Fractures or Dislocations

Compound fractures or open fractures (fractures that result in bone fragments that penetrate the surface of the skin) can be dangerous and can block blood flow to an affected limb.

• A fracture is a break or cracks in the bone. Several types of fractures exist, but fractures resulting in bone fragments that penetrate the surface of the skin (called compound fractures or open fractures) are particularly dangerous. Loss of normal positioning of the fractured extremity can obstruct blood flow to the affected limb.
• A dislocation occurs when 2 bones are out of place at the joint that connects them.
• Dislocation may also cause injury to nerves and blood vessels.
• Joints that become dislocated and later heal improperly are more likely to become dislocated again.

• Tenderness, swelling, deformity, and discoloration occur with fractures and/or dislocations.
• Bleeding occurs when a fractured bone pierces the skin (a compound or open fracture).
• Sensation may be lost below the fracture or dislocation, indicating possible nerve and/or blood vessel injury.

If medical attention is not readily available, try the following guidelines to treat a fracture or dislocation:

• Apply a cold pack to the area of fracture or dislocation to decrease swelling and to relieve pain.
• Flush open wounds associated with compound fractures with clean, fresh water and cover them with a dry dressing.
• Splint the injured area to keep it from moving. Support a broken limb by using the best material available for a splint, such as sticks, part of a backpack frame, or other stabilizing device. Wrap tape around the splint and the extremity affected. Try to immobilize the joint above and below the fracture. For example, if a forearm is broken, the splint should run from across the wrist to the hand and across the elbow to the upper arm, supporting the forearm without repositioning it.
• Monitor the extremity near the fracture or dislocation, assessing any loss of sensation, decreased temperature, and pulse.

If medical attention is unavailable, realigning the fractured or dislocated extremity may restore circulation and save the limb but may also result in further damage to the tissue, blood vessels, or nerves.

Pain may be relieved with 1-2 tablets of acetaminophen (Tylenol) every 4 hours or 1-2 tablets of ibuprofen (Advil, Motrin) every 6-8 hours.

• Seek medical treatment as soon as possible following a suspected fracture or dislocation.
• A victim may still be able to move a fractured extremity. When in doubt, seek medical attention.
• Seek immediate medical attention if a fracture or dislocation penetrates the skin, if the extremity feels cold, or if pulse or sensation decreases.
• Seek prompt medical attention for elbow, knee, and hip dislocations because nerve damage may occur.
• Consult a doctor about treatment with available medications.