2. A break or crack in a bone is called a fracture. Considerable
force is needed to break a bone, unless it is diseased or old. A
bone may break at the point where a heavy blow is received.
Fractures may also result from a twist or a wrench (indirect
force).
3. ■ Deformity, swelling, and bruising at the fracture site
■ Pain and/or difficulty in moving the area
■ Shortening, bending, or twisting of a limb
■ Coarse grating (crepitus) of the bone ends that can be heard
or felt (by casualty). Do not try to seek this.
■ Signs of shock, especially if the thighbone or pelvis are
fractured
■ Difficulty in moving a limb normally or at all (for example,
inability to walk)
■ A wound, possibly with bone ends protruding (Treating an
open fracture)
4. In an open fracture, one of the broken bone ends may pierce
the skin surface, or there may be a wound at the fracture site.
An open fracture carries a high risk of becoming infected.
In a closed fracture, the skin above the fracture is intact.
However, bones may be displaced (unstable), causing internal
bleeding and the casualty may develop shock
5. A stable fracture occurs when the broken bone ends do not
move because they are not completely broken or they are
impacted. Such injuries are common at the wrist, shoulder,
ankle, and hip. Usually, these fractures can be gently handled
without further damage.
In an unstable fracture, the broken bone ends can easily
move. There is a risk that they may damage blood vessels,
nerves, and organs around the injury. Unstable injuries can
occur if the bone is broken or the ligaments are torn
(ruptured). They should be handled carefully to prevent
further damage.
7. WHAT TO DO FOR A CLOSED FRACTURE
• Advise the casualty to keep still. Support the joints above and below
the injury with your hands until it is immobilized with a sling or
bandages, in the position in which it is found. Place padding around
the injury for extra support.
• Take or send the casualty to the hospital; a casualty with an arm injury
may be transported by car; call for emergency help for a leg injury.
• For firmer support and/or if removal to the hospital is likely to be
delayed, secure the injured part to an unaffected part of the body.
• For upper limb fractures, immobilize the arm with a sling
• For lower limb fractures, move the uninjured leg to the injured one
and secure with broad-fold bandages). Always tie knots on the
uninjured side.