Open fractures (i.e. those in which the broken bone is exposed to the air through a wound in the skin) should be treated in much the same way as closed fractures. The main problem is that as the wound is open, it is more prone to infection and there may be considerable blood loss. As with any fracture, it is essential to arrange for early removal of the casualty of hospital. Whilst waiting for the ambulance to arrive, proceed as follows:
1. Support the wound in the same way as you would with a closed fracture.
2. Gently cover the wound with a sterile dressing or clean pad of material. Do not touch the wound.
3. Place more soft padding around the pad and build it high enough to prevent pressure on any protruding bone.
4 Bandage the padding gently but finely in place. Take care not to bandage it so tightly that it impedes circulation or causes the casualty more pain.
5. If possible, elevate and immobilize the limb.
6 Reassure the casualty and observe for shock.