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Recognising Fractures

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A fracture is a broken bone. With over 200 bones in the body there is plenty of potential to cause some harm and it is often difficult to tell whether one is broken or whether there is just soft tissue damage. If in doubt always seek medical advice. The only way to accurately determine whether a fracture has happened is to x-ray the affected bone.<
Damage to bones occurs usually as a result of the following forces:

  • direct force- landing directly on the affected part
  • indirect force- landing on another part of the body and the shock waves travel up the bones to the next weakest point causing that to break e.g landing on an outstretched hand, often causes the collar bone to give way.
  • twisting force
  • shearing force
  • pathological causes (old age, brittle bones, osteoporosis etc)

Types of fracture

Fractures tend to present in 4 main ways:

  • closed simple fractures – the bone had broken but not moved position
  • open – where the bone protrudes through the skin or where there is a wound leading down to break
  • complicated- where other structures are involved or where the bone breaks in multiple places
  • greenstick- commonly seen in children, where the bone only partially breaks or cracks.

Possible Signs and Symptoms of Fractures

  • history of an injury- always consider the mechanism of injury, i.e how did the injury occur?
  • swelling
  • pain
  • tenderness
  • bruising
  • loss of power
  • lack of movement
  • deformity
  • noise- did the person hear it snap or can you hear crepitus (grating sound caused by the ends of the bone rubbing against each other)
  • shock- often the biggest clue that someone has hurt themselves


If you suspect that someone may have fractured a bone then seek medical advice. Fractures can be difficult to assess and only an x-ray will give a definitive answer. In the meantime keep the injured area as still as possible. You may find that slings are helpful in supporting arms and wrists. Remove any jewellery from affected limbs as soon as possible, before the limb starts to swell. Advise the casualty not to eat or drink anything until they have been assessed by the medical team.