Fractures

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Fractures Dislocations
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• The body is built on a framework of bones-the
  skeleton- that supports the muscles, blood
  vessels nerves of the body protects organs as
  the heart.
• Movement is made possible by muscles attached to
  the bones by movable joints where the bones
  meet.

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• There are 206 bones in the human body and it is
  possible to break just about all of them.
• There are different types of breaks but first aid
  for broken bones is pretty much the same.

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Types of injury

• Bones may be broken (fractured), displaced at a
  joint (dislocated) or both.
• Muscles the tendons that attach them to bones
  may be strained or torn the ligaments holding
  the joints together can tear.
• If you have any doubt about which type of injury
  you are dealing with, it is best to opt for the
  most serious (fracture).

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• A dislocation
• Occurs when 2 bones are out of place at the
  joint.
• Dislocation may occur in major joints as
  shoulder, hip, knee, elbow or ankle or in smaller
  joints as finger, thumb or toe.
• It may also cause injury to nerves and blood
  vessels.
• Never try to manipulate a dislocated joint back
  into place, as this cause further injury.

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Fractures

• Is a break or crack in a bone.
• Generally, considerable force is required to
  break a bone, unless it is diseased or old.
• Conversely, young bones still growing are supple
  may split, bend or crackle just like a young
  sapling, hence the name green stick fracture.
• Any type of fracture may be accompanied by an
  open wound complicated by injury to adjoining
  nerves, muscles, blood vessels organs.

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Open closed fractures

• In open fractures, the overlying skin is broken.
  The bone is therefore exposed through the tissues
  to contamination by bacteria from the skin
  surface or from the air.
• When the skin around a broken bone is intact, the
  injury is known as closed fracture. There will
  often be bruising swelling around the fracture
  site.

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• Types of Fractures
• Open fractures, When the bone protrudes through
  the skin
• The bone can also separate completely from the
  other half
• It is possible for the bone to break in more then
  one place

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Assessment of injury

• Some injuries as open fracture or dislocated
  thumb are obvious. Others may only be revealed by
  X-ray examination
• When you are assessing an injury, note as many
  features as possible, without moving the injured
  part unnecessarily.

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Recognition

• Difficulty in moving a limb normally (inability
  to walk).
• Pain at or near the site of injury made worse by
  movement. (Stickening severe pain indicates
  dislocation, tenderness over a bone if gently
  touched is a sign of fracture.)
• Distortion, swelling bruising at the site of
  fracture.
• Signs of shock, if the fracture is to the thigh
  bone, ribcage or pelvis.
• A shortening, bending or twisting of the affected
  limb.

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• If you even suspect a break get the victim to a
  hospital. A broken bone not properly treated can
  cause future deformities and limited movement.
• You can expect a break if...
• The damaged limb is not useable or unable to bear
  weight
• There is a lot of bleeding and bruising in the
  damaged area
• The injury was caused by a powerful blow

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• The damaged limb is blue or cold
• The patient is sweating, pale, dizzy or thirsty.
  These are sign of shock and require immediate
  medical attention
• The damaged limb is crooked
• The damage occurs in the pelvis or thigh go to
  the hospital (there are a lot of nerves and
  arteries that run through the pelvis you will
  need to be x-rayed )

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• First Aid Management
• Breaks and fractures require immediate medical
  attention.
• There are a few things you can do while waiting
  for help or on the ride to the hospital
• Apply ice to the injured area to reduce pain and
  swelling
• Create a splint to reduce pain and prevent shock

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Treatment for open fractures

• Your aims are to prevent blood loss, movement
  infection at the site of injury. Arrange removal
  to hospital.
• Cover the wound with a clean pad or sterile
  dressing apply pressure to control the
  bleeding.
• Without touching an open wound with your fingers,
  carefully place some clean paddling over around
  the dressing.

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• If the bone is protruding, build up pads of soft
  non-fluffy material around the bone until you can
  bandage over the pads.
• Secure the dressing padding bandage firmly, but
  not so tightly that the circulation is impeded.
• Immobilize the injured part as for closed
  fracture.
• Treat the casualty for shock. Check the
  circulation beyond the bandage every ten min.

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Do not

• Press down directly on a protruding bone end.
• Move the casualty until the injured part is
  secured supported, unless he is in danger.
• Let the casualty have anything to eat or drink.

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Treatment for closed fractures dislocations

• Your aims to prevent movement at the injury site.
  To arrange removal to hospital.
• Tell the casualty to keep still steady
  support the injured part with your hands until
  immobilized.
• For firmer support, secure the injured part to a
  sound part of the body. Bandage from the
  uninjured side
• For upper limb fractures support the arm against
  the trunk with a sling if needed bandaging.

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• For lower limb fractures bandage sound leg to
  the injured one.
• Treat the casualty for shock if necessary. If
  possible raise the injured limb.
• Check the circulation beyond any bandages every
  ten min. loosen if necessary.
• DO NOT
• Move the casualty until injured part is secured
  supported, unless he is in danger.
• Let the casualty eat or drink.
• Try to replace a dislocated bone into its socket.

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Treatment for soft tissue injuries

• Follow the RICE procedure to treat sprains,
  strains deep bruising.
• R Rest the injured part
• I apply Ice or a cold compress
• C Compress the injury
• E elevate the injured part

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• Splints can be made from rolled-up newspapers and
  magazines, an umbrella, a stick, a cane and
  rolled up blankets.
• Place the splint around the injury gently holding
  it in place with a necktie, strip of cloth or
  belt.
• The general rule is to splint a joint above and
  below the fracture.

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Types of Splints
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• Lightly tape an injured leg to an uninjured leg
  placing padding between the legs

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• Lightly tape an injured arm to the chest if the
  elbow bends.
• If the arm is straight tape it to the side of the
  body place padding between the arm and the body

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• For a broken arm make a sling from a triangle of
  cloth. Place the arm in the cloth and tie the
  ends around the neck so the arm is resting at a
  90 degree angle

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• Check the pulse in the injured limb below the
  splint. If you can't feel a pulse the splint is
  too tight
• Other signs that the splint is too tight include
  numbness, a blue tinge to the skin, tingling and
  swelling. Loosen the splint if these symptoms
  arise

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• DO NOT try and set a broken bone or push a
  protruding bone back under the skin
• N.B. in suspected fractured spine (neck and/or
  backbone) never to try to move the victim from,
  fear of spinal cord injury with the chopped
  fractured spine.