Fracture, dislocation or bruise, sprain: asdistinguish how to give first aid

Update: October 2018

Any injury resulting in pain, bruise and restraint
mobility is at least unpleasant. But often beyond the banal
bruised lurking heavier consequences: stretching, sprains and
fractures. Yes, and some bruises can cause complications for
health Therefore, it is important to be able to distinguish these states in time.
consult a doctor.

What is a bruise?

Bruising refers to closed tissue damage to organs or organs.
the result of mechanical stress. Depending on the location
the volume and depth of the damaged tissue, the force of impact,
bruises can have different manifestations. For example, the well-known bruise
– This is a hemorrhage due to vascular damage. The remaining symptoms
also familiar to many.

Signs of injury:

  • Pain after mechanical stress
  • Swelling (due to edema and hemorrhage)
  • Hemorrhage into damaged tissues (hematomas)
  • Increased skin temperature and redness over the injured
  • Limiting the function of a specific organ or body part

Pain occurs at the moment of injury, then several
blunted. But with an increase in hematoma and tissue edema, pain can
appear again with a vengeance. Especially discomfort
occur in places without fat on the front surface
shin, for example. Sometimes боль и отечность настолько сильные, то
Difficult to distinguish fracture and injury.

First Aid:

  • Peace for the affected part of the body, its elevated position
    (lift the limb, lie on the opposite side, etc.)
  • Applying a pressure bandage
  • On the first day – applying cold (for the prevention of
    hematomas). Bubbles with ice should be periodically cleaned so as not to
    cause damage to blood vessels by low temperatures. The best thing
    apply an ice pack immediately to a pressure bandage for 25-30
    minutes, then every 2-3 hours apply for 10-15 minutes.
  • In case of severe pain, edema, large hematomas, it is recommended
    consult a doctor. Observation of a specialist may be necessary when
    head injuries, internal organs and other dangerous
  • Do not rub the injury site and heat it for the first two days.
    (after 48 hours you can warm up)
  • It is important to remember that first aid for fractures and bruises,
    sprains and sprains are absolutely identical: rest, cold,

Health care:

  • In a medical institution, physiotherapy can be prescribed and
    Novocainic blockade for anesthesia
  • Surgical treatment of severe injuries: skin puncturing and
    pumping blood from large hematomas, cleansing the joint cavity from
    fluids, the introduction of antibiotics.

What is stretching?

Damage caused by, and not accompanied by a violation
tissue integrity is called stretching. Tendons suffer
ligaments and muscles – that is, the elastic parts of the body. Usually cloth
damaged around the joints.

Signs of stretching:

  • Pain at the site of injury (especially when moving, repeating
    injury mechanism)
  • Swelling
  • Sometimes — небольшое кровоизлияние (синяк, см. мазь от
  • Restriction of the function of the damaged part of the body

First Aid:

  • Покой и возвышенное положение limbs
  • Cold to the injury site (as with bruises)
  • Fixation bandage on the joint (elastic bandage)
  • With severe pain, swelling and deterioration – refer to
    to the doctor. More serious injuries have similar symptoms – gap
    ligaments, for example, often requiring surgical treatment. To that
    however, it is difficult to understand whether stretching or fracture caused such
  • Do not rub or heat the first damage site. 2

Health care:

  • Pain relief if necessary
  • Physiotherapy after pain subsides
  • Mild treatment for injured body parts
  • Recovery usually occurs after 1-4
    of the week

What is dislocation?

Dislocation – это стойкое разъединение поверхностей the joint, в норме
adjacent to each other. Usually results from
mechanical stress (most commonly in middle-aged men). If a
the articular surfaces are not completely broken, then such a phenomenon
called subluxation. Its signs are similar to a complete dislocation.

Signs of dislocation

  • Severe joint pain
  • The impossibility of active movement in the joint
  • Вынужденное положение limbs (наименее болезненное)
  • Often – внешняя деформация the joint, относительное укорочение

Dislocation treatment

An attempt to cure dislocation at home with poultices, lotions, compresses–
very dangerous undertaking. Fresh dislocation (up to three days) the doctor will be able to
set right much easier than the old, so every road
minute after injury. Repair dislocation yourself in no way
the case can not, because you can exacerbate the situation, breaking the ligaments,
muscle, and even breaking a bone. The only thing you can do is
provide maximum rest to the injured person attach
cold and call an ambulance, or quickly get to the emergency room
on their own.


Health care

  • Anesthesia (often – strong drugs)
  • Вправление вывихнутой limbs (для каждой разновидности
    dislocation have special tricks)
  • Overlay on set limb bandage to limit
  • Recovery period: physiotherapy, therapeutic
  • Surgical treatment for habitual dislocations (when at least
    injuries, the joint “jumps out” again and again).

What is a fracture?

Fracture is a bone integrity disorder that is caused by
mechanical impact or pathological process in
the body. Due to the huge variety of bone types in the body
rights, there are many types of fractures (see

Types of fractures:

  • Closed (without disturbing the integrity of soft tissues)
  • Open (with soft tissue damage and penetration
    bone fragments out)
  • Without displacement of fragments (parts of the bone do not change their
  • Offset (fragments are displaced relative to each other in
    different planes)
  • Traumatic
  • Pathological (due to tumor, osteoporosis, genetic
    brittle bones with minimal impact)

Signs of fracture

  • Pain
  • Неестественное положение limbs
  • Abnormal mobility (limb can be slightly bent in
    области, где нет the joint)
  • Visible bone fragments in a wound with an open fracture
  • Crepitus (crunch) of small fragments when pressing on a sore point
    (this symptom distinguishes fractures from sprains or bruises)
  • Swelling in the area of ​​injury
  • Hemorrhage and hematoma
  • Symptom Axial Load (усиление боли в месте перелома при
    поколачивании по оси limbs – например, боль по пятке при
    fracture of leg bones)

Fracture treatment

Fractures are often accompanied by other injuries, wounds.
skin and bleeding. Therefore, the most important thing is to render
first aid before the arrival of physicians. In this case, it makes no sense
wonder if a fracture or dislocation caused the pain. First aid
will be the same.

