| A
broken bone (fracture) occurs when a force exerted against
the bone is stronger than what the bone can structurally withstand.
Bones
are a form of connective tissue in the body, made from bone
"cells", reinforced with calcium crystals, with
marrow in the middle. The bone marrow makes blood cells.
Other
functions of bones include support, movement, and protection
for vital organs.
Therefore,
when a bone is fractured, it affects not only blood production
and function, but can also cause complications associated
with the surrounding muscles, tendons, nerves and blood vessels.
Types
of fractures
- Open
- where the bone has broken and penetrated the skin.
- Closed
- where the bone has fractured but has no obvious external
wound
- Complicated
- which may involve damage to vital organs and major blood
vessels as a result of the fracture.
- Greenstick
- A child's bones are still relatively soft, so sometimes
break like a "green stick" would, more a "bend
and splinter" type fracture.
- Comminuted
- the bone has "shattered" into more than 2 pieces.
- Pathological
- where a bone has been weakened by disease (i.e. Osteoporosis), and is much easier to break than normal.
Signs
& symptoms
Some,
or all, of the following:
- pain
at the site
- swelling,
bruising
- deformity
- loss
of power to limb
- associated
wound and blood loss
- pale,
cool, clammy skin
- rapid,
weak pulse
- nausea
First
Aid
Remember
ABC!  (Airways,
Breathing, Circulation)
- Check
for any Danger for you or the patient
- See
if patient Responds to you when you yell or shake
them
- Check
Airways (Are they clear? Patient not choking?)
- Check
Breathing (Breathing rate, depth)
- Check
Circulation (Pulse)
The
next step is to attend to any bleeding wounds. Put pressure
on these with a clean dressing. Then cover the wound with
a bandage if you can.
You
can also bandage a "splint" to the patient’s
limb as well.
Get
Medical help immediately (call 000), and try and be reassuring
to the patient.
(If
you would like to learn First Aid, please see http://www.stjohn.org.au for your nearest St John’s Ambulance First Aid
Training Course)
Treatment
- In hospital
Once
you reach our Emergency Department, you will be assessed
by a triage nurse who decides how bad your injuries are,
and how quickly a doctor must see you.
You
will be given pain relief, and have any more urgent problems
(such as bleeding) attended to.
The
doctor will examine you, and then order tests, which would
usually involve an x-ray. Sometimes they may also order
a CAT scan or MRI scan if a diagnosis cannot be made from
the original x-ray.
Treatment
- What happens after being in hospital?
You
will come back for a check-up to make sure the plaster (or
metal pin/rod) is holding the bones in proper position (this
is checked by more x-rays). Some people need to be followed
up even more (if they have had complications, or surgery).
People
who have had metal inserted may eventually need to get it
removed, as sometimes it can be a source of pain, or infection
in the bone. Your surgeon will discuss this with you.
As
stated before, different factors affect the length of time
it takes for a bone to heal. Once your surgeon is happy
with the result, any plaster can be taken off. However,
it will still take some time for the bone to get back to
full strength, so you may be advised to avoid sport or other
activities for a little while after the plaster is off.
You may also need to do some exercises to rebuild muscles
in the area.
Complications
of fractures
There
are risks with any of the methods used to treat fractures,
even something as simple as putting the limb in plaster!
Some
complications include:
- excess
swelling under the plaster, causing reduced blood supply
to limb, and pain (the plaster will be cut and replaced)
- neurological
or vascular damage, either from the fracture, or method
used to treat it
- infection
(if "open" fracture, or if surgery needed)
- Excessive
bleeding (i.e., from internal injuries – broken pelvis,
femur)
Your
doctor will discuss the risks of any procedures with you.
Please feel free to ask any questions you may have.
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