A fracture is a crack or break in a bone. It takes a considerable degree of force to break bones as they are not simply brittle sticks but living tissues supporting the body.
However, the bones of the elderly or those affected by disease may become more brittle and vulnerable, whilst those of children may be more likely to split under force as they are suppler.
Bones are supplied with a rich network of nerves and blood vessels, which accounts for the amount of pain and swelling experienced when a fracture is sustained.
Types of fracture
1. Simple fracture: a clean break in a bone.
2. Closed fracture: a break in which the bone does not pierce the skin. However, there may be damage to surrounding tissue indicated by localized swelling and/or bruising.
3. Compound or open fracture: a break in which the broken bone pierces the skin or is accompanied by a wound. In a compound fracture, the bone is exposed to contamination by infection from the air.
4. Comminuted fracture: the bone is shattered into several fragments at the site of the break.
5. Greenstick fracture: most commonly experienced by children. This type of fracture will show up on an X-ray as an incomplete break or split in a bone. 6 Pathological fractures the bone may break spontaneously where affected by disease or some other weakening factor such as a cyst.
Signs and symptoms of fracture
1. The casualty may report having beard or felt a snap, although this can be caused by injuries other than fracture.
2 The casualty will often experience severe pain at the site of the injury that is worsened by attempts to move the limb.
3 The casualty will be unable to move the limb normally as a result of the pain and the instability of the broken bone.
4 Bleeding from the damaged bone and surrounding tissues will quickly result in swelling. Later, localized bruising will probably occur, again as a result of hemorrhage within the tissues.
5. The limb may appear misshapen, deformed or shortened as a result of the break, or thrown into an unnatural position.
How to help a fracture victim
1. With the exception of suspected fractures to small bones in the upper limbs, it is best not to move the casualty, especially if you suspect the spine may be fractured.
2. Steady the broken limb by holding it gently but finely above and below the fracture site, but do not attempt to straighten it.
3. Dial 999 for an ambulance at the earliest possible opportunity.
4. It may be possible to immobilize the injured part without moving it unduly. For example, it may be possible to support a broken leg between two cushions or pads of folded clothing, but do not attempt this if it involves moving the limb or altering its position. It is always a good idea to immobilize a broken arm against the body, using a sling.
5. If it looks as if help may be some time in arriving, a broken leg may be gently secured to the sound leg with bandages. However, do not persist with this if it seems to be causing additional pain or distress.
6. Reassure the casualty. Observe for shock.
7. Keep the casualty warm, but do not give him or her anything to eat or drink, as he or she may require a general anesthetic on admission to hospital.