Dealing with Breaks and Fractures

As a first aider, we need to manage the casualty until help arrives, do not try to straighten bones, just immobilise the injured area, take care of the casualty and get them to the help they need.

The Skeletal System

The skeleton consists of 206 bones, the functions of which are to.

Provide support for the soft tissues of the body. This gives the body its shape.
Provide protection for important organs such as the brain, lungs ,and spinal cord.
Allow movement, by incorporating different types of joints and attachment for muscles.
Produce red blood cells, some white blood cells, and platelets in the marrow of bones such as the femur.
Provide a store of minerals and energy such as calcium and fats.

Causes of injury to the bones

Injury can be caused to the bones, muscles, and joints by different types of force.

Direct Force – Damage results at the location where the force was applied, such as the impact area of a blow or kick.
Indirect Force – Damage occurs away from the point where the force was applied, a fractured collar bone, as a result of landing on an outstretched arm.
Twisting Force – Damage results from torsion forces on the bones and muscles, such as twisting an ankle.
Violent Movement – Injury results from a sudden violent movement, such as injuring the knee joint by kicking violently.
Pathological – Injury results because the bones have become brittle or weak, due to disease or old age.

Types of fracture

A fracture can be defined as a ‘break in the continuity of the bone’. The basic categories of fracture are:

Closed

This is a clean break or crack in the bone, with no complications.

Open

The skin has become broken by the bone which may (or may not) still be protruding from the wound. This type of injury has a high risk of infection.

Complicated

With this type of injury, there are complications that have arisen as a result of the fracture, such as trapped blood vessels or nerves.

Green Stick

This type of fracture occurs more commonly in children, who have young, more flexible bone. The bone is split, but not totally severed. fractures are often mistaken for sprains and strains, because only a few of the signs and symptoms of a fracture are present.

Possible signs and symptoms of a fracture

Pain – At the site of the fracture. Strong pain killers, nerve damage or dementia may mask the pain, so beware.
Loss of Power – not being able to lift anything with a fractured arm.
Unnatural movement – This type of fracture is classed as ‘ unstable’ and care should be
taken to prevent the fracture from moving.
Swelling or bruising – Around the site of the fracture.
Deformity – If a leg is bent in the wrong place, it’s broken!
Irregularity – Lumps or depressions along the surface of the bone, where the broken ends of the bone overlap.
Crepitus – The feeling and sound of bone grating on bone, when the
broken ends rub on each other.
Tenderness – At the site of the injury.

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Treatment of a basic fracture

Reassure the casualty, tell them to keep still.
Keep injury still with your hands until it is properly immobilised. The casualty might be able to do this on their own.
Don’t move the casualty until the injury is immobilised, unless they are in danger.
Don’t try to bandage an injury if you have called an ambulance, just keep it still (cover open wounds with a sterile dressing).
Don’t let the casualty eat or drink – they may need an operation.

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For an upper limb injury

Carefully place the arm in a sling against the trunk of the body. Arm fractures are normally placed in a support sling. Collar bone fractures are normally supported by an elevated sling (keep the elbow down at the patient’s side when using an elevated sling for a collar bone fracture).
If the casualty is in severe pain, circulation or nerves to the arm are affected, the casualty has breathing difficulties, or you are unsure, dial 999 for an ambulance.
Arrange transport to hospital.

For a lower limb injury

Keep the casualty warm and still. Dial 999 for an ambulance.
If the ambulance arrival will be delayed (e.g. remote countryside) immobilise the injury by bandaging the sound leg to the injured one.
Check circulation beyond the injury and any bandages. Loosen bandages if necessary.

Dislocations

A dislocation is where a bone becomes partially or fully dislodged at a joint, usually as a result of wrenching movement or sudden muscular contraction. The most common dislocations are the knee cap, shoulder, jaw, thumb or a finger.

There may also be a fracture at or near the site of the dislocation, and damage to ligaments, tendons and cartilage. It can be difficult to distinguish between a fracture and a dislocation.

Never attempt to manipulate a dislocated joint back into place. This is a job for the experts, the procedure can be extremely painful for the patient, and you may cause further damage.

Treat a dislocation as you would a break.

First Aid Lessons and Help

Book Your First Aid Training

These lessons and information do not replace actual attendance on a first aid course, getting hands on practice with your first aid skills is the best way to ensure you are a competant and capable first aider.

If you would like to book a first aid course or if you have a question for us please call 0191 7166601, email admin@firstaidsafeytraining.com or complete our online enquiry form and a member of the team will get back to you shortly.

We provide workplace onsite training for Emergency First Aid, First Aid at Work and Paediatric First Aid but a range of other First Aid Courses across the North East, our first aid training centre is based in South Shields.