'cause someone really cares about you

Fall from a height

Trauma

Motor vehicle accidents

Direct blow

Child abuse

Repetitive forces, such as those caused by running, can cause stress fractures of the foot, ankle, tibia, or hip

DO NOT

DO NOT move the person unless the broken bone is stable.

DO NOT move a person with an injured hip, pelvis, or upper leg unless it is absolutely necessary. If you must move the person, pull the person to safety by their clothes (such as by the shoulders of a shirt, a belt, or pant legs).

DO NOT move a person who has a possible spine injury.

DO NOT attempt to straighten a bone or change its position unless blood circulation appears hampered and no medically trained personnel are nearby.

DO NOT try to reposition a suspected spine injury.

DO NOT test a bone's ability to move.

FRACTURES

A fracture is a partial or complete break in the bone. When a fracture happens, it’s classified as either open or closed:

Open fracture (compound fracture): The bone pokes through the skin and can be seen. Or a deep wound exposes the bone through the skin.

Closed fracture (simple fracture). The bone is broken, but the skin is intact.

Fractures have a variety of names. Here is a list of types that may happen:

Greenstick. This is an incomplete break. A part of the bone is broken, causing the other side to bend.

Transverse. The break is in a straight line across the bone.

Spiral. The break spirals around the bone. This is common in a twisting injury.

Oblique. The break is diagonal across the bone.

Compression. The bone is crushed. This causes the broken bone to be wider or flatter in appearance.

Comminuted. The bone has broken into 3 or more pieces. Fragments are present at the fracture site.

Segmental. The same bone is broken in 2 places, so there is a "floating" piece of bone.

Avulsion. The bone is broken near a tendon or ligament. A tendon or ligament pulls off a small piece of bone.

Symptoms may be a bit different for each person. Symptoms of a broken or fractured bone may include:

Sudden pain

Trouble using or moving the injured area or nearby joints

Unable to bear weight

Swelling

Obvious deformity

Warmth, bruising, or redness

The symptoms of a broken bone may seem like other health conditions or problems. Always see a healthcare provider for a diagnosis.

Treatment of Fractures

The goal of treatment is:

to put the pieces of bone back in place,

control the pain,

give the bone time to heal,

prevent complications, and

restore normal use of the fractured area.

Treatment may include:

Splint or cast. This immobilizes the injured area to keep the bone in alignment. It protects the injured area from motion or use while the bone heals.

Medicine. This may be needed to control pain.

Traction. This is the use of a steady pulling action to stretch certain parts of the body in a certain direction. Traction often uses pulleys, strings, weights, and a metal frame attached over or on the bed. The purpose of traction is to stretch the muscles and tendons around the broken bone. This helps the bone ends to align and heal.

Surgery. Surgery may be needed to put certain types of broken bones back into place. Sometimes internal fixation devices (metal rods or pins located inside the bone) or external fixation devices (metal rods or pins located outside of the body) are used to hold the bone fragments in place while they heal.

Fractures can take months to heal as broken bones “knit” back together when new bone is formed between the broken parts.

Your boots slip on packed ice hidden beneath the snow. You catch yourself on the brick wall of an apartment building. You lean there for a moment, head bowed. Heaving breaths come out in puffs of white. Every part of your body is numb or on fire.

You listen for any far off engine or footsteps. The rush of blood in your ear is all you get in response. 

You knew you shouldn’t have taken this job.

The pay was good. It always was in your line of work. 

But you couldn’t get the money if you were dead.

Your eyes fall shut. This was a quick job. The route you had been given was simple. No security. No family. No one to find the body. 

Your target was asleep. 

Your feet were light on the carpeted floor. The room smelt faintly of cigarette smoke and old books. 

The moonlight from the cracked window allowed a glimpse of your victim’s face. Messy grey hair, forehead wrinkles, and an unkempt beard. His breathing was slow. Calm. Oblivious. 

On the nightstand lay a half filled glass of water and a pair of cracked reading glasses. Beside them, a clock with bright red numbers reading 12:26 am.

The cold knife lay heavy in your gloved hand. In and out before sunrise. Keep it quick. Keep it professional. Don’t ask questions. That was the deal. 

You weren’t going to ask why an old man living in a rundown apartment needed someone like you sent after him.

And you weren’t going to hesitate.

You couldn’t hesitate.

And look where that got you now. 

You use every ounce of strength you have to push yourself off the brick wall. Traces of blood drip from where your hand once was. It’s not your own. It never is. 

