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First Aid for a Fracture: What to Do and What to Avoid Before Arriving at the Hospital.
The Importance of an Immediate Response
A fracture (broken bone) or a dislocation is a medical emergency that can cause significant alarm. Acting correctly during the first few minutes is crucial to prevent further damage, reduce pain, and facilitate the work of the emergency medical team.
As an Orthopedic and Trauma Surgeon, my recommendation is always to remain calm and follow these steps while arranging transportation to a medical facility.
- Basic Protocol: Stop the Damage and Protect the Area
The initial management of a fracture is based on the principle of immobilization and risk control:
Assess the Situation and Call for Help:
Make sure the environment is safe. If the person is conscious, reassure them.
Call emergency services (911 in Costa Rica) or arrange immediate transport to a healthcare facility.
Immobilization (The Most Important Step):
DO NOT attempt to realign the bone. Never try to straighten a limb or push a bone back through the skin.
Immobilize in the Current Position: Use an improvised splint (boards, cardboard, magazines) or simply secure the injured limb to a healthy part of the body (e.g., tie a fractured leg to the uninjured leg). The goal is to prevent movement of the joints above and below the injury site.
Control Bleeding (If There Is an Open Wound):
If the fracture is open (the bone has pierced the skin), cover the wound with a clean or sterile cloth.
Apply gentle pressure around the wound to control bleeding, but never directly on the exposed bone.
Ice and Elevation:
Apply an ice pack wrapped in a towel to the area to reduce swelling and pain.
Elevate the extremity if possible, provided this does not cause additional pain.
- ❌ Three Serious Mistakes to Avoid
Avoid Massage or Rubbing:
This can worsen fracture displacement and cause further damage to the surrounding tissues.Do Not Give Food or Drinks:
If the patient requires emergency surgery (and we do not know yet), the stomach should be empty for safety reasons.Do Not Assume “It’s Just a Bruise”:
Only an imaging study can rule out a fracture. If there is pain, swelling, and difficulty using the limb, orthopedic evaluation should be sought.
The Golden Rule in Sports: How Can I Prevent Anterior Cruciate Ligament (ACL) Injuries?
Protecting the Stability of Your Knee
The Anterior Cruciate Ligament (ACL) is the main stabilizer of the knee, and its injury (usually a tear or rupture) is one of the most feared injuries in sports such as soccer, basketball, skiing, and running.
Taking advantage of my interest in sports and my specialization in knee surgery, my approach is twofold: treating the injury once it occurs and, more importantly, educating patients about prevention.
Why Does the ACL Tear?
Most ACL injuries are not caused by contact, but by specific dynamic movements:
Sudden Braking: Stopping quickly while running.
Changing Direction with the Foot Fixed: Rotating the torso while the foot remains planted on the ground.
Incorrect Landing: Landing from a jump with the knee straight and hyperextended.
Dr. [Your Name]'s Prevention Protocol: 3 Keys to Stability
Effective prevention focuses on neuromuscular training to teach the body how to land and pivot safely.
Strength and Balance of the Posterior Chain:
The Most Important Muscles: Strengthening the hamstrings (back of the thigh) and gluteal muscles. Weak gluteal muscles cause the knee to collapse inward (dynamic valgus), placing stress on the ACL.
Key Exercises: Squats and lunges with perfect technique.
Plyometric Training (Safe Landing):
The body must learn to absorb the energy of landing. Practice landing with both legs and then with one leg, making sure the knee bends slightly (absorbs impact) and does not collapse inward.
Control and Body Awareness (Proprioception):
Balance exercises on unstable surfaces (e.g., a cushion or mat) to improve communication between the nerves, muscles, and brain. This gives the knee a quick "stability sensor."
Consult Early
If you are an athlete who has suffered a knee sprain or feels instability (a sensation that the knee "gives way"), do not wait. An early evaluation can identify muscular weaknesses and prevent a devastating ACL injury.
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