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Fractures, Dislocations and Soft Tissue InjuriesFracture is just another word for a broken bone. A dislocation occurs at the site of a joint and is where a bone is fully or partially displaced. Soft tissue injuries include sprains, strains and ruptures. They are often caused in the same way as fractures, and generally, are hard to distinguish from broken bones.Broken bones There are two main types of broken bone. The first is a closed (simple) break or fracture, where the bone has broken but has not pierced the skin. A closed fracture is sometimes difficult to diagnose, even for experienced medical staff, who will usually rely on an X-ray to determine whether or not the bone is definitely broken. The second type is an open (compound) break or fracture, where the bone has either pierced the skin or is associated with an open wound. The greatest risk with open breaks is infection. Both open and closed breaks can result in injury to underlying organs or blood vessels and rnay also be unstable if the ends of the broken bone are moving around. In young children the bones are not fully formed and may bend rather than break (termed a greenstick fracture). While it is possible to give some general guidance for the recognition of broken bones, no two people are identical in their response. The first general rule therefore is, if in doubt, assume that a bone is broken and treat as such. Be particularly aware of potential fractures if the accident involved a sharp blow, a fall, a rapid increase or decrease of speed, or a sudden twist. Dislocations The most common sites for dislocations are the shoulders, thumbs and hips. Dislocations are usually characterised by intense pain and an obvious deformity. There may be signs and symptoms similar to a broken bone, including feelings of pins and needles or numbness below the site of the injury, caused by trapped nerves or blood vessels. Do not attempt to replace the bone. Make the casualty comfortable and take or send him to hospital.Soft tissue injuries Strains are an overstretching of the muscle, leading to a partial tear. Ruptures are complete tears in muscles. Sprains are injuries to a ligament at or near a joint. The signs and symptoms of soft tissue injuries will be similar to the signs and symptoms of a fracture and will generally follow a sharp twisting or stretching movement.Signs and symptoms of broken bonesPain This accompanies most, but not all, fractures and is caused by the broken bone ends pushing on to nerve endings. Deformity An injured part may appear deformed, particularly when compared to the uninjured side. Swelling Some swelling may be present at the site of a fracture. Tenderness This accompanies most broken bones and can often only be felt when the injured part is gently touched. Shock The signs and symptoms of shock will often accompany major fractures in particular. There may be reddening or bruising over the site of the break, but this often takes some time to appear. You may also hear the ends of broken bone rubbing together, a sound known as crepitus. Another potential sign of a broken bone is a lack of feeling or a 'pins and needles' sensation below the fracture site. This may indicate nerve damage or a reduction in circulation caused by the bone pushing on either the nerves or the blood vessels. The treatment for injuries displaying these symptoms is the same as for any broken bone. However, if you have been trained, applying traction may alleviate the problem. If your casualty is displaying any combination of these signs and symptoms or the nature of the accident suggests that a fracture is likely, assume that a bone is broken. |
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