Your face stings from snow being thrown at you by the harsh winds. At least you could feel your face, you couldn’t say much about the rest of your body.

The world staggers sideways. For one disorienting second all you see is falling streetlights and specks of snow. With a sickening crack your skull slams against ice.

Dazed, you stare at the sky. Snow falls softly on your face, melting when it makes contact.

Warmth puddles around your head. Your hand reaches for it.

Your blood this time.

You try to push yourself off the ground but it only sends pain shooting through the rest of your body. There has to be a way to get out of this, but even if there was, your brain was too jumbled to think of one. 

You’ve fought enough, maybe this time you don’t have to. 

Your eyes fall shut and you think, just for a moment, maybe death will be more peaceful than life.

Then you feel it. 

You feel your sins crawling on your back.

The wind dies, the silence that follows is worse than any storm. Panic claws at your throat, choking the air from your lungs.

Your eyes snap open. 

The snow covered sidewalk is no longer empty. Snow is swallowed by a dark unknown substance, it creeps close to your face, but it doesn't touch you. Your eyes follow it upwards.

You’ve seen monsters before, but this… this thing was wrong. 

Black goop clings to its body, dripping lazily onto the ground, infecting it. Thick tendrils convulse behind it.

Then, its grin, the only thing you can confidently define. It curves unnaturally wide, taking up too much space. 

Permanently etching itself into your brain.

A door slams. 

You're upright. Light stuns you and it takes a moment for your eyes to adjust.

"heyyy sleeping beauty," a familiar voice taunts.

Dark walls slowly come into focus, highlighted by your half drawn curtains. The light bounces around the room, landing on nothing in particular. Not that there was much for it to land on, you had very little furniture and no clutter. 

Your room is empty, just how you like it.

Well it was empty. 

“Killer.” You mumble bitterly.

He stands beside your bed, senselessly twirling his knife around in his fingers. 

“that’s my name~” He sings.

You were fighting an internal war to keep your eyes open. 

Sleep was a luxury here. 

“Leave.” 

Killer leans forward, knife still lazily spinning between his fingers. He’d probably live in your skin if he could but you wouldn't say that out loud, you don’t want to give him any ideas. 

"can’t, boss wants you up,” he says, dragging each word out in a mock pout. “he's got a new job for us." 

Your jaw tightens.

“Move,” you mutter, swinging your legs to the side of the bed.

He rocks back on his heels, getting amusement from your irritation. 

Begrudgingly you get to your feet. Killer doesn’t bother to move out of your way so you shove him.

"that's the spirit," Killer exclaims, wrapping his arm around your shoulder.

You are practically dragged down to the kitchen.

It’s immaculate like always. Every surface gleams in a way that causes you to squint. Dust is sat slouched over the marble kitchen island, a mug full of his black coffee in hand. Across from him, Horror is downing an entire plate of sausage like he hasn’t eaten in years, which you know isn’t true.

The kitchen drops in temperature.

At the far end of the island stands Nightmare.

His posture is straight, his hands folded neatly behind him. He appears far more domestic in this lighting but that doesn’t stop the prey-like instinct inside of you from flaring up.

"You've finally decided to join us," Nightmare hisses. 

His gaze is heavy as you take your seat, you avert it choosing to look at the checkered floor instead.

Killer stretches in his chair next to you, yawning like he was the one just woken up.

“whatcha got for us today, boss?” 

Cool air pricked your throat. It was almost too fresh. You purse your lips to control the swirls that come from your breath. 

Stars litter the sky, like an artist had intentionally placed each and every one. Shades of emerald green bled into soft violet, the colors danced together so naturally they looked alive. 

You’d be lying if you said you didn’t stop to take it in.

“woah this universe is really pretty,” Killer marvels.

You hate to agree.

Outertale. The idea of monsters in space intrigues you. It’s the same concept, monsters imprisoned by humans. You’ve seen it time and time again. Every universe you travel to has the same idea. Even yours was like that. 

Though, yours wasn’t nearly as peaceful as the rest. You should be grateful to have gotten out of there. Places like that imprint on you. You adapt to survive. 

But is it really that different from your current situation?

"shit." Horror curses.

You’re snapped back to the present. "What? What is it?" 

"they're here."

Killer’s tone drops. "what do you mean they're here?" 

He scans the area, his gazing locking on something. 

"oh."

You follow your confidants stare. 

By the Snowdin sign, three familiar skeletal figures, the same three skeletons you were told to avoid. 

