A fracture is a break or a crack in a bone that has the potential to cause shock and serious injury to internal body structures.
Fractures can be classified as either:
- open—the bone pierces the skin and soft tissue when it breaks and can be seen through the skin. Alternatively, an open fracture may be caused by an object penetrating the skin and fracturing a bone
- closed*—*the bone does not pierce the skin and cannot be seen.
Signs and symptoms
- Bone/s protruding from an open, bleeding wound
- Deformity—the affected part has changed in shape
- Feeling/sound of bone ends grating or the sound of a snap or pop at the time of injury
- Loss of function
- Pain and tenderness at the site
- Signs and symptoms of shock (see Shock)
- Swelling at the site, resulting from internal bleeding
- Tingling or numbness
- Unnatural movement—the affected part can be moved too freely
Management
The precise treatment of a fracture depends on the location of the injury. However, these steps for an injured limb apply to most fractures.
- Reassure the person.
- Advise the person not to move and to support their injury in a position of least pain.
- Send for help, additional resources (first aid kit) and request an ambulance.
- Gain consent to provide (and document) treatment.
- Immobilise the injured limb in the position you found it in.
- Check for circulation to their limb—press on the nearest fingernail/toenail to see if the blood circulation returns after applying pressure.
- Monitor and reassure the person where they fell or injured themselves if possible and safe to do so while waiting for the paramedics to arrive.
Note
- A lifesaver qualified in providing pain management may also administer methoxyflurane for pain relief.
- If the fracture is open, apply a clean dressing to the wound where appropriate and treat for shock (see Shock).
- Treat for shock (see Shock).
- When moving the person is required, first immobilise the area above and below the fracture.