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First aid: Broken bones

Fractures (breaks or cracks) in bones occur either as a result of considerable direct force, common in a fall from a horse, or from indirect force, as in a twist or wrench.

Fractures are stable when the two ends of bone are firmly together and do not move – often held in place by undamaged ligaments or because the break is incomplete. These are commonly seen at the ankle, wrist, hip or shoulder, and can usually be handled gently without further damage.

In an unstable fracture, the bones move easily apart and out of position; potentiallycausing damage to blood vessels, nerves and organs, or even breaking through the skin – an “open fracture”. Often, the ligaments are ruptured, and these injuries should be handled with great care to avoid inflicting further damage.

Symptoms include swelling, distortion and bruising; pain (severe in dislocations) and difficulty in moving the injured part; possible bending, twisting or shortening of a limb, or an open wound with protruding bones.

Top fracture tips

  • Help the casualty to support the affected part and surrounding area in the most comfortable position and protect with padding
  • If the wound is open, cover with a sterile dressing and bandage into place
  • Call an ambulance. Alternatively, transport to hospital if safe to do so
  • Monitor the casualty for signs of shock

Dislocated joints

These are extremely painful injuries often associated with torn ligaments, and can potentially be very serious. Dislocation of the vertebrae can lead to injury to the spinal cord, and injuries to the shoulder or hip may damage major nerves supplying the limbs, resulting in paralysis.

Facial fractures

Fractures of the cheekbones or nose should be examined at hospital because swollen facial tissues may cause breathing problems. Early application of a cold compress will help reduce pain and swelling.

A casualty with a fracture of the lower jaw should sit with their head well forward to allow fluids to drain from the mouth. Dislodged teeth should be spat out, and kept (in milk if possible) to take to hospital. A soft pad should be used to support the injured jaw.

Serious facial fractures can look terrible. There may be swelling, bruising and bleeding from the nose, mouth or tissues, the eye sockets may be distorted and there is serious danger that swollen tissue, blood or saliva might obstruct the airway, causing breathing difficulties.

What to do

  • Dial 999 for an ambulance
  • Do not bandage the lower face or jaw in case the casualty vomits or has breathing difficulties
  • Apply a cold compress
  • Treat for shock if necessary

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