First Aid for Fracture

A fracture is a break or crack in bone.

1. Closed fractures

Closed (or simple) fractures are those not related to open wounds on the surface of the body, although there may be a laceration over or near the fracture site.

2. Open fractures

Open (or compound) fractures are those associated directly with open wounds. An open fracture may result external violence or may produced by injury from within as broken ends of a bone protrude through the skin at the time of the accident or later through the skin at the time of the accident or later through motion or mishandling of the fractured bone.

Causes of Fractures

The most common causes of fractures are motor vehicle accidents, or accidents related to falls and recreational and sports activities. Some fractures result from very slight injuries, particularly in older people, because of brittle or abnormal bones.

Signs and symptoms of Fractures

If an accident victim is conscious he will usually be able to provide clues to possible fractures. He may recall his position before the injury and relate what happened as he fell or struck some object. In addition—

• He may have heard or felt a bone snap.
• He may indicate the location of pain and tenderness and difficulty in moving the injured part.
• He may also report a grating sensation of broken bones rubbing together.
• He may report abnormal or false motion in an area of the body.

Other signs of fracture include—

• Differences in the shape and length of corresponding bones on the two sides of the body.
• Obvious deformities
• Swelling
• Discoloration
• Pain or tenderness to touch

First Aid Principles

1. To maintain an open airway and apply artificial respiration if indicated.
2. To rescue, if necessary, and to protect against further injury.
3. To call for an ambulance, if indicated, or medical assistance.
4. To prevent motion of the injured parts and the adjacent joints.
5. To elevate involved extremities, if possible, without disturbing the suspected fracture.
6. To apply splints, if modern ambulance service is not available, if there is a delay in transportation, or in less serious injuries before seeking medical assistance for diagnosis and treatment.

Do not attempt to set (or reduce) a fracture or try to push a protruding bone end back.

If splinting and transportation are necessary, the bone end may slip back when the limb is straightened for splinting.

If an ambulance or rescue squad can arrive within a short period after an accident, when an injured person obviously requires hospitalization, do not attempt to move the victim unless there is danger of fire, carbon monoxide poisoning, explosion, drowning, or other life-threatening emergencies. Above all, in attempting rescue, do not drag victims out of vehicles, or from under wreckage, or throw them on the ground in your haste to save their lives.

If possible, even in the midst of a crowded street or highway, take the time to tie a victim’s injured leg to his uninjured one, or bind his injured arm to his chest or side.

Lift and move an unconscious victim as though there is injury to his neck or spine.

Wait for adequate help—at least three and preferably four persons—and obtain a rigid support for the victim’s back, if possible.

Following a neck or spinal injury during water activity, float the victim to shore without bending his neck or back. Do not lift the victim out of the water without a back support.

Delegate others to telephone for an ambulance and the police, if necessary, and to assist in maintaining order in the area of the accident.

If an open fracture is evident or suspected, treat the wound as outlined previously:

1. Remove or cut away the victim’s clothing.
2. Control hemorrhage by applying pressure through a large sterile (or clean) dressing over the wound.
3. Do not wash the wound, do not probe it, and do not insert your fingers into it.
4. If a fragment of bone is protruding, cover the entire wound with a large, sterile bandage compress or pads; if these are not available, use freshly laundered sheets or towels.
5. Do not replace bone fragments.

Apply splints if necessary, according to the location of the fracture. Then elevate the limb slightly to reduce hemorrhage and swelling. Open fractures should have priority over closed fractures for transportation and medical treatment, unless associated injuries dictate otherwise.

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