A closed fracture occurs when a bone breaks within the human body but does not pierce the skin. This is considered to be a fairly uncomplicated fracture that does not require as much treatment as an open fracture, in which the bone splinters and breaks the skin. Treatment for a closed fracture can vary depending on the severity of the injury; some minor injuries such as hairline fractures may only require immobilization and rest in order to heal, while more severe injuries to the bone may still require a surgery to repair.
First aid for a closed fracture will include assessing the injury, treating the patient for shock, and assessing any other injuries that may complicate treatment. The injured limb should be elevated if possible to reduce swelling, and the limb should also be immobilized to prevent further injury. This process must be done carefully to avoid exacerbating existing injuries or causing new ones. The RICE treatment, or rest, ice, compression, and elevation, can be used, but not if any of these actions cause pain or risk furthering the injury. Compression should especially be avoided, as this can make the injury worse. Any objects such as wrist watches or tight clothing should be removed if possible, as they can restrict blood circulation to the injury.
Once the patient is at the hospital, the treatment for a closed fracture will usually involve an x-ray that reveals the extent of the injury. From there, a doctor can make a determination about the best course of treatment. Hairline fractures are very minor and are usually treated non-surgically; a cast may be applied to the injured limb, or the bone will otherwise be immobilized, and the patient will need to refrain from using that limb for several weeks.
More serious instances of a closed fracture may need to be addressed surgically. A surgeon will make an incision so the bone can be accessed, and plates and screws may be installed into the bone to stabilize it. Soft tissue that may have been damaged will also be addressed during the surgery. If nerves have been damaged, the patient may need to undergo surgery to repair such damage and will more than likely need to undergo extensive physical therapy once the injuries have begun to heal. The injured area of the body will be casted to prevent any movement during the healing process. Once the cast is removed and a doctor gives the approval, physical therapy can begin.