chapter 10. Broken bones
J Walsh and PJ Kenny
Broken bones occur commonly in contact sports. They can also occur in individual sports such as skiing, riding and gymnastics. There are many different methods that can be used to describe fractures but, for the purposes of this section, they have been divided into two types: closed and open fractures (Fig. 10.1).
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| Fig. 10.1 |
Closed
• The bone is fractured and may be markedly deformed; however the skin surrounding the broken bone remains intact
Open
• One or both of the broken bone ends pierces the skin
• The bone does not necessarily have to be visible for the fracture to be open (it may pierce the skin and return inside the body)
The on-field management of broken bones is divided into Red and Amber Zones. There are no green zone injuries in this section. All suspected fractures should be removed from the field of play.
Red Zone
• Any open fracture
• Any long bone fracture
• Any fracture to a finger or toe with marked deformity
Amber Zone
• Broken finger or toe with minimal deformity
• Suspected fracture
The majority of fractures will require immediate transfer to hospital. If in doubt, transfer!
What should I check for?
Speak to the player
• ‘What happened?’
• ‘Where does it hurt?’
• ‘What kind of pain is it?’
• ‘Did you feel/hear a crack/snap?’
Problem identification
• Get player to point to sore area
Observe
• Look at the affected area for signs of swelling/redness/deformity
• Is the skin broken?
• Could this be an open fracture where the bone has gone back in?
• Compare the affected area with the other side – is there a difference?
Rule out serious injury
• Ask the player to move the injured area on their own
• Does this cause pain?
• Does the injured area appear deformed?
Touch for tenderness
• Touch the area to feel for warmth (indicates inflammation)
• Touching allows you to assess the extent of the pain
• Is there a specific point of tenderness?
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