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I don't seem to be able to cornor any of my friends who work at the local hospital, so I'm looking for help from the Hatrack medical team. When a bone is broken but does not puncture the skin, what does it feel like to touch the skin? Is the skin warm or cold? Damp or dry? Can you actually detect the break by touch? I am curious what it is like about ten minutes after the break occurs. I am breaking a character's upper leg or hip. I don't really care about the pain the guy with the break feels, more how his body physically feels and responds to touch.
[This message has been edited by Kickle (edited February 20, 2006).]
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I broke my fingers once, but that was a long time ago way back in 7th grade. Let's see if I can remember what it was like...
My fingers became horribly swollen and I remember them feeling cold and clammy--but this could just be because I was so shocked and terrified. The doctor couldn't tell whether my fingers were broken or just sprained, so he tapped my fingertips with some little tool he had, and I remember that I could feel the bones clicking against one another as he did so--which was, needless to say, very painful. Also, my first finger was dislocated as well as broken and I remember that it felt very much like a bad bruise after the initial sharp pain went away. Then, after a while, my hand became numb to the pain and all I could feel was this dull sensation as if someone were squeezing my fingers in a tight handshake.
This was all, of course, from my point of view so I don't know if that answers your question or not, but there you go.
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Hey Kickle! I think I have the answer for you. This is from personal experience, and may be tainted a bit because there was alot of pain involved, but the pain didn't come from my skin around the broken bones (at least not mostly).
I broke my femur in two places, tibia, fibula(one of those was a compound break), ankle and most every bone in my left foot. This was caused from a motorcycle accident many years ago. I guess that might qualify me as an expert?
The pain from breaking a large bone is pretty severe. Although, there was so much trauma, that I think my brain was shutting down that portion of my body. I knew I was in alot of pain, but it wasn't like stubbing your toe or a deep gash that really seems to hurt. I could feel the road rash on my back and arms more so than the broken bones in my leg. Maybe it has to do with the amount of pain receptors on your skin versus the pain receptors for bone (if there are any). I could feel definate pain in my shin where the compound break was, and my foot that was a bloody piece of hamburger, that is where most of the pain was.
It wasn't until they put the splint on my leg and applied pressure that I felt the ENORMOUS pain from the fractured bone ends scraping each other. I almost passed out, but kept awake for some reason. The paramedics were afraid to give me pain medication at the time because, I guess from the serious loss of blood (6 pints roughly) and the fact that I was still coherent. They got chewed out by the attending doctor in the ER for that. It was the best feeling in the world to finally get the morphene.
I guess if all I had to worry about was a single break, the factors might be different. If the bones broke and stretched the skin over the break, I would guess it would be very painful. If someone were to touch it at that point it might hurt enough to make you pass out, or want to punch them in the nose, depending upon your mental state at the time. I was more of the wanting to punch them state.
Anyway, if you want all the gory details or need any other info, just email me at my new address: truhero@oasisbb.net. I am always glad to help!
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Such great discriptions. I cringe from reading about the pain. But actually this time I need to know what the doctor or person who treats the person with the broken bones feels when they touch the skin around the break. Tru, I'm on the second draft and may come begging at your doorstep in a few weeks. Hmm, road rash--that gives me a story idea.
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When I broke my arm, the skin around it went numb and turned a pinkish blue. My arm was actually bent into a V shaped and I had to hold the hand still. I don't remember the initial pain, but the throbbing grew so bad that I thought I would pass out. When it was reset, using weights, my mother passed out as she watched, but for me is was instant relief to feel it move back into place. It was as if it weren't there anymore, weren't functional. I could feel it, the presence of my hand and arm, but not sensations. Not until it was put back together. Then it hurt like hell for a few days. The throbbing was bad enough to keep me awake at night.
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It depends on what is broken, how badly it's broken, and other conditions of the patient.
