Orthopaedic First Aid: What To Do For Sprains, Strains & Fractures

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Orthopaedic injuries, such as fractures, sprains, and strains, affect people of all ages and are commonplace. Acquiring a fundamental understanding of orthopaedic first aid can contribute to preventing additional harm and alleviating pain. This article will explore each injury, offering in-depth insights and emphasising their unique characteristics.

The Most Common Orthopaedic Injuries


A ligament undergoes stretching or tearing beyond its normal range of motion, resulting in a sprain. Such incidents often occur due to sudden impacts, like falls, lifting heavy objects, or accidental collisions—particularly prevalent in sports or exercise. Sprains can be categorised into three severity levels:

  • Minor Sprain: The ligament stretches, but the joint remains stable without loosening.
  • Moderate Sprain: A partial tear of the ligament leads to joint instability.
  • Severe Sprain: A complete tear or separation of the ligament from the bone.

Common symptoms of sprains include:

  • Pain, bruising, and swelling
  • Restricted movement in the injury area
  • Hearing or feeling a ‘pop’ when the sprain occurs
  • Instability or looseness of the joint


An injury to a muscle or tendon, the tissue cord linking muscle to bone, is known as a strain. Commonly occurring in the legs, wrist, neck, knees, feet, and back, strains result from the muscle or tendon being overstretched, twisted, or torn. That is why strains are often referred to as ‘pulling a muscle’.

These injuries may occur suddenly due to abrupt exertion, lifting heavy objects, or direct impact. Alternatively, they can develop gradually from repetitive actions such as playing sports or engaging in daily chores. Symptoms accompanying a muscle strain often include:

  • Pain, bruising, and swelling
  • Restricted muscle movement
  • Muscle weakness
  • Muscle cramping or spasms


A bone experiences a partial or complete break, known as a fracture, when the force applied exceeds the bone's strength. This typically results from traumatic incidents like sports injuries, vehicle accidents, or falls. Individuals with conditions such as osteoporosis or certain forms of cancer face a heightened risk of fractures.

The signs and symptoms of a fracture vary based on the specific bone and the injury's severity. Generally, these encompass:

  • Pain, bruising, numbness, deformity, and swelling
  • Restricted movement in the affected area
  • A 'crack' or 'snap' sound during the injury
  • A grating sensation emanating from the broken bone ends
  • A wound with a protruding bone in the case of an open fracture

Orthopaedic First Aid for Sprains

To alleviate sprain symptoms, follow the RICE treatment method:

Rest: Allow the injured area to rest, refraining from putting weight on it or engaging in activities that may worsen the injury.

Ice: Apply a cold pack to the affected area for approximately 15-20 minutes at a time to reduce swelling and numb pain.

Compression: Use a compression bandage to help reduce swelling. Make sure not to wrap it too tightly, as this could impede blood flow.

Elevation: Elevate the injured area above the level of the heart when possible. This helps reduce swelling by allowing fluids to drain away from the injured area.

Additionally, non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (Tylenol) can help manage pain and inflammation for mild and moderate sprains.

Immobilisation Techniques

Early, controlled movement benefits mild sprains, while immobilisation with a sling, splint or brace minimises swelling and aids recovery of more moderate cases.

Severe sprains or tears often mandate extended periods of immobilisation, potentially involving a cast or, in serious cases, surgery. Casts offer prolonged immobilisation but may need adjustments if swelling is severe, possibly requiring a cut for relief. In certain scenarios, a splint may be initially applied to facilitate a reduction in swelling before transitioning to a cast.

In the case of torn ligaments, the use of braces or orthotics is essential for at least five weeks, restricting movement to promote healing. Additional support, such as crutches, may be necessary, particularly when faced with significant swelling.

When To Seek Medical Attention

While many cases of minor sprains may be treated at home, consult an orthopaedic specialist if you encounter any of the following:

  • Signs of infection (increased warmth, redness, streaks, swelling, and pain)
  • Numbness or cold sensation in the wounded area
  • Limb looks crooked or has unusual lumps
  • Noticeable bruising
  • Inability to move the injured joint or muscle
  • Inability to put weight on the injured limb
  • No improvement after three days of home treatment

Orthopaedic First Aid for Strains

Apply the RICE treatment method to treat a strain:

Rest: Avoid activities that could worsen the strain or put weight on the affected area.

Ice: Apply a cold pack to the strained muscle for 15-20 minutes at a time to alleviate swelling and numb pain.

Compression: Use a compression bandage to help minimise swelling, being careful not to wrap it too tightly to avoid impeding blood flow.

Elevation: Elevate the strained muscle above heart level, if possible, to facilitate fluid drainage to reduce swelling.

Non-steroidal anti-inflammatory medicines (NSAIDs) and acetaminophen (Tylenol) can also help minimise pain and inflammation for strains.

When To Seek Medical Attention

Though mild muscle strains can usually be managed at home, severe cases may require surgical intervention to repair torn muscles or ligaments, followed by an extended period of rest and recovery. Get medical attention if you encounter the following:

  • Bleeding from the injury
  • Numbness or cold sensation in the affected area
  • Noticeable deformity
  • Noticeable bruising
  • Difficulty moving the joint or muscle
  • Inability to bear weight on the limb
  • Signs of infection (increased warmth, redness, streaks, swelling, and pain)
  • No improvement after three days of home treatment

Orthopaedic First Aid for Fractures

Severe bone fractures resulting in a visible deformity and significant pain require immediate medical attention. While awaiting medical assistance, follow these first-aid steps:

Control bleeding either by applying pressure around the wound using a sterile dressing or clean cloth, while avoiding direct pressure on the protruding bone. Secure the dressing with a bandage.

Use ice packs to diminish swelling and alleviate pain. To avoid direct skin contact with ice, wrap it in a towel or cloth before applying.

Immobilisation Methods

Medical professionals’ primary approach in fracture management is usually immobilisation, which includes various methods such as splints, braces, casts, slings, and others. In emergencies, make-shift splinting may be useful for stabilising injured body parts temporarily, preventing further harm and easing pain until professional help arrives.

Multimodal Pain Management

To enhance patient comfort and recovery, a combination of methods may be used to address pain:

Pharmacological methods: non-steroidal anti-inflammatory medicines (NSAIDs) or acetaminophen

Non-Pharmacological Methods: Physiotherapy or ice therapy.

For more severe pain, opioids might be used short-term, alongside transcutaneous electrical nerve stimulation (TENS) or acupuncture, offering both immediate and sustained relief.

Common Mistakes to Avoid When Giving First Aid

Mistake 1: Putting heat on a sprain, strain, or fracture.

While heat can be soothing for general aches and pains, it is not suitable for sprains, strains, or fractures as it may worsen swelling. Heat can worsen the swelling.

Mistake 2: Trying to realign a broken bone or push a protruding bone back in.

Attempting to realign a broken bone without proper training can damage surrounding tissues, complicating the repair and healing process.

Mistake 3: Applying ice directly to the skin during RICE treatment

Applying ice without a protective barrier can lead to skin damage.


Understanding basic orthopaedic first aid is crucial for addressing common injuries such as sprains, strains, and fractures. While orthopaedic first aid can provide initial relief, seeking prompt professional assistance is crucial for accurate diagnosis, appropriate treatment, and ensuring the best possible outcome for the patient's recovery.


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Dr Yung Shing Wai, Consultant Orthopaedic Surgeon: With his decades of specialist experience, Dr Yung is committed to providing not only high-quality, personalized and modern orthopaedic treatments; he also shares his knowledge by reviewing and contributing informative articles to provide patients with trustworthy and up-to-date orthopaedic insights.

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