An open fracture occurs when a broken bone (fracture) causes a break in the skin. This is a serious injury and requires prompt first aid treatment.

The two main risks from open fractures are infection and bleeding. Broken bones are vulnerable to infection, so if they are exposed to the environment there is a significant risk of developing a bone infection. These infections can lead to loss of life or limb.

Bleeding is another significant risk, as the broken bone end can act like a jagged knife and damage major blood vessels as it moves. Bleeding may occur beneath the skin (concealed bleeding) so will not be immediately apparent to the first aider. 

Another term for open fracture is compound fracture. 

First aid treatment for an open fracture

Stop any bleeding 

This may require pressure around the injury if the bone is still exposed. If you have access to bandages then place one either side of the exposed bone to apply pressure around the injury and stop the bleeding. If possible cover any exposed bone with a sterile dressing to reduce the risk of infection.

Immobilise the injured part

Any further movement could cause the injury to worsen. If you are trained then apply a splint to the injured limb.

If untrained you can immobilise a limb using your hands. Support the injury from above and below.

Monitor the patient 

If they loose a significant amount of blood then shock can develop. Monitoring the casualty’s pulse and respiratory rate can help you pick up the early signs of shock.

Nil by mouth

The casualty may require an emergency operation on arrival at hospital. Therefore do not give them anything to eat or drink. 

Call for emergency medical help

Open fractures require expert emergency medical help. Do not delay in calling for assistance!