Fractures

A fracture is a broken bone. It can range from a thin crack to a complete break. Fractures usually occur when a bone is impacted by force or by more pressure than it can support.

Treatment

Reassure the child and ask them not to move.
Do not strap or bandage an injured limb unnecessarily, especially if an ambulance has been called.
A child will ‘guard’ an injury. This means they will hold the injury in the most comfortable position for themselves.

Only move the child if they are in danger or if it is safe to do so. Call an ambulance if:

There is no circulation beyond the injury.
The child has difficulty breathing, or the fracture is a chest bone.
The child is in severe pain.
The injury looks unstable.
A bone is protruding through the skin.

Signs and symptoms of a fracture

Loss of power, e.g., not being able to lift their arm
Pain: these types of injuries are usually painful.
Tenderness: where the break or dislocation is located.
Unnatural movement
Bruising: around the location of the injury
Swelling: around the location of the injury
Crepitus: This is the feeling and sound of the bones grating.
Deformity: if a limb is bent or shaped in an unnatural way
Irregularity—or concave areas on the skin where a break or dislocation is.

Helpful Questions and Answers

Should a dislocated or unnatural-looking bone be put back into place?

No, leave this to someone who is medically trained. There is a danger of causing more damage by trapping nerves and blood vessels by attempting this.

What if there isn’t an obvious sign that the bone is broken?

Unless it’s an open fracture, it’s impossible to tell if a bone is broken without getting an X-ray done. If you are in doubt, seek medical attention.

What if there is severe bleeding from an open fracture?

Severe bleeding takes priority over a broken bone. Apply pressure to either side of the protruding bone without causing too much movement, if possible.

What can cause a fracture?

Twisting, direct force, indirect force, underlying condition, violent sudden movement

How to administer first aid for fractures, dislocations, sprains, and strains:

Sprains and strains

Sprains and strains are very common injuries that occur when muscles and ligaments are stretched, twisted, or torn. They often happen when changing direction and speed suddenly or falling awkwardly.

TREATMENT (R.I.C.E)

REST: Rest the affected area as soon as possible. If necessary, use a sling for an arm or crutches for a leg. Splint an injured toe or finger by taping it to an adjacent finger or toe.
ICE (PACK): Try to ice the affected area for 10 minutes every hour. Never place the ice directly on the skin.
Compression or comfortable position: compress the area by dressing it with a bandage or sleeve. 'Lightly, not tightly.’
Elevate: Elevate the area above the level of the heart. This will decrease the blood pressure, which will reduce the swelling.
An X-ray should be considered to determine the extent of the injury.

Signs and symptoms

Pain
Swelling
An inability to move the injured area
Numbness
Bruising
Deformity
Weakness and loss of power

Helpful Questions and Answers

How do I know if the child needs an X-ray?

If symptoms don’t begin to improve after R.I.C.E. treatment, you should consider having an X-ray to rule out a fracture to the bone.

What is the difference between a sprain and a strain?

Sprains affect ligaments, whereas strains affect muscles.

Why does cooling help?

This reduces pain and swelling. Place ice cubes or a bag of frozen peas in a tea towel or cloth and place them on the skin.

First Aid for Fractures, Dislocations, Sprains and Strains

Unii's Paediatric First Aid Journey shares how you can support a child with a fracture, dislocation, sprain or strain.