Broken bone


Definition

If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures the skin, it is called an open fracture (compound fracture).

A stress fracture is a break in the bone that develops because of repeated or prolonged forces against the bone. The repeated stress weakens the bone until it finally breaks.

Alternative Names

Bone - broken; Fracture; Stress fracture; Bone fracture

Considerations

It may be hard to tell a dislocated joint from a broken bone. However, both are emergency situations, and the basic first aid steps are the same.

Causes

This EM Should be displayed at the top of the article section "Causes"

The following are common causes of broken bones:

Symptoms

Symptoms of a broken bone include:

First Aid

First aid steps include:

  1. Check the person's airway and breathing. If necessary, call 911 or the local emergency number and begin rescue breathing, CPR, or bleeding control.
  2. Keep the person still and calm.
  3. Examine the person closely for other injuries.
  4. In most cases, if medical help responds quickly, allow the medical personnel to take further action.
  5. If the skin is broken, it should be treated right away to prevent infection. Call emergency help right away. DO NOT breathe on the wound or probe it. Try to cover the wound to avoid further contamination. Cover with sterile dressings if they are available. Don't try to line up the fracture unless you are medically trained to do so.
  6. If needed, immobilize the broken bone with a splint or sling. Possible splints include a rolled up newspaper or strips of wood. Immobilize the area both above and below the injured bone.
  7. Apply ice packs to reduce pain and swelling. Elevating the limb can also help to reduce swelling.
  8. Take steps to prevent shock. Lay the person flat, elevate the feet about 12 inches (30 centimeters) above the head, and cover the person with a coat or blanket. However, DO NOT move the person if a head, neck, or back injury is suspected.

CHECK BLOOD CIRCULATION

Check the person's blood circulation. Press firmly over the skin beyond the fracture site. (For example, if the fracture is in the leg, press on the foot). It should first blanch white and then "pink up" in about 2 seconds. Signs that circulation is inadequate include pale or blue skin, numbness or tingling, and loss of pulse.

If circulation is poor and trained personnel are NOT quickly available, try to realign the limb into a normal resting position. This will reduce swelling, pain, and damage to the tissues from lack of blood.

TREAT BLEEDING

Place a dry, clean cloth over the wound to dress it.

If the bleeding continues, apply direct pressure to the site of bleeding. DO NOT apply a tourniquet to the extremity to stop the bleeding unless it is life threatening. Tissue can only survive for a limited amount of time once a tourniquet is applied.

Do Not

When to Contact a Medical Professional

Call 911 or the local emergency number if:

Even though other broken bones may not be medical emergencies, they still deserve medical attention. Contact your health care provider to find out where and when to be seen.

If a young child refuses to put weight on an arm or leg after an accident, won't move the arm or leg, or you can clearly see a deformity, assume the child has a broken bone and get medical help.

Prevention

Take the following steps to reduce your risk of a broken bone:

References

Geiderman JM, Torbati S. General principles of orthopedic injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 41.

Kim C, Kaar SG. Commonly encountered fractures in sports medicine. In: Miller MD, Thompson SR, eds. DeLee Drez & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 10.

Whittle AP. General principles of fracture treatment. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 53.

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