Breaks and sprains are extremely common, but how do you know whether you have broken a bone or just have a soft tissue injury?

Unless the bone is sticking out, or the limb is at a very peculiar angle, the only way to know for sure that a bone is broken is to have an X-ray.

However there are a few possible indicators:

• Pain – it hurts.
• Loss of power, it can be hard to move a broken limb.
• Unnatural movement – the limb may be at an odd angle and have a wider range of movement than it should have.
• Swelling, bruising or a wound around the fracture site.
• Deformity- often limbs may be shortened, or the broken area could have lumps and bumps or stepping (with an injured spine it is uneven as you gently feel down their back).
• Irregularity – lumps, bumps, depressions, or stretched skin.
• Crepitus – the grinding sound when the end of bones rub against each other.
• Tenderness – pain at the site of injury.

Although broken bones on their own, rarely cause fatalities, a severe break can cause the casualty to go into shock particularly if there is bleeding associated with the injury (either internal or external bleeding) and it is this shock that has the potential to be life threatening. For more in-depth guidance on managing severe internal and external bleeding, you can download our free ‘First aid for catastrophic bleeding and tourniquets’ ebook.

A fractured fractured pelvis or even a fractured hip can lead to serious internal bleeding. If these types of injuries are suspected, keep the casualty calm, still and warm and get the emergency services on the way as quickly as possible. If you have been taught how to stabilise a possible pelvic fracture, then it would be sensible to do this. Remember the pelvic cavity can collect a lot of blood and it is possible the casualty may start to show signs of shock. If you are aware that they are becoming pale, cold, clammy, feeling sick, dizzy and looking seriously unwell – update the emergency services and ensure they are on their way fast.

It is important to keep the casualty warm and dry and be aware that pain and stress will adversely affect their condition. If you are at all worried about them, phone an ambulance and keep the emergency services updated.

To build your confidence in dealing with breaks, sprains and other emergencies, you can join our Essential First Aid for All Ages course, which covers practical skills for adults and children.

Different types of fractures

Open Fractures

If the bone is sticking out, the bone is broken and this is known as an open fracture! The main priority with an open fracture is to stop any bleeding without pushing on the bone or moving the broken limb at all – then call for emergency help.

It is important to keep the casualty warm and dry and observe for signs of shock. If they display any symptoms, lie them down, but do not elevate the injured limb. They are likely to need an ambulance to safely transport them to hospital.

Complicated fractures

With complicated fractures, muscles, nerves, tendons and blood vessels could be trapped and damaged by the broken bone. If the casualty has lost feeling in part of their limb, or if it has changed colour, they will need urgent medical treatment.

Keep the casualty calm, warm and supported and phone for an ambulance.

You can read more about the differences between breaks, sprains and dislocations, and how to treat each, in our dedicated guide.

Closed fractures

With a closed fracture, the bone has not come through the skin. Children commonly have greenstick fractures, where the bone doesn’t snap, but half breaks like a young sapling, rather than a bit of dead wood.

With closed fractures (and also with soft tissue injuries such as sprains and strains) – you should initially do the following:

If you would like a copy of the poster above , please email emma@firstaidforlife.org.uk

PRICE

Treatment for soft tissue injuries and closed fractures

Protect the injury (stop using the injured limb, pad to protect)

Rest the injury

Ice – apply a wrapped ice pack

Comfortable support – apply a supportive bandage

Elevate – to reduce swelling

Care of soft tissue injuries

Call an ambulance if:

• The casualty starts to show signs of shock
• There is a possibility that they have injured their spine or head
• They have any difficulty breathing or begin to lose consciousness
• It is an open fracture, with the bone through the skin
• If they lose feeling in the limb, or if it dramatically changes colour
• You are unable to safely transport the casualty to hospital yourself keeping the limb stable and supported
• There is a suspected pelvic or hip fracture
• You are worried about them in any way.

You may also find it useful to print our free ‘When to call an ambulance’ poster as a quick reference for the situations where urgent medical help is needed.

About us

It is strongly advised that you attend a Practical or Online First Aid course to understand what to do in a medical emergency. Please visit First Aid For Life or Onlinefirstaid.com emma@firstaidforlife.org.uk or tel 0208 675 4036 for more information about our courses. First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.

Author: Emma Hammett