First Aid:

  • If a есть кровотечение – остановить его одним из методов:
    • press the vessel visible in the wound
    • put on a pressure bandage
    • put a tourniquet in case of severe bleeding (specify in the note
      time to keep no more than 1-1.5 hours)
  • Close the wound with a clean or better sterile material.
  • Introduce painkillers
  • Keep the broken part of the body stationary (using tires,
    fixing the joints, located next to the place
  • Put cold in place of injury
  • If a перелом закрытый, то начинать надо с обезболивания

Health care

  • Anesthesia (often – Novocain blockade)
  • Comparison of bone fragments and their fixation
    • conservatively (plaster bandages, skeletal traction)
    • surgically (manually or with the help of special devices,
      internal or external osteosynthesis)
  • Antibiotic therapy (with open fractures and after
  • Physiotherapy during the recovery period
  • Physiotherapy

Injuries in children

Children due to their mobility and unformed
musculoskeletal system often get bruised, damaged
связок и даже fractures. Distinguish them at home yet
harder than adults. The child is hard to describe the pain, it happens
напуган травмой либо перспективой попасть к to the doctor. There are the most
frequent injuries in babies that can be suspected at home. But for
making a diagnosis quite often requires an inspection

Subluxation of the radius head

Small children, especially girls under 3-4, often get
such a sublimation when squeezing hands. For example, parents or nanny
pulls the kid’s hands to avoid falling. This injury even
got the name “nanny elbow”. The main symptom is a click
(not always) and sharp pain in the elbow during any movements of the forearm.
The kid does not allow to move a sick hand. If a создать limbs покой,
then the pain subsides noticeably. The doctor in the emergency room usually immediately
определяет такую типичную травму по положению limbs,
produces reposition and releases the child home. Additional
no treatment required.

Subperiosteal fractures

The bone of a small child has a number of structural features,
therefore, they often have subperiosteal fractures,
when the bone is broken and the periosteum is intact. It looks like green
branch of a shrub when trying to break it off. Such fractures are harder.
diagnose even with x-ray examination. How to distinguish
a fracture from a bruise in this case, only the specialist knows. But also
bones in children grow together three times faster than in adults, which
significantly speeds up recovery times.

How to distinguish травмы друг от друга?

In some cases, everyone can make a diagnosis. For example,
bruise after kicking a corner, accompanied by
weak pain is surely a bruise. And the gap of bone fragments through
a wound is an open fracture. There are more signs that allow
make a presumptive diagnosis.





Pain At the time of injury, then weakens and dulled. With
increasing edema may intensify
At the time of injury acute, intense, over time can
grow stronger
Intense at the time of injury, worse when trying
Intense at the time of injury, increases with movement and
Edema Often Sometimes Often Often, сильный
Изменение длины limbs Not Not  Yes Often
Pathological mobility outside the joint Not Not Not Often
Crepitus of bone fragments Not Not Not Often
Deformation of the damaged part of the body Not Not Often Often
Increased pain when you press the injury site Often Often Often Often
Symptom Axial Load Not Not Not Positive (increased pain)
Деформация the joint Not Not Often With intraarticular fractures, with a capsule rupture
Blood in the joint Sometimes, when blood is poured from a hematoma into the joint. Sometimes Often With intraarticular fractures
Limb axis change Not Not Often Occurs (with a strong displacement of fragments)
Active (independent) movements Saved Limited due to increased pain Impossible Impossible либо крайне болезненны и ограничены
Passive movement Saved Saved Limited due to increased pain Extremely painful and limited

The final diagnosis can only
trauma specialist. First aid for sprains and fractures is
only a way to ease the condition before the ambulance arrives. Therefore, for all
types of damage that cause inconvenience, it is better to refer to
specialist in the emergency room. Sometimes достаточно одного взгляда на
damage and pairs of questions to determine the type of injury. But more often
you have to use an x-ray and sometimes MRI, CT and
other methods.

All the above signs are more related to injuries.
limbs. But there are parts of the body that react
completely different. With head injuries, symptoms can
match the nature of the damage. So, brain contusion
cannot be seen on an x-ray. But he can manifest
poor health and loss of consciousness. Fracture of the bones of the skull
may be accompanied only by a weak headache, and be complicated
severe hemorrhage. Therefore, there are cases when it is necessary
consult a doctor even without obvious complaints of well-being.

You need to consult a doctor if:

  • Injured head, chest, spine, stomach
  • Trauma is associated with the fall of a child from a height (especially in the
  • A crash was heard at the time of the injury
  • The pain that occurred at the time of the injury does not subside, but increases.
  • There is a significant wound in the injury site, bleeding
  • Swelling increases
  • A bruise does not “bloom” over time (that is, does not turn yellow), but
    reddens and the skin gets hot.
  • There are no active and passive movements in the damaged
  • There is a decrease or complete disappearance of sensitivity in
  • Degradation occurs (loss of consciousness, decrease or
    increased pressure, shortness of breath, urinary retention).

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