Fractures: Types, First Aid

Fractures

• Defined as a break or crack in the continuity of a bone.
• Causes include motor vehicle accidents, falls, and recreational or sports activities.
• Signs and symptoms include pain, swelling, tenderness, difficulty moving the injured part, the sensation of bones rubbing, abnormal movement, differences in shape/length compared to the opposite side, deformities, and discoloration.

Types of Fractures

• Closed Fracture: A broken bone with no associated wound; first aid may only require splinting.
• Open Fracture: A broken bone with an associated wound that allows contaminants to enter.
• Open fractures pose a higher risk of severe bleeding and infection, they require more frequent monitoring.
• Displaced Fracture: The fractured bone is no longer aligned.
• Non-Displaced Fracture: The fractured bone remains aligned.

First Aid for Open Fractures

• Avoid drawing exposed bones back into the tissue.
• Do not irrigate the wound.
• Cover the wound.
• Splint the fracture without disturbing the wound.
• Place a moist 4" x 4" dressing over the bone end to prevent drying.
• Elevate the injury.

Dislocations

• It is an injury to the ligaments around a joint, leading to bone separation from its normal position.
• Signs are similar to fractures, so treat suspected dislocations like fractures.
• Never attempt to relocate a suspected dislocation; immobilize the joint instead.

Sprains

• It involves the stretching or tearing of ligaments at a joint.
• Usually caused by overextension of the joint.
• Signs of a sprain include tenderness, swelling, bruising, and restricted use
• First aid includes cooling with ice water, immobilization, and elevation.

Strains

• It involves the stretching and/or tearing of muscles or tendons
• Most often affects muscles in the neck, back, thigh, or calf.
• Difficult to distinguish from sprains or fractures; if uncertain, treat as a fracture.

Splinting

• Most common procedure for immobilizing an injury
• Cardboard often is used for "makeshift" splints; other materials can be used like:
• Soft materials: Towels, blankets, or pillows, tied with bandaging materials or soft cloths
• Rigid materials: Boards, metal strips, or folded magazines can be used
• Anatomical Splints securing a fractured bone to an adjacent un-fractured bone is another splinting method.
• Anatomical splints are usually reserved for fingers and toes but, in an emergency, legs may also be splinted together.

Principles for Splinting

• Support the injured area above and below the injury site, including the joints.
• Splint the injury in the position found, if possible.
• Do not attempt to realign bones or joints.
• Check for proper circulation (warmth, feeling, color) after splinting.
• Immobilize above and below the injury.

Spinal Cord Injury - When to Suspect

• Age greater than 65 years
• Motor vehicle, motorized cycle, or bicycle crash.
• Fall from greater than standing height.
• Tingling in the extremities.
• Pain or tenderness in the neck or back.
• Sensory deficit or muscle weakness involving the torso or upper extremities.
• Not fully alert or is intoxicated.
• Other painful injuries, especially of the head and neck.
• Children 2 years of age or older with evidence of head or neck trauma.
• Falls(especially from a height or diving), sports, and assaults are frequent causes.
• Injury to the cervical spine may result in further (secondary) spinal cord injury.
• Manipulation or movement can result in permanent neurological damage, including quadriplegia.
• Spinal motion restriction should be maintained.
• Stabilize the head manually to minimize head, neck, and spine movement
• Immobilization devices are needed in special circumstances when immediate extrication is needed.
• First aid providers should not use immobilization devices unless properly trained.