FIRST AID AND EMERGENCY
CARE
LECTURE 9
FRACTURES
DEFINITION
A fracture is any break in a bone, including
chips, cracks, splintering, and complete breaks
TYPES OF FRACTURES
A. Basic Types of Fractures
1. Closed Fracture (Simple fracture): Occurs
when a bone is broken but there is no
penetration extending from the fracture
through the skin.
2. Open Fracture: (Compound fracture): Is a
fracture in which there is a wound over the
fracture site, with or without bone protruding
through it. This type of fracture is more serious
than closed fractures because the risks of
contamination and infection are greater
B. Types according to appearance on x-ray
1. Green stick fracture: Usually occurs in
children whose bones are still pliable (like
green sticks) A break occurs straight across
part of the width of the bone, perpendicular to
the long axis
2. Transverse Fracture: Cuts across the bone at
right angles to its long axis, often caused by
direct injury
3. Oblique Fracture : The fracture line crosses
the bone at an oblique angle
4. Comminuted Fracture: The bone is
fragmented into more than two pieces
5. Impacted Fracture: The broken ends of the
bones are jammed together
6. Spiral Fracture: Usually results from twisting
injuries The fracture line has the appearance of
a spring
Impacted Fracture
Comminuted Fracture
CAUSES OF FRACTURES
1. Direct Force: The bone breaks at the spot of
application of the force such as in direct hit
over a bone, bullet injury
2. Indirect Force: The bone breaks away from
the application of force somewhere else such
as after falling on outside stretched hands.
3. Force of powerful muscle actions: such as
violent cough may cause rib fracture
4. Aging: and bone disease which can increase
the risk of fractures (pathologic fractures), with
bones breaking even with minor accidents
5. Twisting forces: such injuries are often seen
in football and skiing accidents where a
person's foot is caught and twisted with
enough forces to fracture a leg bone.
SIGNS AND SYMPTOMS OF
FRACTURES
1. Pain
Pain is the primary symptom of fractures
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Pain is often severe and constant and is felt at
or near the site of fracture snap
2. Swelling and discoloration
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These begin shortly after injury
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Discoloration my start as reddening of the skin
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3. Tenderness or Discomfort
It leads to severe restriction or use of the area
affected
4. Bone breaking through the skin
5. Deformity.
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GENERAL PRINCIPLES FOR
TREATMENT OF FRACTURES
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Establish and maintain an open airway
Control hemorrhage
Close sucking chest wound
Begin fluid resuscitation
After dealing with life-threatening conditions,
identify and immobilize all fractures
Immobilization achieved by Splints
Types of Splints
1. Improvised splints: Rolled newspaper , Wood
, Strong cartons , Cane , Ironing board , and
any other objects that can provide stability
2. Commercially Available Splints: Rigid splints
(padded board, aluminum splint)
3. Inflatable splints
4. Traction splints
Traction splints
Rigid splints
Inflatable splints
Improvised splints
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General Principles Of Splinting:
The clothing is best removed from the area of
any suspected fracture or dislocation
Note and record motion and sensation status
distal to the site of injury
The splint should immobilize the joints above
and the joints below the fracture.
During splint application, minimal movement of
the limb should be allowed.
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Severely deformed limb should be straightened
with constant gentle manual traction so that the
limb can be incorporated in to the splint.
If gentle traction increases the patient's pain
significantly or if resistance to the limb alignment
is encountered, the limb must be splinted in the
position of deformity.
Cover all wounds with dry sterile dressing
before applying a splint.
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Pad the splint to prevent local pressure.
Do not move or transport patients before
splinting extremely injuries.
when in doubt, splint.