Broken bone
Definition
If more pressure is put on a bone
than it can stand, it will split or break. A break of any size is
called a fracture. If the broken bone punctures the skin, it is
called an open fracture (compound fracture).
A stress fracture is a hairline
crack in the bone that develops because of repeated or prolonged
forces against the bone.
Alternative Names
Bone - broken; Fracture; Stress
fracture
Considerations
It is hard to tell a dislocated bone from a broken bone. However,
both are emergency situations, and the basic first aid steps are
the same.
Causes
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
- 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
- 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. Don't 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 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.
Other 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.
DO NOT
- DO NOT move the person unless
the broken bone is stable.
- DO NOT move a person with an
injured hip, pelvis, or upper leg unless it is absolutely
necessary. If you must move the person, pull the person to safety
by his clothes (such as by the shoulders of a shirt, a belt, or
pant-legs).
- DO NOT move a person who has a
possible spine injury.
- DO NOT attempt to straighten a
bone or change its position unless blood circulation appears
hampered.
- DO NOT try to reposition a
suspected spine injury.
- DO NOT test a bone's ability to
move.
When to Contact a Medical Professional
Call 911 if:
- 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.
Prevention
- Wear protective gear while
skiing, biking, roller blading, and participating in contact
sports. This includes helmets, elbow pads, knee pads, and shin
pads.
- Create a safe home for young
children. Gate stairways and keep windows closed.
- Teach children how to be safe and look out for
themselves.
- Supervise children carefully.
There is no substitute for supervision, no matter how safe the
environment or situation appears to be.
- Prevent falls by not standing on
chairs, counter tops, or other unstable objects. Remove throw rugs
and electrical cords from floor surfaces. Use handrails on
staircases and non-skid mats in bathtubs. These steps are
especially important for the elderly.
References
Browner BD, Jupiter JB, Levine
AM, Trafton PG, Krettek C, eds. Skeletal Trauma. 4th ed.
Philadelphia, Pa: Saunders Elsevier; 2008..
Geiderman JM. General principles
of orthopedic injuries. In: Marx J, ed. Rosen’s Emergency
Medicine: Concepts and Clinical Practice. 6th ed. St
Philadelphia, Pa: Mosby Elsevier; 2006:chap 46.
Review Date: 5/2/2009
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX
Northwest Division of Physician Assistant Studies, University of
Washington, School of Medicine. Also reviewed by David Zieve, MD,
MHA, Medical Director, A.D.A.M., Inc.
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