A fracture is termed:

• closed where there is no break in the skin;

• open where the bone end has broken the skin or a wound is present with the fracture.

The fractured or dislocated part should not be moved and first aid should be confined to providing soft padding and support in the position chosen by the patient.

Symptoms and signs – Not all may be present

• pain
• swelling
• deformity of the injured area (when compared with the uninjured side of the body)
• loss of normal function of the injured part
• discolouration of the skin (i.e. blueness) or bruising
• a wound if it is an open fracture
• altered sensation – e.g. ‘pins and needles’ – if a nerve is under pressure
• a grating sensation if injured bone ends are rubbing together
• patient may have heard/felt the bone break

How you can help

1.    Control any bleeding

• If a wound is present, check for any significant bleeding; and if bleeding, apply direct pressure around any exposed bones.
• Apply padding around the wound, or above and below the wound. Apply a clean dressing loosely over the injured part.

2.    Immobilise the injured part

• Reduce the pain and the risk of further injury by supporting and immobilising the injured area. Usually this simply means supporting the injured part in a comfortable position.

3.    Make the patient comfortable

• Help the patient into the position of greatest comfort without any unnecessary movement. Use blankets, pillows or clothing for general comfort and support.
• Place generous padding around the injured area and in the nearby hollows of the body, using soft towels, clothing, pillows or blankets, etc.
• Where an ambulance is likely to be delayed for more than 1 hour immobilise the injured part. Specific immobilisation techniques for various injuries are outlined on the following pages.
• Do not move any injured part unnecessarily.

Call 111 for an ambulance if the person is in severe pain, if it is a suspected rib or thigh fracture, or if there is severe bleeding that is uncontrolled.

• See a doctor or medical clinic with xray facilities for any other suspected fracture or dislocation
• Call Healthline on 0800 611 116 if you are uncertain.

Fractures and dislocations that need special care

Fracture of the face or jaw

Injuries to the face may be associated with a head injury or with a serious eye injury. 

• If unconscious but breathing normally, place the patient on their side in a supported position.
• If conscious, allow the patient to rest in the position of greatest comfort.

Fracture of the arm, wrist or collarbone or dislocation of the shoulder joint

• Use a pillow or folded clothing to allow the patient to support the weight of the arm in the most comfortable position.
• The person may feel most comfortable in an arm sling.

Fracture of the ribs

• Assist the patient into a position of greatest comfort.

Call 111 for an ambulance.

Leg fractures

Ankle fractures

It is often difficult to decide whether an ankle joint is fractured or sprained, and unless there are obvious signs of fractures, the injury should be managed as a soft tissue injury.

Thigh bone fractures

The thigh bone is a very large bone and fractures can involve significant blood loss. All people with a suspected thigh fracture should have an ambulance called.

Dislocations, including fingers and toes

Dislocations, including those of fingers and toes, should only be relocated by a medical professional.

• Apply generous soft padding around the hand or injured finger(s).
• Apply an elevation sling, taking care to avoid touching the hand or fingers when tying the knot.

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