How to tell if you’ve broken a bone

Broken, bruised, sprained? Credit: Colourbox
Broken, bruised, sprained? 
Credit: Colourbox

The question:

I slipped on the ice and landed on my wrist. How do I know if it’s broken, sprained or bruised?

Slips and falls in snowy, icy winter weather are common — so frequent that there is a commonly used orthopedic abbreviation for one type of injury, F.O.O.S.H. (Fall On Out-Stretched Hand). Sprains, strains, fractures and contusions (bruises) are all musculoskeletal injuries that may occur if and when you take a spill. Differentiating these may determine if you only need some first aid at home or if you need to see a doctor — and further, what type of evaluation and treatment is required.

First, a brief anatomy lesson:

  • Ligaments are the tough fibrous connective tissues that hold bones together and are subject to stretching or tearing when stressed, resulting in sprains.
  • Tendons are cord-like fibers connecting muscles and acting as pulleys that move your bones. These are subject to strains or “pulls” (“I pulled my hamstring”) when injured.
  • Muscles are injured by bruising when subject to blunt force.
  • Bones can be broken, cracked and chipped, all of which are terms for a fracture.

So how do you know what to do? Initial basic first aid for any of these injuries should include R.I.C.E. — Rest, Ice, Compression and Elevation. These measures will allow you to do some damage control by limiting pain and swelling, while preventing further injury and assessing the situation. Never use heat at any time in the first 48 hours following any trauma. While heat may feel good, it will increase swelling and make the pain and disability worse in the days following.

If you are at all uncertain about the severity of your injuries, then by all means see a doctor at the nearest urgent care office or emergency room for evaluation and treatment. That may include x-rays, some sort of immobilization device (such as a sling, splint or brace) crutches and a prescription for pain relief.

Keep in mind

  • Pain that is ongoing, whether or not you are moving or putting weight on the injured part, is possibly due to a fracture. See a doctor as soon as possible for further assessment if the pain is severe.
  • Any time an external force is involved (for example, someone falls on top of you, you strike your arm on a metal railing or your leg gets wedged in a pothole) a broken bone is more likely.
  • If you twist your ankle or fall and it hurts initially, feels better a few minutes later and then results in pain and swelling six to 12 hours later, this is more likely a sprain or contusion. It takes some time for inflammation to develop after bruises and minor ligament tears, so delayed onset of symptoms may signal a less severe injury.

 


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