What Happens in the ER When You Break a Bone?

A broken bone must be treated in an emergency room (ER), regardless of the level of pain or visual severity of the injury.

To be sure, here are some telltale signs that a patient should go to the ER:

• If there are any open wounds with visible bone protruding from the skin, consult a doctor.
• If more than one bone appears to be broken, consult a doctor (the injured will be able to assume if the pain is radiating from more than one area).
• If the injury occurred anywhere other than a limb or appendage such as a rib, collarbone, neck, hip, shoulder, face, and so on.
• If the injured site appears disfigured, it requires setting and/or surgical correction.

If a person is concerned that the injury may fall into one of the above categories, it is best to go to the ER right away so that there is no delay in care or risk of worsening the injury.

Doctors use a few basic terms to describe broken bones as fractures, which include:

• Open or closed: Closed fractures, also known as simple fractures, do not break through the skin. Open or compound fractures may break through the skin.
• Partial or complete: Partial fractures do not extend through the bone. Complete fractures indicate that the bone is in two or more pieces.
• Displaced or nondisplaced: If the broken pieces still line up, it's a nondisplaced break. If they don't, it's displaced.

Common types of fractures include:

• Single fracture: When a bone is broken in a single location
• Complete fracture: When the bone splits into two pieces
• Comminuted fracture: When the bone is broken into more than two pieces or crushed
• Transverse fracture: Breaks straight across the bone
• Stress fracture: A very thin crack, also called a hairline fracture
• Oblique fracture: Breaks at an angle
• Greenstick fracture: Breaks on one side but bends on the other like a fresh stick from a tree
• Bowing fracture: Applies to children’s bones that have bent but not broken
• Compression fracture: Often occurs in the spine, spiral fractures, and avulsion fractures, when a tendon or ligament pulls off a piece of bone

The foremost first aid to help a patient with a broken bone is to address their symptoms.

Symptoms of a bone fracture may include:

• Pain around the area of the injury
• Swelling
• Deformity
• Bruising or discoloration
• Difficulty or impossible to move the limb normally
• Loss of power in the limb

Over-the-counter pain relievers such as acetaminophen and ibuprofen can help. Aside from that, take the ICES approach: Ice, compression, elevation, and support.

• Ice reduces pain and swelling:
  • In the absence of an ice pack, wrap some ice cubes in a dish towel or plastic bag and crush them with a hammer or by slamming them against the kitchen counter.
  • Alternatively, take a bag of frozen vegetables from the freezer and wrap it in a towel.
  • Apply an ice pack to the injured area for at least 20 minutes four times per day.
• Compression reduces swelling:
  • Wrap an elastic or fabric bandage around the injured limb after it has been iced. It should be snug but not too tight.
  • Check the tightness regularly; if the limb continues to swell, the bandage may become painful.
• Elevation reduces pain and swelling:
  • If the patient can lie still, elevate the affected limb to about six inches above the heart level with a pillow.
• Support helps immobilize the limb and reduces pain:
  • Put a splint on the affected limb. If it is a broken arm, rib, or collarbone, use a cloth or diaper sling to hold the arm in a bent position next to the body.

Broken bones or fractures typically heal in six to eight weeks. There are numerous factors at play, and healing times do not always go as planned. Some fractures can take up to 12 weeks to heal, and some can take even longer.

Foods that are particularly good for the bones include:

• Dark leafy greens and vegetables
• Yogurt
• Salmon
• Walnuts
• Beans
• Milk
• Sardines
• Eggs
• Tuna
• Fortified cereals

Maintaining a physically active lifestyle and eating a balanced diet with plenty of calcium, vitamin D, and possibly other supplements as needed are important for healthy bones.

• Calcium-rich diet:
  • 99 percent of the calcium we consume is stored in the bones, with the remaining one percent used for other biological functions.
  • When calcium intake is low, bone breakdown occurs because the body requires stored calcium to maintain normal biological functions.
  • Calcium levels are higher in foods such as low-fat or non-fat dairy products, dark green vegetables, fish, beans, and tofu.
• Calcium supplements:
  • Calcium carbonate and calcium citrate malate are the two most common forms of calcium in supplements.
    • Calcium carbonate must be taken with food, and it may cause stomach upset and bloating.
    • Calcium citrate malate is better absorbed by the body when taken with or without food.
  • Before taking any supplements, the patient must consult a good orthopedic doctor. They will provide insights into the patient’s specific needs, assisting them in making the best decision here.
• Vitamin D:
  • Vitamin D promotes bone development by increasing the body's calcium absorption from food.
  • Vitamin D–rich foods include fortified beverages and cereals, fatty fish, and eggs.
  • Patients who are susceptible to vitamin D deficiency should discuss with their doctor regarding vitamin D supplement.
• Sesame seeds and oil:
  • According to Ayurvedic studies, sesame oil can be a remedy for bone strengthening as sesame seeds are high in protein, copper, magnesium, calcium, and healthy omega-3 fatty acids, and have high protein content, which can be beneficial for people with bone problems.
  • 30 grams of unhulled sesame seeds provide 22 percent of the recommended dietary allowance for calcium.
  • A handful of sesame seeds will provide the recommended amount of antioxidants, minerals, vitamins, and protein. Sesame seeds can be sprinkled on top of salads daily.

Doctors usually prescribe osteoclast inhibitors to patients who have brittle bones. These medications can postpone skeletal-related events in the bone (such as fractures or spinal cord compression) while strengthening the bones.

The medications work in various ways, but they all have the same effect.

• Xgeva (denosumab) is administered as a monthly injection (shot) under the skin.
• Zometa (zoledronic acid) is a bisphosphonate medication that is typically administered intravenously every one to three months.

Xgeva and Zometa are linked to a rare side effect called osteonecrosis of the jaw, in which the cells in the jawbone begin to die. Another uncommon side effect of these medications is kidney dysfunction.

Patients should, therefore, follow up with their physician regularly when on the above medications.