position you found them in and call an ambulance
• you suspect they have injured or broken their back – call an ambulance and do not move them

Do not give the person who is injured anything to eat or drink, as they may need an anaesthetic (numbing medication) when they reach hospital.

When To Seek Medical Help

Call an ambulance or seek immediate medical help (e.g. Emergency Department) if you have:

• an open fracture (bone sticking out) or visible wounds
• suspected broken back, neck or pelvis
• a broken leg
• signs of a severely broken bone, such as deformity, inability to move or severe pain
• numbness or can't feel anything in the injured area
• signs of shock

Get medical help if you:

• suspect a broken bone, even if the symptoms seem mild