What Happens in the ER When You Break a Bone?

At the emergency room (ER), the ER doctor will assess the broken bone and determine the treatment.

Patients with a broken bone in the ER will see a board-certified ER physician who will assess the break and determine the treatment.

Pain control is addressed and treated from the start.

• X-rays are taken to examine the broken bone.
• The fracture may be treated with a splint, cast, or sling, depending on its type and severity. Patients may need an orthopedic boot, crutches, or a cane.
• Intravenous fluids and pain relievers may be given if needed.
• Some broken bones may require additional treatment, such as surgery or a prolonged hospital stay.
• In such cases, the ER facility can arrange transfers to other medical facilities or referrals to specialists.

The treatment plan depends on factors like the nature and severity of the injury and may include:

• Manually repositioning a dislocated bone in its joint
• Using a sling or splint to immobilize a dislocated joint
• Using a cast or brace to support a broken bone while it heals
• Surgery to reposition and stabilize broken bones or repair torn ligaments after a dislocation
• Orthopedic rehabilitation to regain muscle strength or joint range of motion after healing

Treatment options for broken bones include:

• Immobilization using a plaster or fiberglass cast, the most common method
• Using traction to reposition bone pieces
• External fixation, a surgical procedure involving metal pins or screws inserted into bone fragments and attached to a metal bar on the skin’s surface
• Open reduction and internal fixation, a surgery to reposition and hold bone fragments together with metal pins, screws, or plates
• Joint replacement for fractures involving major joints

People break bones due to impacts, ranging from sports injuries to unintentional falls.

Bones are strong but have limits. They may bleed after a serious break. Moreover, diseases like cancer and osteoporosis can weaken bones and cause breaks.

Is a broken bone an emergency?

A broken bone requires emergency room (ER) treatment, regardless of pain or visual severity.

Signs that warrant ER visit include:

• Open wounds with visible bone protrusion
• Multiple broken bones
• Non-limb fractures (ribs, collarbones, neck, hip, shoulder, face, etc.)
• Disfigured injuries requiring setting or surgical correction

If concerned, it’s best to go to the ER immediately to avoid delay or worsening of the injury.

What are the types of fractures?

Doctors describe broken bones as fractures, which include:

• Open or closed: Closed fractures (simple) don’t break through the skin. Open (compound) fractures may break through the skin.
• Partial or complete: Partial fractures don’t extend through the bone. Complete fractures indicate the bone is in two or more pieces.
• Displaced or nondisplaced: Nondisplaced breaks have the broken pieces still lining up. Displaced breaks don’t.

Common types of fractures include:

• Single fracture: Bone broken in one location
• Complete fracture: Bone split into two pieces
• Comminuted fracture: Bone broken into more than two pieces or crushed
• Transverse fracture: Break straight across the bone
• Stress fracture: Very thin crack, also called a hairline fracture
• Oblique fracture: Break at an angle
• Greenstick fracture: Break on one side but bends on the other, like a fresh stick from a tree
• Bowing fracture: Bending but not breaking children’s bones
• Compression fracture: Often in the spine, spiral and avulsion fractures

What to do if a person can’t get medical help right away

First aid for a broken bone involves addressing symptoms.

Symptoms of a bone fracture may include:

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

Over-the-counter pain relievers like acetaminophen and ibuprofen can help. Apply ICES: Ice, compression, elevation, and support.

• Ice reduces pain and swelling:

• If no ice pack, crush ice cubes in a dish towel or plastic bag.
• Alternatively, use a bag of frozen vegetables wrapped in a towel.
• Apply an ice pack to the injured area for at least 20 minutes, four times per day.

Bone healing typically takes six to eight weeks but may take longer. Factors affect healing times. Some fractures take up to 12 weeks or more.

How to strengthen bones

Foods good for bones include:

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

Maintain an active lifestyle and eat a balanced diet with plenty of calcium, vitamin D, and necessary supplements for healthy bones.

• Calcium-rich diet:

• 99% of consumed calcium is stored in bones, with the rest used for other functions.
• When calcium intake is low, bone breakdown occurs as the body requires calcium for normal functions.
• Low-fat or non-fat dairy products, dark green vegetables, fish, beans, and tofu are calcium-rich.

Doctors may prescribe osteoclast inhibitors to patients with brittle bones, delaying skeletal-related events like fractures or spinal cord compression while strengthening bones.

These medications work differently but have the same effect.

• Xgeva (denosumab) is a monthly injection.
• Zometa (zoledronic acid) is typically administered intravenously every one to three months.

Xgeva and Zometa are linked to rare side effects like jawbone death and kidney dysfunction.

Patients on these medications should regularly follow up with their physician.

Patients on these medications should regularly follow up with their physician.