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Broken bones and fractures

Dr Lynn Thomas, OStJ, BSc, MB.BS, MA, FRCPClinically reviewed: 28/04/2025

A break or crack in a bone is called a fracture. Find out what to look for and how to perform first aid.

What are fractures?

A break or crack in a bone is called a fracture. In the case of an open fracture, it will present as an open wound or break in the skin near the site of a broken bone. In a closed fracture, the skin around the fracture is intact. However, broken bones may be unstable, causing internal bleeding, and the casualty may develop shock.

Signs and symptoms

Look for:

  • deformity, swelling, and bruising around the fracture

  • pain or difficulty moving the area

  • a limb may look shorter, twisted, or bent

  • a grating noise or feeling from the ends of the broken bones

  • difficulty or being unable to move the limb normally. Don't ask the casualty to attempt movement if they are unable to

  • a wound over the fracture when the bone is not visible or a wound where you can see the bone sticking out (known as an open fracture)

  • signs of shock, particularly with a fracture of a thigh bone, hip, or pelvis.

What to do

  1. 1

    Open fractures and long bones - these patients need immediate transfer to A&E by calling 999 or 112 for emergency help.

    Suspected broken back, neck, or pelvis - these patients need immediate transfer to A&E by calling 999 or 112 for emergency help.

    Smaller bones or other fractures - these patients will need transfer to A&E or an Urgent Treatment Centre, but it is less urgent. If possible, the patient can make their own way to hospital with a friend, family member, or on public transport.

    Remove any rings, watches, or anything that wraps around the limb as soon as possible.

    If it is an open fracture, or there is a visible wound, cover the wound with a sterile dressing or a clean non-fluffy cloth. Apply pressure around the wound, but not over the protruding bone or suspected fracture site, to control any bleeding. Then secure the dressing with a bandage.

  2. 2

    Advise the casualty to keep still while you support the injured part to stop it from moving. Do this by holding the joint above and below the injured area.

    Place padding around the injury for extra support.

  3. 3

    Ask the patient if they have any changes in the sensation of the affected bone or site:

    • feels normal

    • pins and needles

    • feels hot or cold

    • can't feel anything or numb

    If you have not called 999 or 112 for emergency help, do this now.

  4. 4

    Do not move the casualty until the injured part is secured, unless they are in immediate danger. You can secure an upper limb fracture with a sling and a lower limb fracture with broad fold bandages.

  5. 5

    If necessary, treat for shock, but do not raise the legs if either are suspected to be broken or there is injury to the pelvis or a hip. Monitor until help arrives.

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