Fractures and Dislocations:
How to Recognise and Provide First Aid

Fractures and dislocations are injuries that involve the bones and joints, which can be extremely painful and require immediate attention. A fracture refers to a broken bone, while a dislocation occurs when the bones at a joint are forced out of their normal position. Knowing how to provide first aid in these situations can prevent further damage and alleviate pain until professional medical help is available.

What is a Fracture?

A fracture is a break, crack, or shattering of a bone. Fractures can vary in severity, from small hairline fractures to complete breaks where the bone has separated into two or more pieces. The most common causes include falls, accidents, or direct trauma to the bone.

There are several types of fractures, including:

• Simple (Closed) Fracture: The bone is broken but the skin is intact.
• Compound (Open) Fracture: The bone pierces the skin, increasing the risk of infection.
• Greenstick Fracture: An incomplete fracture where the bone bends and cracks, common in children.
• Stress Fracture: A small crack in the bone caused by repeated stress or overuse.

What is a Dislocation?

A dislocation occurs when a bone is forced out of its joint, often due to a fall or sudden impact. Commonly dislocated joints include the shoulders, elbows, fingers, and knees. Dislocations can cause severe pain and may damage the surrounding ligaments, nerves, and blood vessels.

Signs and Symptoms of Fractures

• Pain: Severe pain at the site of the injury, especially when attempting to move the affected area.
• Swelling: Swelling around the injured area.
• Deformity: The limb or joint may appear deformed or out of place.
• Bruising: Discolouration around the site of the fracture.
• Loss of Movement: Inability to move the affected limb or joint.
• Open Wound (in compound fractures): A visible wound where the bone may be exposed.

Signs and Symptoms of Dislocations

• Pain: Intense pain at the joint, especially when trying to move it.
• Deformity: The joint will often appear out of place or misshapen.
• Swelling and Bruising: The area around the joint will swell and bruise quickly.
• Inability to Move the Joint: The joint may be immobile or stuck in an abnormal position.

First Aid for Fractures

1. Call 999 or Seek Medical Help:
   • For serious fractures, or if you are unsure about the severity of the injury, seek medical help immediately. If the casualty is unresponsive, call 999.
2. Immobilise the Fractured Area:
   • Keep the injured area as still as possible to prevent further damage. Encourage the casualty to avoid moving the affected limb.
   • If possible, immobilise the area using a splint or sling. Use a rolled-up newspaper, clothing, or any firm material as a temporary splint.
   • Ensure the splint or sling extends beyond the joints above and below the fracture site.
3. Support the Injury:
   • In the case of an arm fracture, you can use a sling to support the arm. If the leg is fractured, support it by keeping it elevated and as still as possible.
4. Apply Cold Compresses:
   • To reduce swelling and pain, apply a cold compress or an ice pack (wrapped in a cloth) to the injury. Do not place ice directly on the skin.
5. Treat for Shock:
   • If the casualty is pale, cold, or clammy, or shows signs of shock (such as rapid breathing, weakness, or confusion), lie them down and raise their legs. Keep them warm while waiting for medical help.
6. For Compound Fractures (Open Fractures):
   • Do not attempt to push the bone back into place.
   • Cover the wound with a sterile dressing or clean cloth to reduce the risk of infection.
   • Control any bleeding by applying gentle pressure around the wound, avoiding direct pressure on the exposed bone.

First Aid for Dislocations

1. Call 999 or Seek Medical Help:
   • Dislocations can be serious injuries, especially if the joint cannot be moved or is accompanied by severe pain or deformity. Call for professional help.
2. Do Not Attempt to Relocate the Joint:
   • Do not try to pop the dislocated joint back into place. This should only be done by a healthcare professional, as attempting to do so could cause further damage.
3. Immobilise the Joint:
   • Keep the joint in the position it is found. Support it with a sling, bandages, or soft padding to prevent movement. For example, if the shoulder is dislocated, place the arm in a sling.
4. Apply Cold Compresses:
   • Use an ice pack or cold compress (wrapped in a cloth) to help reduce swelling and pain.
5. Monitor for Shock:
   • As with fractures, dislocations can lead to shock. Keep the casualty warm and monitor for signs of shock, such as rapid breathing, clammy skin, and confusion. If shock occurs, lie the person down and elevate their legs if possible.

When to Seek Medical Help

Always seek medical help if:

• You suspect a fracture or dislocation.
• The injury involves the head, neck, or spine.
• The casualty cannot move the affected limb or joint.
• There is severe pain, swelling, or deformity.
• The bone is exposed, or there is significant bleeding.
• The casualty shows signs of shock.

Prevention Tips

• Wear Protective Gear: When engaging in high-risk activities like cycling or contact sports, wear protective gear such as helmets, pads, and proper footwear.
• Exercise Regularly: Strengthening muscles and improving balance through regular exercise can reduce the risk of falls and injuries.
• Ensure a Safe Environment: Remove hazards that could lead to falls, such as loose carpets, poor lighting, or cluttered floors.

Key Points to Remember

• Fractures and dislocations require immediate attention to prevent further injury.
• Immobilise the affected area and do not attempt to move or reset the bone or joint.
• For compound fractures, cover the wound and avoid touching the bone.
• Always seek professional medical help, and treat for shock if necessary.