1-8

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1-8. SIGNS AND SYMPTOMS OF FRACTURES

A fracture may be found during the primary or secondary survey of the casualty. Life-threatening injuries (lack of breathing, massive bleeding, and shock) should be treated before fractures since they immediately threaten a casualty's life. A serious fracture, however, can also be life threatening. A fracture can be identified by the following signs and symptoms.

NOTE: 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.

CAUTION: Do not ask the casualty to move the injured body part in order to test for crepitation.

g. Loss of Motion. The casualty may not be able to move the injured limb. If a spinal injury is present, paralysis may exist, especially paralysis of the legs.

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.

i. False Motion. There may be motion at a point where there is normally no motion. This movement at the fracture site is called false motion.

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