Fractures, Sprains and Dislocations PDF

# Fractures, Entorses et Luxations ## Fractures ### Definition A fracture is a complete or incomplete break in the bone or cartilage (crack or break). It is accompanied by more or less serious injuries to the surrounding soft tissues, particularly blood vessels. ### Types of Fracture * **Closed...

# Fractures, Entorses et Luxations ## Fractures ### Definition A fracture is a complete or incomplete break in the bone or cartilage (crack or break). It is accompanied by more or less serious injuries to the surrounding soft tissues, particularly blood vessels. ### Types of Fracture * **Closed Fracture:** This is a fracture with or without displacement (Fig. 1. and 2.) where the skin remains intact. A hematoma and swelling are common. * **Open Fracture:** This fracture presents a wound that can be caused by the impact (external) or by the bone itself. (Fig. 3.). Because this type of wound carries a risk of infection, it must be protected with clean dressings. ### Clinical Signs The clinical signs of fractures include one or more of the following elements: * Pain or localized sensitivity * Possibility of shortening, rotation or angulation * Abnormal mobility * Localized swelling (it may appear almost immediately or only a few hours to a day after the accident) * Functional impairment ### Localization #### 4.1. Fracture of the skull: In addition to the bone break, it can also cause either a concussion of the brain due to the impact against the skull, or a compression of the brain by bleeding that forms a pocket against the brain (intracranial hematoma). In both cases, we speak of a head injury. It is essential to look for these signs, which may be: * A wound or bump on the head * Headache, nausea or vomiting that appear after the accident * External bleeding from the nose or ears, a clear fluid discharge, from the nose or ears * Behavioral changes * Consciousness disorders * One or two dilated pupils **Conduct to follow:** * Keep the victim resting with the head flat on their back if they are conscious, or in the recovery position (PLS) in case of nausea, vomiting, loss of consciousness or drowsiness; * Call for help; * Carefully monitor the victim's vital signs. #### 4. 2. Spinal Injuries: These are possible during a violent trauma, a blow to the back, a fall on the feet or the head. Signs of a spinal fracture can be: * Pain localized at the site of the impact or injury * Sensory disturbances: tingling, pain, a feeling of electric shocks, sensations of hot and cold * Motor disturbances: inability to perform certain movements affecting the lower limbs or all limbs. **Conduct to follow:** * Avoid any inappropriate movement of the victim * Keep the victim's head still * If the victim is unconscious, place them in the recovery position (PLS) with caution * Call for help #### 4. 3. Chest Injuries: A blow to the chest can cause a fracture of one or more ribs, or of the sternum. The signs to look for are: * Pain on palpation * Pain on inspiration, expiration or when coughing * Respiratory distress (or circulatory distress in a second time) * Coughing up blood **Conduct to follow:** * Place the victim in a semi-seated position. * Handle them as little as possible * Call for help; * Carefully monitor the victim. #### 4. 4. Limb Injuries: A limb fracture can be caused by a direct impact, but also by an indirect impact. It is therefore possible for the bone to break not at the point of impact, but at the weakest point of the bone. Signs can include: * Often, the victim hears a "crack" at the time of the accident * Variable pain at the fracture site * Functional impairment (pain makes movement difficult or impossible) * Weak or absent radial pulse while the carotid pulse is easily felt. **Conduct to follow:** * Immobilize the fracture by blocking the joint above and below * Call for help; * Monitor the victim. Whatever the type of fracture, remain by the injured person's side, check their consciousness, breathing, and pulse until help arrives. ## Entorses ### Definition Entorses are caused by violent stretching of the ligaments following a forced movement of a joint. This involves stretching or tearing the ligaments. The most frequent entorses are those affecting the ankle and the knee. ### Classification of Severity According to the severity of the injury, entorses are classified into three groups: * **Mild Sprain**: A stretching of the ligaments, often called a sprain. At this stage, the joint is still functional. (Fig. 1). * **Moderate Sprain**: A stretching of the ligaments accompanied by a partial tear (not torn through). * **Severe Sprain**: A complete tear of the ligaments, possibly with a bone avulsion. (Fig. 2). ### Symptoms * **Mild Sprain:** * Pain in the joint. Movements are possible. * Swelling of the joint in the hours or days following. * No bruising * **Moderate Sprain:** * Pain in the joint. Movements are limited, but possible. * Swelling of the joint within four hours. * Bruising * **Severe Sprain:** * A popping or tearing sensation * Intense pain, difficulty moving the joint. * Rapid swelling, within a few minutes, in addition to bruising.. ### Conduct to follow In an emergency, it is essential to immobilize the injured limb to prevent worsening. Do not attempt to stretch or move the affected limb before help arrives. Applying a cold compress can be used (a bag of ice). Place a cloth between the skin and the ice to prevent burns. This reduces pain and swelling. Take the victim, if possible, to the nearest medical facility, helping them to walk without putting weight on the injured limb. If evacuation is difficult or the victim cannot stand up, call for help. ## Luxations ### Definition Luxations are displacements of the articular surfaces of the bones of a joint. The most frequent luxations are those affecting the shoulders, elbows, knees, jaws, and fingers. ### Symptoms They are characterized by severe pain, inability to move the affected joint, and a deformity or abnormal posture of the affected limb. ### Conduct to follow * Immobilize the injured joint in the least painful position using a sling or a sweater. * Do not attempt to reposition the joint yourself. * Call for help. If the person can walk without difficulty (finger luxation and often shoulder luxation) accompany them to the nearest medical facility.