Fractures

A fracture is a break in a bone. Most fractures are from falls, road accidents, or sports injuries. Some happen with minimal force — in osteoporosis or in bone weakened by disease (pathological fracture). Quick, correct first aid + timely surgical care + good rehabilitation are what decide long-term function.

Types

• Closed — skin intact.
• Open (compound) — bone breaks through skin; medical emergency; higher infection risk.
• Displaced — bone ends out of alignment.
• Comminuted — broken into multiple fragments.
• Greenstick — partial break in children's flexible bones.
• Stress fracture — small crack from repeated impact (runners, military training).
• Pathological — in a bone weakened by disease.

First aid at the scene

• Don't move a suspected fracture more than necessary — especially spine, pelvis, hip, severe limb deformity.
• Open wound with bone visible — cover with clean cloth; don't push bone back in; dial 112.
• Severe bleeding — direct pressure with clean cloth; 112.
• Immobilise the area — support above and below; a rigid splint if available (folded magazine, piece of wood, rolled paper).
• Ice pack over clothes for pain and swelling.
• Don't eat or drink if surgery may be needed.
• Dial 112 or get to the nearest hospital with orthopaedic facilities — especially for suspected spine, hip, pelvis, or multiple injuries.

Red flags — urgent

• Open fracture.
• Numbness, inability to move the limb beyond the break.
• Cold, pale, bluish limb — possible blood supply compromise.
• Severe pain, worsening swelling disproportionate to injury.
• Neck or back injury — don't move the person unless absolutely necessary; stabilise the head and call 112.
• Fractures in older adults — hip fractures in particular — surgery within 24-48 hours substantially reduces complications.

Treatment

• X-ray, sometimes CT or MRI for diagnosis.
• Reduction — aligning the bones (closed or open).
• Cast, splint, traction, or surgical fixation (plates, screws, rods) — decision based on fracture type.
• Pain management, infection prevention, blood-clot prevention in major fractures.
• Rehabilitation — physio, gradual return to weight-bearing, strength; vital to full recovery.
• Investigate why — pathological or fragility fractures deserve evaluation (osteoporosis, vitamin D, TB, cancer) so future fractures are prevented.

Prevention

• Calcium, vitamin D, weight-bearing exercise — lifelong.
• Fall prevention — home modifications, eye check, review dizzy-making medicines.
• Helmet/seat belt every time.
• Bone density testing after menopause or in at-risk men.
• Don't smoke; moderate alcohol.