Physical Education

Fractures
A break or rupture in a bone is called a fracture. There are two basic types; open and closed. A closed fracture does not produce an open wound in the skin, also known as a simple fracture (Fig. 6-lA). An open fracture produces an open wound in the skin, also known as a compound fracture (Fig. 6-1B). Open wounds are caused by the sharp end of broken bones pushing through the skin; or by an object such as a bullet that enters the skin from the outside.
Open fractures are usually more serious than closed fractures. They involve extensive tissue damage and are likely to become infected. Closed fractures can be turned into open fractures by rough or careless handling of the casualty. Always use extreme care when treating a suspected fracture.

Figure 6-1 - Types of Fractures

It is not easy to recognize a fracture. All fractures, whether open or closed, can cause severe pain or shock. Fractures can cause the injured part to become deformed, or to take an unnatural position. Compare the injured to the uninjured part if you are unsure of a deformity. Pain, discoloration, and swelling may be at the fracture site, and there may be instability if the bone is broken clear through. It may be difficult or impossible for the casualty to move the injured part. If movement is possible, the casualty may feel a grating sensation (crepitus) as the ends of the bones rub against each other. If a bone is cracked rather than broken, the casualty may be able to move the injured part without much difficulty. An open fracture is easy to see if the end of the bone sticks out through the skin. If the bone does not stick out, you might see a wound but fail to see the broken bone. It can be difficult to tell if an injury is a fracture, dislocation, sprain, or strain. When in doubt, splint.