We all know someone who has had a break, sprain or dislocation at some time. Be it from ice skating, slipping whilst running by the side of a swimming pool, or even just falling badly, these injuries happen all the time, no matter what time of year. Whilst breaks and sprains are extremely common, it is very tricky to 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. There are some key signs you need to look out for though, so here’s what you need to know.
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
You may feel faint, dizzy or sick from the shock of breaking a bone.
If it’s a minor break or it’s just a small crack, it is possible that you may not feel much pain or even realise that you’ve broken anything. However, if you do think you’ve broken a bone, you should seek medical help as soon as possible. If it’s a toe or finger you think you might have broken, it’s best to go to a minor injury unit or urgent care centre.
Different types of fractures
If the bone is sticking out, the bone has to be broken! Your priority is to stop bleeding without pushing on the bone or moving the broken leg at all – then get emergency help.
Be very aware of the onset of shock – keep them warm and dry, if they show any signs of shock, lie them down, but do not elevate the injured limb.
With complicated fractures, muscles, nerves, tendons and blood vessels could be trapped and damaged. If you are aware that they have lost feeling in part of their limb, or if it has changed colour, they will need urgent medical treatment.
Keep them calm, warm and supported and phone for an ambulance.
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 spring stick.
With closed fractures (and also with soft tissue injuries such as sprains and strains) – you should initially do the following:
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
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Broken bones on their own rarely cause fatalities. However, 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). Shock is life threatening, so make sure you keep the casualty warm and dry. Try to keep as calm as possible, as stress is contagious! Being in pain and anxious may adversely affect their condition.
Call an ambulance if:
- They start 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 the extremities dramatically change colour
- You are unable to safely transport the casualty to hospital yourself, whilst keeping the limb stable and supported
- There is a suspected pelvic or hip fracture
- You are worried about them in any way
Written by Emma Hammett for First Aid for Life
It is strongly advised that you attend a Practical First Aid course to understand what to do in a medical emergency. Please visit www.firstaidforlife.org.uk and www.onlinefirstaid.com for more information about our practical and online courses and to access free resources.
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.