If a long bone (like the femur) is badly broken, you can usually see that it's broken, no need to feel at all. On the other hand, a hairline break or a break in a short bone will usually require X-rays or whatever. You can tell a lot about the break by feel but it isn't such a good idea to handle the area carelessly, broken bones activate highly sensitive nerves inside the bone, and there can be problems with fragments and such too. In the area of the hip you have the femoral artery and such, so you shouldn't muck around.
It takes a while for an area like the upper thigh/hip to swell up, how long depends on the individual. That area shouldn't become clammy unless the victim has lapsed into shock (which is quite possible) but it normally feels warm (compared to your fingers, at least), so it would be hard to detect the initial rise in temperature that goes with swelling. And since the amount of pressure that can be sustained in that area is much less than would be the case elsewhere, the drop in temperature due to constricted blood flow is going to be minor.
Other factors affecting the victim's overall body temperature will have a much more noticible impact, because you're effectively dealing with a vital body area.
Really, what I'm saying is that all the conditions you're talking about are things that would be indicative of various possible problems. And short of breaking some part of the skull or spine, the femur (near the hip, no less) is just about the worst bone to break, so a lot of stuff could happen.
I'll vote for sweaty, by the way. That would be normal a few minutes after a major break, and the converse would worry me. Of course, some people just don't sweat that much, and it could be a dry climate.
quote: It takes a lot of force to break an "upper leg or hip," unless the victim has very weak bones (as do the elderly in our society).
When a bone breaks, the powerful muscles attached to both parts of the bone tend to yank the two broken ends beside each other. Like this: [I had to add the dot otherwise the BB made them line up.]
So if you run your hand along the bone, you can actually feel this discontinuity. Unless it's hidden by thick layers of muscle -- as it would usually be in the upper leg or hip.
For a hip or thigh fracture, one of the textbooks signs is that the broken leg is shorter than the other leg. (See above excellent illustration for the explanation.) This is generally observed as the patient lies on his back (since he's usually not going to be doing a lot of standing at this point).
There's also bleeding pretty immediately from the various blood vessels that get torn when the bone is broken. So within a matter of minutes there will be a significant swelling of the limb at the point of the break. Again, though, in the upper leg or hip this swelling can be hidden by the thick layer of muscles present. In fact, a break in this region can result in a very large blood loss into the leg around the break, even though there's often no obvious swelling or discoloration.
As you'd deduce, therefore, the skin over the broken region isn't going to feel or look different from the surrounding skin. However, because of the blood loss and the pain, the patient will probably be in some degree of shock -- which means that he'll be rather pale as all of his peripheral blood vessels clamp down.
I could pull out some books later tonight if your friend needs more info.
Oh -- your friend should Google, say, "fracture femur signs" (without the quotation marks). Or maybe "fracture femur diagnosis". There's probably a lot of good stuff out there. I'd be happy to translate any Medicalese into English.
[This message has been edited by MaryRobinette (edited February 21, 2006).]
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Thanks Survivor and Mary that is exactly what I needed. I don't need tons of information, I just have been working on a small scene and I did not want to have the skin temperature or appearence wrong. And the guy is on his back, so the short leg detail is great. The story is a fantasy, but it seemed foolish not to get this detail right.
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Now that I've started to work on the scene, I realize how wonderful it is to have read the first hand accounts of bones breaking and being set--particularly Susanna's memory of the feelings. Thanks. And Mary, that primitive technical drawing also helped.
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I've noticed a peculiar weakness that I seem to notice a lot when it comes to Mary. There are things that I can think and write about quite coldly without any discomfort, but when Mary comes along I suddenly realize just how horrible the subject is and want to faint. That little text graphic provided by her friend really got me.
That's the difference between "you can see it's broken" and "cause it looks like this!"
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Any one with smarts knows to double check the shape of the glass if Mary offers you a glass of champagne. and I am glad I missed the tapeworms, they bother me way more than snakes.
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Anyway, I'm very glad my bones don't break. I'll tastefully refrain from mentioning other things I'm very glad about.
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