In both children and adults, fractures are classified as open or compound when the ends of the bone have broken through the skin, raising the risk of infection. In non-displaced fractures, the pieces on either side of the break remain lined up, and with displaced fractures the pieces of bone are not in line and may require surgery to align before casting. Hairline fractures have only a thin break in the bone, single fractures have only one break in the bone, segmental fractures have at least two and sometimes more breaks in the same bone, and in a comminuted fracture the bone is splintered or crushed.
You can identify a broken bone if you or the injured person hears, or the injured person feels, the bone break. The area will also be very tender to the touch, particularly in the area of fracture. Other signs of a broken bone include:
Swelling around the break
An unnatural position of the limb
Pain on any attempts to move the limb
Loss of a pulse below the injury
Bone protrusion through the skin
A grating sensation
Loss of function of the limb
Call 911 for any of the following:
If even gentle pressure or movement causes pain
Any limb or joint appears deformed
A bone has pierced the skin
Any extremity of an injured arm or leg is numb or bluish at the tip
You think that a bone is broken in the neck, head, back, hip, pelvis, or upper leg
First Aid for Broken Bones
Remember to stay calm. Broken bones require medical attention, and fractures that are a result of a major trauma or injury require emergency care. Do not move the injured person, but do keep them warm.
Until medical help arrives, check for ABCs, treat for shock, and begin CPR if needed as outlined in Chapter 2.
Apply pressure to any wounds with a sterile bandage, clean cloth, or clean piece of clothing to control and stop any heavy bleeding.
Use covered ice packs to reduce swelling.
How to Make a Splint
If you think the bone is broken but it is not piercing the skin (closed fracture), you need to splint the limb before moving the injured person. It's important to immobilize the joint above and below where you believe the fracture site to be.
Look around for something stiff and hard to use as a splint, such as a heavy, rigid stick. Or, you can use a rolled blanket or pack that will maintain a rigid state. If you have no other option, you can secure the injured body part to another, uninjured, body part to keep it stabilized and immobile (tape an injured finger to an adjacent, uninjured, finger).
Also keep the following in mind:
In case of a broken bone that pierces the skin (open or compound fracture), you must apply pressure in order to control bleeding, but avoid pushing on any bone that is protruding through the skin. This is when those sanitary napkins you packed come in handy.
Don't ever try to straighten a broken, open-fractured limb; replace bone fragments; or return the limb to a natural position.
Don't touch or try to clean the wound; just fasten a sterile or clean pad or cloth securely in place over the wound and secure it with bandages or cloth strips (belts, scarves, neckties).
The splint must extend beyond the injured area to keep the limb from moving. Try to cover the joint below and the joint above the injury with the splint; do not overtighten, which can cut off the circulation.
Continue to check the area frequently for swelling, paleness, or numbness, and loosen the splint if needed.
Do not move the injured person until a splint has been applied unless there is a greater danger of life-threatening urgency. If you do have to move a person in order to save her life, apply a splint as soon as you are able to.
Wait for professional help and continue to monitor the area, be alert for signs of shock, and keep the injured person warm. If you are not able to call for help, you must prepare to carry the person to safety.
Your doctor may immobilize some fractures with a splint to keep the bone from moving, kept in place with Velcro or wrapped with gauze or a bandage. Most fractured bones are placed in a cast made with either plaster of Paris or synthetic fiberglass material. For any pain in the first few days, use acetaminophen or ibuprofen, unless your pain is severe — then ask your doctor for a prescription pain medication. Sometimes there is swelling after the cast is applied, causing it to be too tight, so you need to notify your doctor immediately if your fingers or toes turn white, purple, or blue or if the skin around the edges of the cast gets red or raw, as the cast is probably too wet inside from water or sweat. Try to avoid picking at and removing any padding from the edges of fiberglass casts because the edges will then rub on the skin and cause irritation.
How long does it take for a broken bone to heal?
Fractures without any life-threatening complications may heal in as little as three weeks in children and four to six weeks in teens and adults. Be patient and follow the advice of your medical provider including any recommended physical therapy after the fracture has healed.