fracture its final

8/14/2019 Fracture Its Final

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FRACTURE


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Mechanism of InjuryThe force that injures a bone or

joint may also cause injuries to

the surrounding soft tissues (suchas nerves and arteries), or even tobody areas distant from bone

injury site.


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Ex. A victim in an automobileaccident who is not wearing a

seatbelt might be thrustforward,


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Indirect ForceIndirect force affects one end of alimb, causing an injury to the limb

some distance away from thepoint of impact. In this case, theprevious scenario might lead to ahip fracture or dislocation.


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Ex. Woman thrown from ahorse may land on twooutstretched hands. One armsustains a fractures wrist, andthe clavicle (collarbone) at the

end of the other arm isfractured.


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Ex. A child running across a field maystep into a hole. The foot is rammedsnugly into the hole and stays stationarywhile the rest of the lower leg twist and isfractured. Bone and joint injuries fromtwisting force commonly occur in footballor skiing accidents.


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Childrens bones

are much moreflexible thanthose of

adults, andfractures areoften

incomplete(gree ns tickfra ctures )


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The most important first aid care ismobilization of any suspected fracture orextensive soft-tissue injury. You should

immobilize before you apply ice or elevatethe injured part; doing so:

Minimizes damage to soft tissue, muscle,

or bone sheathing that may becomewedged between fracture fragments.Prevents a closed fracture from becomingan open one.

Prevents more damage to surroundingnerves, blood vessels, and other tissuesfrom the broken bone ends.


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vMinimizes bleeding and swelling

vDiminishes pain, which helps control

shock

vPrevents restriction of blood flow by bone

ends compressing blood vessels


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Any fracture to the spine is always a firstpriority for treatment. Treat the fractures as

follows:Support the injured part; gently remove

clothing and jewelry around the injury sitewithout moving the injured area.


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Cover any open wounds with sterile dressingsto control bleeding and prevent infection.

Gently wipe away dirt and debris, and irrigatethe exposed bone end with clean water.


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Assess blood flow and nerve function; this step isessential, since the most serious complication offracture is reduced blood flow and subsequent

tissue death. Check the distal pulse of thesuspected fracture site- the wrist for an armfracture, the ankle for leg fracture. Lack of a pulseindicates a direct medical emergency. Gentlymanipulate the limb once in an attempt to restore

circulation. Also check the capillary refill bypressing on the nailbeds. As you let go, the nailswill turn from white to pink, if normal. To assessnerve function, gently squeeze the victims fingersor toes; if the victim cant feel squeeze, there maybe nerve damage.


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If there is severe deformity orangulation, apply minimaltraction- a firm, steady pull tobring the limb into more normalalignment- except for crushinginjuries; immobilize the jointsabove and below the fracture.When applying traction, grasp anarm with one hand on either ofthe injury, and pull injury and

steadily downward. Do notattempt to push bone endsback underneath the skin, andavoid excessive pressure on the


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General rule:Never st raig ht en a wr ist , elb ow, kn ee orsh ou lder . Except for the wrist and shoulder,

make one attempt to straighten closed,

angulated fractures if no dist al pulse isfoun d. If pain, resistance, or crepitus increases,

stop. Wrap from the distal end of the splint to

the proximal end; splint firmly enough to

immobilize but not tightly enough to stop blood

circulation.


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Check the distal pulses and capillary refill after the splint

is in place to make sure circulation is still adequate

Use cold compress and elevation to relieve pain and

reduce swelling.


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