FRACTURES AND DISLOCATIONS
This week we want to discuss fractures, which are a common occurrence in all age groups, perhaps much now so among sports persons and the elderly. A Fracture is a break or crack in the bone. It may be a chip\crack, a clean break, twist\split or a shatter\crumble. When a bone breaks, the surrounding tissue may be damaged. A fracture where there is no open wound is called a closed fracture and where there is an open wound it’s called an open fracture.
A dislocation is when bones at a joint are partly or completely pulled out of position. The force that causes the dislocation may result in the injury of soft tissue around the joint, resulting in a sprain or strain.
It is often very difficult to tell the difference between a fracture and a dislocation, so if in doubt, treat the injury like a fracture.
Being hit by a blow e.g. a car or a fist, or falling from a height, can cause fractures and dislocations. Can also result from a twisted (turned) or wretched (hard twist or pull) limb.
Recognition of fractures
- May have had a fall or blow recently
- May have pain and tenderness around the area
- Difficulty moving the limb or area
- Have deformity or swelling or bruising
- Sound of breaking bone can be heard from the injury site (in case of a fracture)
- There may be shortening, bending or twisting of the limb
- There may be signs of shock if injury is bad
- In case of an open fracture, there will be a wound and possibly a bone sticking out.
Action for closed fracture (general approach)
Steady and support the affected area by bandaging it to an unaffected part of the body, making sure that the bandage is tied to the uninjured side
For specific limbs:
Arm
Make the casualty sit
Gently support the injured arm across the chest and place padding between the arm and the chest
Place padding around the affected area \part
Immobilize the arm by using an elevation or an arm sling
Support with a broad-fold bandage around the arm and the body, avoiding the affected part.
Seek medical help
Collarbone
Gently place the arm on the injured side across the person’s chest (the finger tips should almost be resting on the other shoulder)
Put the elevation sling to support the arm then support with a broad-fold bandage around the arm and body.
Seek medical help
Leg
Lay the casualty down
Support the injured leg below and above the injury
Bring the good leg to the bad, place padding between the legs
Tie the legs together starting with under the feet and ankle, then around the knees tying the knots away from the injured leg (immobilizing the leg to prevent further damage)
Wait for medical help; do not make the casualty move the injured limb
Knee
Do not try to straighten the leg
Lay the casualty down on a blanket if possible
Place soft padding under the injured part to support it in the most comfortable position
Keep the casualty in this position until medical help arrives.
Lower Jaw
Make the casualty to sit down on a chair
Place a soft cloth or pad under the jaw and let the casualty support it him \herself.
Casualty’s head must tilt forward to allow fluids to drain from the mouth.
Seek medical help
Ribs
Sit the casualty down in the most comfortable position inclined towards the injured side
Support the arm on the injured side using an elevation sling
Seek medical help
Neck and Spine
The casualty should not move or be moved
Support the head and neck by kneeling behind the casualty’s head with your hands over the ears. If you suspect neck injuries ask helper to roll up towels, blankets or any clothing items and place them on either side of the neck.
Support throughout (no matter how long) until medical help comes
Pelvis
Lay the casualty down on his\her back
Support by placing a soft pillow below the knees
Place padding between the bony parts of the legs i.e. the knees and the ankles
Immobilize the legs by bandaging them together with folded triangular bandages: secure the feet and ankles then the knees and seek medical help
For Open Fractures:
Attend to the wound first
Wear disposable gloves and control bleeding by covering site with a clean dressing,
Place padding over and around the dressing
If a bone is sticking out, build up pads of clean cloth around the bone, until you can bandage over the pads without pressing the bone.
Then proceed as described above for the different limbs.
Please note: for all fractures NEVER move the casualty unless it is safe to do so.
NEVER force the injured part into position
For all these and more come to St John Ambulance to train as a Lifesaver our address is