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Fractures
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Fractures are classified as exposed and closed. In exposed fractures the broken bone pierces the surrounding skin. Exposed fractures bring about additional risks, due to blood loss and the danger of infection. However, a closed fracture can also provoke dangerous internal hemorrhages. These are generally noticed by the swelling and hardening of the affected extremity. The blood loss can lead to shock, which must be treated in the corresponding manner.
Measures
- First, the wound must be cured and the hemorrhage stopped.
- If the fractured extremity is in unnatural position, it must be put in its original position to prevent pain. In order to do this, the bone ends must be separated at the fracture area by pulling them in opposite directions and, while keeping this tension, straighten the extremity. In exposed fractures, the displaced bone is put back under the skin. To avoid infection the injury and its surroundings must be disinfected before straightening the extremity. If a resistance is detected the procedure must be immediately stopped. If it is an articulation fracture, there could be additional damages, so articulations should be straighten only if there are strangled nerves or blood vessels. This is noticed by the lack of irrigation and alterations in sensitivity. If this is not the case, the articulation should be splinted as is, in its current position, and then evacuate the patient with utmost care.
- Locally cooling the affected area further reduces the irrigation of the damaged vessels.
- Next, the affected extremity must be immobilized with splints and raised.
- Evacuate the injured person.
Closed fracture
The exposed fracture area is, in most cases, uncovered and so it is visible. A closed fracture, on the other hand, is more difficult to distinguish from a sprain. If the fracture is not evident, not even through a perceptible careful palpation, then the following test can be applied:
Sure indications
- Parts of the bone are visible through the open wound.
- Abnormal position of the extremity.
- Abnormal motion of the extremity.
- Bones friction.
Unsure indications
- Painful sensation
- Swelling
- Bleeding
- Limited movements
Splints
Even the slightest movements cause severe pain in a fractured extremity. Splints guarantee the immobility of the injured extremity during evacuation. As material to make splints are parts of the equipment, like walking sticks, pad mattresses, backpack aluminum frameworks, and also natural materials like branches.
Applying splints
- Collect al the necessary material to make the splints.
- In order to reduce unnecessary pain, the material must be dimensioned to fit the affected extremity.
- Pad the extremity with soft material (clothes).
- Splints must be applied tightly, but without impeding blood circulation, which must be controlled every 15 minutes. To fix the splints you can use broadcloths or, as an alternative, pieces of clothes.
- In low temperatures the affected extremity must be protected from the cold.
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Splints for leg fractures
In leg fractures, muscular contractions can cause additional painful damages, by the perforation of tissue provoked by the pointy ends of the broken bones. This is why the splints must be put while continuously pulling the fractured leg in a direction opposite the body. This measure cannot be applied to articulation fractures. |
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Splints for arm fractures
The arm must be inserted into a hunk of padded mattress, previously cut to measure and immobilized, supporting it with a broadcloth or loop. |
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