Fractures across a growth plate
Fractures across a growth plate
Internal fixation devices
Internal fixation devices
Fracture types (2)
Fracture types (2)

Fracture

Definition:
A fracture is an injury that disrupts bone tissue. A stress fracture is a break in a bone, usually small, that develops because of repeated or prolonged forces against the bone.

Alternative Names:
Bone - broken; Broken bone; Stress fracture

Considerations:

If more pressure is put on a bone than it can stand, it will split or break. An open fracture (in which bone breaks the skin) can easily become infected.

Assume a young child has a broken bone and get medical help if the child does not start to use an injured arm or leg within hours of an accident, or if they continue to cry when the injured area is touched. It is hard to tell a dislocated bone from a broken bone. However, both are emergency situations, and the basic first aid steps are the same for both.

Causes:
  • Fall from a height
  • Motor vehicle accidents
  • Direct blow
  • Child abuse
  • Repetitive forces such as those caused by running can cause stress fractures of the foot, ankle, tibia, and hip
Symptoms:
First Aid:
  1. Check the victim's airway, breathing, and circulation. If necessary, begin rescue breathing, CPR, or bleeding control.
  2. Keep the victim still, provide assurance, and call for medical help.
  3. Examine the victim closely for other injuries.
  4. In most cases, if medical help can respond quickly, allow the medical personnel to take further action on the fractured bone.
  5. If the skin is broken by a fractured bone, don't breathe on the wound or probe it. If possible, lightly rinse to remove visible dirt or other contamination, but do not vigorously scrub or flush the wound. Cover with sterile dressings before immobilizing the injury.
  6. Splint or sling the injury in the position in which you found it. Possible splints include rolled up newspaper or strips of wood. (Make sure to pad any hard splinting material to prevent a pressure sore). Immobilize the area both above and below the injured bone. Ice packs may be applied to ease pain and swelling.
  7. Check the circulation of the affected area after immobilizing -- press firmly over skin that is beyond the fracture site. (For example, if the fracture is in the leg, press on the toes). It should first blanch and then "pink up" in about two seconds.
  8. If circulation appears inadequate (pale or blue skin, numbness or tingling, loss of pulse) and trained personnel are not quickly available, try to realign the limb into a normal resting position. This can be tested with voluntary movement. It should be done as soon as possible (within three hours of injury) to reduce swelling, pain, and damage to the tissues from lack of blood.
  9. Make an effort to prevent shock. Lay the victim flat, elevate the feet about 12 inches above the head, and cover the victim with a coat or blanket. However, do not move the victim if a head, neck, or back injury is suspected.
Do Not:
  • DO NOT move the victim unless the injured area is completely immobilized.
  • DO NOT move a victim with an injured hip, pelvis, or upper leg unless it is absolutely necessary. If you must move the victim immediately, use the "clothes drag" technique.
  • DO NOT move a victim with any suspected spine injury.
  • DO NOT attempt to straighten a misshapen bone or joint or to change its position unless circulation appears hampered.
  • DO NOT try to reposition a suspected cervical spine injury.
  • DO NOT test a misshapen bone or joint for loss of function.
  • DO NOT give the victim anything by mouth.
Call immediately for emergency medical assistance if:
  • The victim has a dislocation or broken bone, or if there is severe bleeding.
  • You cannot completely immobilize the injury at the scene by yourself.
Prevention:
  • Wear the following protective gear while skiing, biking, and roller blading:
    • Helmets
    • Elbow pads
    • Knee pads
    • Shin pads
  • Create a safe environment for young children.
  • Teach safety. Help children learn how to look out for themselves.
  • Supervise children carefully. There is no substitute for adequate supervision, no matter how safe the environment or situation appears to be.
  • Avoid falls by observing posted warnings.

Review Date: 4/9/2001
Reviewed By: Benjamin D. Roye, M.D., M.P.H. Department of Orthopaedics, New York Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network.
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