First Aid for Broken Bones

If more pressure is put on a bone than it can withstand, it will break. These are referred to as fractures. If a bone punctures the skin, these are referred to as open or compound fractures. A hairline crack, or stress fracture, can develop in a bone without parts showing a separation. Fractures are usually the result of an injury due to  falls from heights, overuse during sporting activities, or as a result of aging or bone weakening due to osteoporosis or other diseases.[1]

There are many types of broken bones:

  • A simple or closed fracture is when the bone breaks into two pieces , but the skin is intact.
  • An open or compound fracture has a piece of bone protruding through the skin.
  • A transverse fracture occurs across the bone.
  • A spiral fracture results when the break spirals around the bone usually when a force twists the bone.
  • A comminuted fracture is when an injury caused the bone to shatter into at least three pieces.
  • An impacted fracture results when a force presses against both ends of the bone, pushing the end together.
  • A greenstick fracture happens in children when a break occurs on one side and the other side bends.
  • A linear break occurs along the length of a bone.
  • An oblique fracture occurs when the bone breaks diagonally and tend to occur on long bones.[2]

How do you know if a bone is fractured? You need to follow the bone to see if there is any deformation or not using your hand. When you press on the area, the victim acknowledges pain. The bone bleeds when it breaks completely apart, so you will see a hematoma, under the skin. Swelling will also follow. The extremity will have limited mobility.[3]

 First Aid steps should include:

  1. Check person’s airway and breathing; call 911 and begin rescue breathing, CPR or bleeding control.
  2. Keep the person still and calm and examine for other injuries.
  3. If medical help responds quickly, allow them to take further action.
  4. If the skin is broken, it should be treated immediately to prevent infection. If possible, lightly rinse wound and cover with sterile dressings.
  5. If needed, immobilize broken bone with a splint or sling. Possible splints include rolled up newspaper or strips of wood. Extend the splint above and below the injured bone.
  6. Apply ice packs to reduce pain and swelling.
  7. Take steps to prevent shock, but don’t move the person if a head, neck or back injury is suspected.
  8. Check blood circulation below the fracture by pressing on skin and releasing to see “pinking up.”[1]
  9. If the circulation is poor, and trained personnel are not readily available, try to realign the limb into a normal resting position.
  10. Do not move the person unless the broken bone is stable, nor if the person has a possible spine, pelvis, hip or upper leg, head or neck injury.
  11. Place a clean, dry cloth over the wound to dress it, if bleeding continues apply direct pressure to stop it.
  12. Do not apply a tourniquet unless it is life-threatening.

A medical professional should be consulted. Your doctor will do a careful examination to assess your overall condition, including the fracture injury. He will have twenty questions, so just be patient. The most common way to evaluate a fracture is with x-rays, which provide clear images of bone. The x-ray will confirm the break and help the doctor assess the type of fracture.

 The treatment for fractures is basic:

  • put the bone pieces back together and prevent them from moving until they are healed.
  • The broken bone ends heal by “knitting” back together creating new bone around the edges of the broken parts.
  • Surgery is sometimes required depending on the type and severity of the break. During surgery the patient is anesthetized.

Doctors use a variety of treatments:

Cast immobilization – a plaster of fiberglass cast is the most common type of treatment. Most bones

Broken Bones

Leg with femur fracture
Referenced from:
Basic anatomical knowledge

can heal successfully once they have been re-positioned and cast applied to keep the broken ends in proper position while they heal.
 Functional Cast or Brace – this cast or brace allows limited movement of nearby joints.
Traction – usually used to align a bone or bones by a gentle, steady pulling.
 External Fixation – in this type of operation, metal pins or screws are placed into the broken bone above and below the fracture site and connected to a metal bar outside the skin. This procedure is used in cases where the skin and other soft tissues around the fracture are badly injured and surgery cannot be tolerated.
 Open Reduction and Internal Fixation – during this type of surgery, the bone fragments are re-positioned into alignment, and then held together with special screws or by attaching metal plates to the outside surface of the bone. The fragments can also be held together by inserting a rod down the marrow space in the center of the bone.

Broken Bone Recovery

Recovery takes several weeks to several months, depending on the extent of the injury and how well you follow your doctor’s advice. Pain usually stops before the fracture is solid enough to handle the stresses of normal activity. When the cast has been removed, limited movement may be the prescription as well as physical therapy to restore muscle strength, joint flexibility and motion.
To prevent breaks, eat a diet rich in calcium and Vitamin D to keep bones strong. Consult a doctor before increasing your calcium intake. Weight bearing exercise also helps keep bones strong.[4]

Disclaimer: This information is provided as an educational service and is not intended to serve as medical advice. Consult your personal physician.

References
[1].  https://medlineplus.gov/ency/article/000001.htm
[2].  http://www.healthline.com/symptom/fractures
[3]. Survival MD, 2014, Survivopedia
[4]. http://orthoinfo.aaos.org/topic.cfm?topic=a00139

Billie Nicholson, Editor
October 2016

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