Ink had his brush tucked behind him, posture loose as he chats with a nearby monster. Blue is crouched only a few feet away keeping a group of monster children entertained, their giggles carry over to you. 

Then there was Dream, he was deep in conversation with what must be this universe’s Sans. A genuine smile rests on his face. You stare at it longer than you should, something unfamiliar fluttering in your chest. You push it down.

They were off their guard, you could ambush them no problem.

"Stick to the plan?” You question.

“move faster,” Dust says coldly. “stick to snowdin.” 

Killer’s grin returns in an instant. 

“let’s not waste anymore time then!” 

Before anyone can stop him, he’s gone.

You turn to stealth. Snowdin’s forest absorbs your footsteps completely as you weave through the trees.

"We really appreciate everything you have done for us," Dream says warmly. "If there's anything we can do in return–"

"nah, don't worry about it, “ Outer interrupts with a relaxed smile. “think of it like a thank you for everything you've already done." 

Dream smiles.

"Well, I suppose we should be heading back."

Today has been going surprisingly smoothly.

"DREAM!"

The scream tears through the night.

Dream whips around, bow already in hand. Around him Snowdin erupts into chaos. The monsters that had just surrounded him ran off in a panic. Screams echo out from all directions.

Blue and Ink stand backs pressed. Ink wields his brush, Blue has a stance ready to pounce as Horror and Dust circle them. They stalk around like predators, taunting his friends.

Dream starts for them.

But something in his peripheral moves faster. A blur streaks through the snow towards Outer.

His body moves before he can register. 

Sparks fly as Killer’s knife slams against Dream’s raised bow. 

"heyyya dreamy,” Killer snickers, leaning into his knife with a grin stretching abnormally wide. “didja miss me?" 

Dream shoves him backwards. Killer slides back through the snow. 

"these are the monsters you mentioned?" Outer asks, stepping out from behind Dream with a lot of confidence for someone who was almost just killed.

"didn't know you talked about us so much,” Killer teases. “you really are obsessed!"

Outer, now side by side with Dream, wields one of his bone attacks.

"aw man, two on one?” Killer mocks betrayal. “that's not very fair at all.”

His grin sharpens.

“lets even these odds a little, yea?" 

A twig snaps under your weight as you bolt out from behind some trees. Your knives are raised as you jump at the skeletons from behind. Your instinct takes over as your knives strike against blue magic. You’re thrown back, now shoulder to shoulder with Killer.

"i'll let you have dreamy this time," Killer pipes over his shoulder. "i wanna taste of this new guy."

The space beside you is empty and you know he’s gone. 

There’s a loud earth trembling boom that you can only assume comes from a gaster blaster, signaling the start of Killer’s fight. You pay no attention to it.

You can't say the same about your opponent.

Perfect. 

Snow explodes beneath your boots as you launch forward, knives reflecting the green glow from overhead. Dream barely reacts in time. His bow snaps upward just before your blade collides against it with enough force to shove him backwards. His golden boots dig into the snow.

The impact rings up your arms.

You don’t give him time to recover, pressing forward your movements are quick and relentless. Steel clashes against gold. Again and again. Sparks fly. Each swipe comes faster than the last.

He’s quick. 

But you’re quicker.

The two of you tear through the forest as the fight escalates. For being on another planet, the trees have a striking resemblance to any other you’ve seen. The cold air burns your lungs just the same.

With the terrain change your strategy changes too. 

You adapt quickly.

You start analyzing Dream. 

His weapon of choice is a bow. A powerful weapon, but close combat puts him at a disadvantage. 

You stay glued to him, never allowing more than a few feet in between you. One shot from his bow could end the fight instantly. You weren’t going to let him get that opportunity. 

He’s good, but for a prestigious guardian, he is predictable. He’s fast on his feet. He’s dodged most attacks you've thrown his way. He doesn’t think, he moves on instinct. 

Fighters like that are the dangerous ones.

But he never strikes first. 

That’s his weakness.

You just need to find a way to exploit it.

“I don’t know what my brother has promised you,” Dream starts, voice strained as you force your knife harder against his bow, “but you don’t have to follow him.”

Dream twists to the side, slipping free from your pressure. You stumble a step before catching yourself in the snow. 

This again. 

You’ve heard the same speech from Blue more times than you can count. When do they realize it’s a lost cause? 

Leaving Nightmare isn’t a possibility. 

You spit. Responding would be a waste of energy.

You charge at Dream, but instead of shielding himself again he jumps back. 

