Bone and Joint Injuries

Variety of injuries can occur to bones and joints Frequently occur in accidents and falls Injuries may occur by themselves or together Examples:

Fractures Dislocations Sprains Strains

Bone and Joint Injuries

Fracture A break in the bone 2 types

Closed or simple fracture

Injury to the bone No external or open wound on the skin Break in the bone Open wound on the skin

Open or compound fracture

Bone and Joint Injuries

Signs and symptoms vary and are not all present in every victim

Deformities Limited motion or loss of motion Pain and tenderness at fracture site Swelling and discoloration Protrusion of bone ends through the skin Victim hears a bone break or snap Victim feel a grating sensation or abnormal movement

Bone and Joint Injuries

Objectives of first aid care

Maintain respirations Treat for shock Keep the broken bone from moving with devices such as splints or slings Prevent further injury Obtain medical help for the victim

Bone and Joint Injuries Dislocation

Dislocation Occurs when the end of a bone is displaced from a joint or moves out of its normal position within a joint Frequently accompanied by a tearing or stretching of ligaments, muscles or other soft tissue

Bone and Joint Injuries Dislocation

Signs and symptoms

Deformity of joint or limb Limited or abnormal movement Swelling and discoloration Pain and tenderness Shortening or lengthening of affected limb

Bone and Joint Injuries Dislocation

First aid care

Basically the same as first aid for fractures Make no attempt to reduce the dislocation or replace the bone in the joint Immobilize the affected part in the position in which it is found by using splints and/or slings Avoid any movement of part because movement can lead to additional injury to nerves, blood vessels and other tissues in the area Obtain medical help immediately

Bone and Joint Injuries Sprain

Sprain Injury to the tissues surrounding a joint

Common sites for sprains are the ankles and wrists Signs and symptoms

Usually occurs when part is forced beyond its normal range of motion Ligaments, tendons and other issues are stretched or torn

Swelling, pain and discoloration Impaired motion at times

Bone and Joint Injuries Sprain

Sprains frequently resemble fractures or dislocations and injury should be treated as a fracture if there is any doubt First aid for sprain

Application of cold to reduce swelling and pain Elevation of the affected part Rest and limited or no movement of the affected part Elastic bandage is used at times to provide support Obtain medical help if swelling is severe or if there is any question of a fracture

Bone and Joint Injuries Strain

Strain Overstretching of a muscle

Caused by overexertion or by lifting Frequent site is the Back Sudden pain Swelling And/or bruising

Signs and symptoms

Bone and Joint Injuries Strain

First aid treatment

Rest the muscle affected while providing support Bedrest with a backboard under the mattress is recommended for a strained back Cold applications initially to reduce swelling Warm wet applications applied later because warmth relaxes the muscles Obtain medical help for severe strains and all back injuries

Splints
Splints Devices that can be used to immobilize injured parts when fractures, dislocations and other similar injuries are present or suspected Many commercial splints are available

Inflatable or air splints Padded boards Traction splints (used for fractured femur)

Splints

Splints can be made from cardboard, newspapers, pillows, boards and other similar materials Splints should be long enough to immobilize the joint above and below the injured area

Prevent movement in these joints to hold injured bone or area in position Helps prevent further injury

Splints

Splints should be padded

Make sure padding present at bony areas and site of injury Cloths, thick dressings, towels, etc can be used as pads

Splints should be tied in place with strips of cloth, roller gauze or triangular bandages folded into bands or strips Splints must be applied so they do not apply pressure directly over the site of injury

Splints

If open wound is present, use a sterile dressing to apply pressure and control the bleeding

Wear gloves or use a protective barrier while controlling bleeding to avoid contamination by blood Leave dressing in place and apply splints in such a way that they do not put pressure on wound

Never make any attempt to replace broken bones or reduce a fracture or dislocation Do not move the victim splint where you find him/her

Splints

Observe precautions while using inflatable splints

Available in various sizes and shapes for different parts of the arms and legs Avoid unnecessary movement while splint is being positioned Once splint is positioned, air pressure is used to inflate the splint Avoid over-inflating the air splint

Test for proper inflation by applying slight pressure with thumb to make an indentation mark

Splints

Traction splints provide a pulling or traction effect on the injured bone

Frequently used for fractures of the femur Only persons specially trained for application should apply traction splints

Splints

Check circulation after splints are applied

Make sure the splints are not too tight Check skin temperature to be sure it is warm Check color: pale or blue indicates poor circulation Note swelling or edema from poor circulation Numbness or tingling shows poor circulation Check pulse site below splint area Immediately loosen ties holding splints if any signs of impaired circulation are noted

Slings
Slings Available in different forms

Commercial slings usually have a series of straps that extend around neck and/or thoracic region Triangular bandages often used for sling May be used when casts are in place Used to provide immobility when fracture of arm or shoulder suspected

Used to support the arm, hand, forearm and shoulder

Position sling so hand is higher than elbow to promote circulation, prevent swelling or edema and decrease pain

Slings

Check circulation of limb and state of its nerve supply frequently when sling is in place

Check skin temperature; should be warm Check color; pale or blue indicates poor circulation Note swelling or edema Check amount of pain, tingling and numbness Press nailbeds slightly to check circulation

When pressed, nailbeds blanch or turn white If circulation is good, pink color should return immediately after pressure is released

Slings

Use extreme care to move injured limb as little as possible while sling is being applied

Tie knots of triangular bandage to either side of spinal column and make sure knots do not press against a bone Place gauze or padding under the knot of the sling to protect the skin Apply bandage around thoracic region on top of sling to hold arm against body when should injury present

Movement could result in further injury if fracture present At times, victim can hold injured limb in position while sling is slipped into place

Neck or Spine Injury

Neck or spine injury Most dangerous types of injuries to bones and joints Movement can lead to permanent damage resulting in paralysis Avoid any movement of this victim if at all possible Wait until backboard and adequate help for transfer is available

Bone and Joint Injuries

Other principals of care Be alert to signs of shock and treat as needed Bone and joint injuries usually involve a great deal of anxiety, pain and discomfort

Constantly reassure the victim Encourage the victim to relax Position the victim as comfortably as possible Advise victim that medical help is on the way Direct first aid measures at relieving pain

Bone and Joint Injuries

Obtain medical help for all victims of bone and/or joint injuries

Only definite diagnosis of a closed fracture is an X-ray of the area If a fracture and/or dislocation is suspected, treat as though one is present