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Broken bone

Bone - broken; Fracture; Stress fracture; Bone fracture

If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures the skin, it is called an open fracture (compound fracture).

A stress fracture is a hairline crack in the bone that develops because of repeated or prolonged forces against the bone.

Images

X-ray
Fracture types (1)
Fracture, forearm - X-ray
External fixation device
Fractures across a growth plate
Internal fixation devices
Fracture types (2)
Osteoclast

Presantation

Bone fracture repair  - series

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Considerations

It is hard to tell a dislocated joint from a broken bone. However, both are emergency situations, and the basic first aid steps are the same.

Causes

The following are common causes of broken bones:

Symptoms

Symptoms of a broken bone include:

First Aid

First aid steps include:

  1. Check the person's airway and breathing. If necessary, call 911 and begin rescue breathing, CPR, or bleeding control.
  2. Keep the person still and calm.
  3. Examine the person closely for other injuries.
  4. In most cases, if medical help responds quickly, allow the medical personnel to take further action.
  5. If the skin is broken, it should be treated immediately to prevent infection. Call emergency help right away. DO NOT breathe on the wound or probe it. If possible, lightly rinse the wound to remove visible dirt or other contamination, but do not vigorously scrub or flush the wound. Cover with sterile dressings.
  6. If needed, immobilize the broken bone with a splint or sling. Possible splints include a rolled up newspaper or strips of wood. Immobilize the area both above and below the injured bone.
  7. Apply ice packs to reduce pain and swelling.
  8. Take steps to prevent shock. Lay the person flat, elevate the feet about 12 inches above the head, and cover the person with a coat or blanket. However, DO NOT move the person if a head, neck, or back injury is suspected.

CHECK BLOOD CIRCULATION

Check the person's blood circulation. Press firmly over the skin beyond the fracture site. (For example, if the fracture is in the leg, press on the foot). It should first blanch white and then "pink up" in about two seconds. Signs that circulation is inadequate include pale or blue skin, numbness or tingling, and loss of pulse.

If circulation is poor and trained personnel are NOT quickly available, try to realign the limb into a normal resting position. This will reduce swelling, pain, and damage to the tissues from lack of blood.

TREAT BLEEDING

Place a dry, clean cloth over the wound to dress it.

If the bleeding continues, apply direct pressure to the site of bleeding. DO NOT apply a tourniquet to the extremity to stop the bleeding unless it is life-threatening.

Do Not

When to Contact a Medical Professional

Call 911 if:

Even though other broken bones may not be medical emergencies, they still deserve medical attention. Call your health care provider to find out where and when to be seen.

If a young child refuses to put weight on an arm or leg after an accident, won't move the arm or leg, or you can clearly see a deformity, assume the child has a broken bone and get medical help.

Prevention

Take the following steps to reduce your risk of a broken bone:

Related Information

Osteonecrosis
Hip fracture surgery
Leg MRI scan
Femur fracture repair - discharge
Hip fracture - discharge

References

Geiderman JM, Katz D. General principles of orthopedic injuries. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 49.

Wells L, Sehgal K, Dormans JP. Common fractures. In: Kliegman RM, Stanton BF, St. Geme III JW, Schor NF, Behrman RE, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 675.

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Review Date: 5/9/2015  

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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