A fracture may be found when evaluating the casualty. Life-threatening injuries
(lack of breathing and severe bleeding) should be treated first since they immediately
threaten the casualty's life. A serious fracture, however, can also be life-threatening. A
fracture can be identified by the following signs and symptoms.
A sign is something that can be observed by someone other than the
casualty. Bleeding, bruises, and pulse rates are examples of signs. A
symptom is something which the casualty senses, but which cannot be
observed directly by another person. Pain is an example of a symptom.
a. Visible Fracture. In an open fracture, the fractured bone or bone fragments
may be visible.
b. Deformity. The body part may appear deformed due to the displacement of
the bone, the unnatural position of the casualty, or angulation where there is no joint (for
example, the casualty's forearm is "bent" instead of straight).
c. Pain. The casualty will probably experience pain at a particular location. The
pain (point tenderness) usually identifies the location of the fracture. The casualty may
be able to "feel" the fractured bones.
d. Swelling. There may be swelling (edema) at the suspected fracture site.
e. Discoloration. The area around the suspected fracture site may be bruised
or have hemorrhagic spots (ecchymosis).
f. Crepitation. The fracture bones may make a crackling sound (crepitation) if
they rub together when the casualty moves.
Do not ask the casualty to move the injured body part in order to test for
g. Loss of Motion. The casualty may not be able to move the injured limb or
have difficulty in moving the limb. If a spinal injury is present, paralysis may exist,
especially paralysis of the legs.
Do not have the casualty attempt to move the injured arm or leg to test this
symptom. Rely upon what the casualty tells you.
h. Loss of Pulse. If the fractured bone is interfering with blood circulation, there
may be no pulse distal to (below) the site of the fracture.