After a fracture
Many fracture problems I see started in the first few hours, with a bad splint, a long delay or someone setting the bone at home. This page is what I’d want you to do instead.
Call 108 for an ambulance if there is:
- A head, neck or back injury
- Heavy bleeding, or bone through the skin
- A limb that is cold, pale, blue or numb
- Severe pain and swelling that keep getting worse
- Several injuries, or difficulty breathing
112 also works anywhere in India. Get to the nearest emergency department first. You can contact me once you’re safe.
First aid in the first hour
You don’t need any medical training for this. It just stops the injury getting worse on the way to hospital.
- 1
Keep it still
Leave the injured part in the position you found it. Don’t try to straighten it.
- 2
Splint it
Pad a rolled newspaper, a piece of cardboard or a flat stick with cloth and tie it loosely above and below the break. For an arm, a dupatta or scarf makes a good sling.
- 3
Ice and raise it
Wrap ice in a cloth, never straight on the skin, and hold it on for 15 to 20 minutes at a time. Keep the limb raised if you can.
- 4
Take off rings and bangles
The limb is going to swell. Get rings, bangles, watches and anklets off now, while you still can.
- 5
Cover any wound
If the skin is broken or bone is showing, cover it with a clean cloth and press gently to slow the bleeding. Don’t push the bone back in.
- 6
Hold off on food
You might need an anaesthetic, so don’t eat or drink until a doctor has seen you. Paracetamol for the pain is usually fine.
What not to do
- Don’t massage the area or rub oil into it.
- Don’t let anyone pull, twist or “set” the bone outside a hospital. It can tear skin, nerves and blood vessels, and the bone often heals crooked.
- Don’t use tight bandages or herbal plasters. As the limb swells they can cut off its blood supply.
- Don’t walk on a hurt leg or use a hurt arm to see if it’s really broken.
- Don’t wait for the swelling to go down before getting an X-ray.
Getting it right the first time
The first treatment gives a fracture its best chance. If the bone is lined up and held properly, it usually heals straight and you get your movement back. If it isn’t, putting it right can take years and more than one operation, so it’s worth seeing an experienced fracture surgeon from day one.
Exact alignment
When a break runs into a joint, the joint surface has to be put back almost perfectly. Even a small step left behind can wear the joint out early.
Firm fixation
When the bone is held firmly, you can start moving sooner. Moving early is what stops joints getting stiff.
The right timing
Some fractures can’t wait. A hip fracture in an older person, a bone through the skin or a dislocated joint should be treated within hours, or a day or two at most.
Fewer second operations
Fixing a bone that has healed crooked, failed to join or become infected is a much bigger job. Recovery is slower and the result is less certain.
Recovering after fracture surgery
- Your wound
- Keep the dressing clean and dry, and leave it on until I tell you it can come off.
- Swelling
- Keep the limb raised for the first few days. It really does help with the pain.
- Physiotherapy
- Exercises start early, and they matter as much as the operation did.
- Check-up X-rays
- At each follow-up I’ll check the bone is healing in the right position before you put more weight on it.
- Food and smoking
- Eat enough protein, and get your calcium and vitamin D. If you smoke, this is a good time to stop, because smoking slows bone healing.
Had a fracture? Talk to me
Send me your X-ray on WhatsApp or call to book. I see fracture patients in Bhubaneswar and Balasore.
Bhubaneswar
Balasore
General first-aid information only. In an emergency, go to hospital.