Your momentum flings you farther than you intended. You’re momentarily imbalanced. 

When you look up…

He’s gone.

“It’s never too late to change.”

Dream’s voice echoes from the trees above you.

Shit. 

This was exactly what you had been trying to prevent. You’re exposed.

You dash towards the nearest tree, snow kicking up from your boots. Your heart pounds in your chest. 

“There’s a glimmer of a good person inside of you.”

The words echo through your head. More importantly, they’re closer. He’s closer.

The tree is just an inch from your fingertips.

A scream tears from your throat.

Pain pulsates through your arm as the arrow severs flesh and buries itself into the frozen ground beneath you. Violent waves of pain wrack your entire body as you fall with a loud thump. 

Your fingers twitch uselessly against the snow. Your knife is only inches away. 

Your brain screams at you. 

Get up. Fight. 

Above you the aurora’s lively. It’s dancing hasn’t ceased since your conflict began. The colors smear together in your unfocused vision until all you see is overwhelming green. 

Snow crunches nearby. 

It takes a few seconds for your eyes to finally adjust enough to make out the silhouette standing over you. The glow of the aurora surrounds the skeletal frame in an almost angelic way. 

Then you feel it.

The sharp tip of an arrow resting against your throat.

This one won’t just take your arm.

You don’t have it in you to care. Your arm radiates an intense pain, and you feel every cut that litters your body all at once.

You suck in a breath of air.

You’re tired.

Slowly the tension falls from your face. Your ragged breath steadies just slightly. 

For someone who was mere seconds away from ending your life, the guardian's aura is warm. The feeling settles around you, causing emotions you’d buried for years to well inside of you. 

Your throat tightens. Tears prick at the corner of your eyes.

Then…

The pressure at your throat disappears.

The snow crunches beside you and you tense, sending an explosion of pain down your arm. You bite the inside of your cheek. 

Your fingers try for your knife again but they refuse to move more than a tremble.

Dream’s phalanges hover carefully near the arrow pinning you. He’s concentrated, he looks more like he’s found an injured deer than the person who was just trying to kill him.

Your jaw clenches. If he was expecting to get some kind of a reaction from you he wasn't going to get one. 

Without warning the cool arrow is ripped from your wound. All of your senses heighten at once, the once comforting green is blinding, the refreshing cold is biting at you, pain blazes through your entire body until you can’t think about anything else. 

Weight falls on your exposed injury, causing you to jerk, you grab for the closest thing you can, desperate to put an end to your agony. Your hand finds fabric, your fingers tear into it. 

“You’re going to be okay.” A soothing voice hums.

You pry your eyes open. The light is much more tame now. Dream comes into focus, leaned over beside you. His hand on your arm. It takes you a moment to realize you're gripping his cloak with an ungodly amount of strength. You release it.

“...Stop,” you protest, voice hoarse.

“I will not harm you any further,” Dream says softly.

He’s a fool. If he wanted to spare you he should have killed you when he got the chance.

“Mercy will get you killed.” You spat.

He doesn’t respond.

A golden glow spills from Dream’s phalanges, warmth spreads through your arms in steady waves. The pain dulls beneath it, replaced by a tingling sensation that makes your body feel light. 

He’s healing you.

The silence that follows is deafening. Only minutes ago the two of you had been in combat. 

Now he’s kneeled beside you.

“Why?”

The word feels foreign on your tongue and you regret them as soon as they pass through your lips. You shouldn’t be speaking with him like this. You shouldn’t be at your enemies mercy while he tends to your wounds. This shouldn’t be happening at all.

“Everyone deserves a second chance,” Dream declares softly, his voice sickeningly sweet.

You don’t get it. He knows just as well as you that this changes nothing. Nothing will come from this kindness, you will return to your groups and pretend like it didn’t happen.

It’s not like you had a choice, if Nightmare learned of this you’d be dead for certain. 

And your loyalties lay with him. 

Your chest aches in an unfamiliar way, not from pain, but from something you couldn’t distinguish. 

In spite of your circumstances, you share this moment with Dream.

You wish it would last.

But you know better.

A branch snaps somewhere deeper in the forest. 

“They’re coming,” you mutter.

Dreams finally looks at you, gold pupils large in their stare. His expression is unreadable, you continue.

“That means you leave.”

His face softens and you can tell he’s conflicted.

“dreamy~” 

A close shout pulls him from his thoughts, he makes his decision. The warmth around your arm fades as he pulls his hands back. The pain returns, to your surprise it was insignificant to what else was possessing your chest.