First aid: fractures
In the fifth part of our series, Martin Roth and colleagues explain the classification of fractures and give some basic advice about managing them in a first aid setting
We can define a fracture simply as the breaking of bone. Whenever you apply more pressure than the bone can stand it will break. The size shape and consistency of bone varies with age. Old bones need less force to break them than young ones because they are more brittle and may be affected by osteoporosis. Bone is a living tissue with a generous blood supply and can bleed profusely after injury. Blood loss from limb wounds and bleeding from fractures can be severe enough to cause hypovolaemic shock (table). Haemorrhage from multiple fractures, especially pelvic and femoral, may result in an excessive loss of blood.1 For an open fracture the blood loss will be two to three times greater.
Although you can classify fractures in several ways, one important way to define them is either open or closed (box 1). Fractures in which the broken bone protrudes through the