A fracture is a broken bone. The bone may be broken into two or more pieces or it may have a linear crack. Fractures are described as closed if the skin remains unbroken. If there is a wound at or near the break, it is said to be an open fractures.
Careless handling of a patient may change a simple fracture into a compound one, by forcing jagged bone-ends through intact overlaying skin. Compound fractures accompanied by serious bleeding are likely to give rise to shock, especially is a large bone is involved.
The following are indications that a bone is very probably broken:
- The fact that a very heavy blow or other force has been applied to the body or limbs.
- The casualty himself, or other people may have heard the bone break.
- Intense pain, especially on pressure or movement at the side.
- Distortion. Compare good with injured limb or side of the body to see if the affected part is swollen, bent, twisted, or shortened.
- Irregularity. The irregular edges of a broken bone can sometimes be seen in an open facture. They may be seen or felt under the skin in closed fracture.
- Loss of use. The casualty may be unable or unwilling to use the injured part because of the pain. He may also experience severe pain if an attempt, even a very gentle, one is made to help him to move it.
- Unnatural movement and grating of bone-ends. Neither of these symptoms should be sought deliberately. A limb may feel limp and wobbly, and grating may be felt when an attempt is made to apply support to the limb. Either of these indicates that the bone is certainly broken.
- Swelling. The site may be swollen and/or bruised. This may be due to internal bleeding. Swelling almost always occurs immediately and discoloration of the skin may follow.