How do I know if bone is fractured, or is soft tissue damage?

[NamelessEnsign]

I was out running today and slipped in some mud, landing heavily on my forearm on the curb at the side of the road. My arm took the brunt of it, but I have bruised my knees and skinned my other palm.

There’s a big graze and a fair amount of bruising and swelling. Where my arm is usually concave on the side, it is swollen to convex. I haven’t wanted to use that arm and it feels hot where it is swollen - but I can move my wrist and fingers without pain, and it only hurts if I flex my wrist to the side.

I know no one can possibly know without an X-ray. But I live a long way from the hospital (there is a minor injuries, but X-ray will be closed) and since I don’t have debilitating pain, I feel like I might be a bit of a drama llama about it.

I am under a lot of work stress at the moment and not making smart decisions, so please forgive the post.

You need an X-ray. It could lead to long term issues if it is fractured and not treated properly. Just because you can move your fingers does not mean it isn't fractured. So A&E or a MIU with X-ray facilities tonight or in the morning. Sorry if that is not what you wanted to hear.

I would get someone to take you to MIU, if you need an x-ray they can refer you to another hospital if there's isn't open at the moment (or is A&E closer?)

My DD slipped a couple of weeks ago and got a soft tissue injury, it's still painful and she needs to rest it (no dancing for her) for a couple of weeks - even if it's not broken you'll probably need painkillers to reduce the inflammation of a soft tissue injury tbh. Get yourself seen!

I think you need to have an x-ray, it's really hard to tell if it's broken or just bruised. Do you have any funny sensations in the arm or does it just hurt?

Thank you, Faded - it’s good to get decisive feedback. DH is willing to take me now or in the morning but is also sure it isn’t broken so I am dithering. FWIW I have ‘missed’ two fractures in the past and am used to falling/bruising/grazing from playing my sport. And didn’t need pain relief for childbirth! I usually just carry on, but I feel weird and exhausted.

I am so annoyed with myself

Sorry to hear about your DD Sass. I hate it when injury keeps me away from sport!

Sycamore it’s a bit tingly in my palm and fingers in that side - but not surprising because it is so swollen and there are a lot of nerves there. Hot and sore though.

Ok people - thank you. MIU in the morning unless it feels much better. Or unless it gets worse today.

Photo attached by the way!

I would probably get that looked at tonight - if there is a fracture then it's an open fracture and may need antibiotics/proper cleaning as well. (am not an orthopod, but am a doc)

That doesn’t look great - go get it checked out!

I'd get that looked at tonight, OP.

Walking, thank you - there is definitely no bone poking through the skin - is that what an open fracture is? Or just where the skin is broken over damage? The graze is just from scraping down the curb (kerb?), and I cleaned it up when I got home. (It hurt!)

Oh my , I now realise I was expecting you all to tell me to wtfu. Ok. DH is putting kids to bed. We can call on grandparents to look after them if necessary.

But nearest x-Ray is 25 miles away now [argh]

go get it seen now.
if it is broken, getting a cast on will bring enorm pain relief been there done that
being able to move fingers says nothing about the state of a bone.

I've broken my arm 3x. 2 DC have broken their arm. So I Feel like a pro. I know what a broken arm feels like on me & what the symptoms are. Xrays have their own risks so I would try to avoid one if I could, but you've got form for not being able to tell when it was broken b4... and that does sound quite swollen.

ime, breaks swell A Lot. It's the excess swelling, that then leads to some kind of limited movement, that confirms a break for me. They would only sling it tonite anyway (due to the swelling won't cast it yet), so I'd treat it as broken & get it diagnosed properly tomorrow. (Presuming that gash is as superficial as it looks; douse it with antiseptic anyway).

Another vote for getting seen tonight. If there is a fracture, there is a skin break over it. That could let infection in. Infection in a fracture is a route to a potentially very long painful course of events.

Open fracture is a broken bone plus soft tissue injury.

Another saying to get it checked.

If you do go tonite, let us know exactly what they do for you tonite?
(betting no more than quick antiseptic & diagnosis... cast will come tomorrow or even maybe the next day).

Hope you manage to get sorted. Looks painful!

when I broke my arm, it was set in a half cast immediately. oh the relief!

don't take iboprofen for pain relief, it can slow down bone healing.

Thanks MN. Really appreciate the comments and time. I feel less silly about it now!

I'd get it seen tonight due to pins and needles etc in your hand. If it's nerve damage and you leave it too long it can become permanent, I did a similar thing and now my arm will randomly get pins and needles etc when there's no obvious reason.

(Also you are right about infection risk. And I’m allergic to a few kinds of antiobiotic so I want to avoid that if at all possible!)

that looks pretty painful, hope you're ok and get it checked tonight.

Did exactly the same thing 2 weeks ago. Could move my wrist and finger up and down but not sure to side.

I went the next day. It was broken.

Ouch, nobooze!

I think given the swelling, tenderness over the bone, heat, tingling and an open wound you need to get it seen to. Hopefully it's not broken, but you need to have it ruled out.

It was pretty painful. I banaged it up to give it some support then went to hospital at 8am the next day. They confirmed it was broken and put me in a splint .. it was 2 days later that a cast was discussed at the fracture clinic.

Good luck.