OSH 1252

FIRST AID AND EMERGENCY PLANNING

CHAPTER 5:
MUSCULOSKELETAL
INJURIES
 LEARNING OUTCOMES
At the end of the topics, students should be able
to:
• Define fracture, sprain and dislocation
• Differentiate between open and closed
fractures
• List the signs and symptoms of a fracture
• Outline the first aid treatment for fracture
SPRAIN
 SPRAIN

• Sprain is a stretching and/or a partial or

complete tearing of a ligament at a joint.
• Sprain may vary in severity from partial
tearing of a single ligament to complete
disruption of multiple ligaments of a joint.
 SIGN & SYMPTOM
The signs and symptoms of sprains are similar at all
movable joints:

• The history is usually one of a joint being twisted or

stretched beyond its normal range of motion.
• Swelling can start immediately after injury and is
always accompanied by pain.
• There is point tenderness at ligament attachments or
along the length of the ligament.
• Pain is caused by movement in the direction that
stretches the injured ligaments.
 Sprain
 Injury to the ligaments

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DISLOCATION
 DISLOCATION
A dislocation is a displacement of one or more
bones so that the joint surfaces are no longer in
contact.
 SIGN & SYMPTOM
The usual signs and symptoms of a dislocation
are essentially the same as of a fracture:

• Severe pain, especially about the ligaments

• Obvious gross deformity and irregularity
• A complete or near-complete inability to move the
affected joint
• The joint is often locked in a deformed position
 Dislocation

 Injury to the joints

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FRACTURE
 FRACTURE
• A fracture is defined as any break in the
continuity of a bone that is not present
naturally.
• It is usually due to the application of external
force, but can occur spontaneously in the
presence of some underlying disease, such as
cancer.
 Fracture
 Injury to the bones

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 CLASSIFICATION OF
FRACTURES
• Closed (Simple): where there is no open wound
leading to the fracture site.
• Open (Compound): where there is a wound
associated with the fracture site. This is more
serious because there can be more significant
blood loss and a greater chance of infection. Treat
compound fractures as for closed fracture s after
covering the fracture with a sterile dressing and
using local pressure to arrest bleeding.
 Injuries to Bones
• What is a bone fracture?
– Crack or break in the bone
• Closed or open

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 Examples of Fractures

Closed fracture of the

humerus.

Open fracture of the

fibula.

Closed fracture (observe

the deformity).
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 Immobilizing a Bone Injury

An open tibia fracture.

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 Immobilizing a Bone Injury

Support and stabilize the limb above and below the injury,
control bleeding, locate a pulse, and apply a splint.

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 SIGN & SYMPTOM
The signs and symptoms of fractures are:

• pain
• a noise, such as the snapping of bone, may have been heard when the injury
occurred
• deformity
• tenderness, especially point tenderness (usually evident on both sides of the
injured bone in the case of a fracture)
• crepitus (the grating of the bone ends)
• local swelling
• discolouration due to bleeding
• loss, or reduction, of function
• exposed fragments or wounds
 PRINCIPLES OF MANAGEMENT

In managing fractures, first aider should examine for:

• nerve function, by checking for sensation and movement

below the injury before commencing treatment
• vascular function, by checking distal pulse and capillary
return below the injury before commencing treatment;
• signs of hypovolaemic shock, especially with open
fractures (remember however that major closed
fractures such as pelvic or femoral can also cause
hypovolaemic shock)
• reassure the casualty
• treat any bleeding
• treat pain
• support the injured part by applying a sling or
splint, or both
• re-check for nerve and vascular function after
treatment
 SPLINTING
A splint is a mechanism to alleviate pain and may
be a device to provide rigid immobilisation (e.g. a
box or air splint) or to apply traction.
Splinting acts to prevent:

• further damage to muscles, nerves, and blood vessels by

the fractured bone ends or disrupted joints
• laceration of skin by the bone ends
• restriction of blood flow due to pressure of bone ends
on blood vessels
• bleeding into tissue around the fracture due to unstable
bone ends
• paralysis due to spinal cord injury from fractured or
dislocated vertebrae
• Splints should immobilise the joints above and
below (for a fracture), or the bones above and
below (for a dislocation).
• Splints should be padded to prevent pressure on
nerves and blood vessels. Before and after applying
a splint, always check distal pulses, circulation and
sensation.
• If response changes as a result of treatment, tissue
damage may occur; the splint should then be
removed and reapplied if practicable, otherwise
rapid transport to medical care is required.
 Splinting
• General rules for splinting
– Perform only when trained to do so.
– Expose injured site and cover open wounds.
– Do not cause more pain or injury.
– Immobilize joints above and below the injury site.
– Splint the injury in position found, prior to moving the
patient.
– Pad the splint for comfort.
– Treat the patient for shock, if present.

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 Splinting a Long Bone
– Manually stabilize the bone.
– Assess pulse, sensory, and motor functions
below the injury site.

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 Splinting a Long Bone
– Measure the splint.
– Splint should immobilize bone and joints above and below
the injury site.

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 Splinting a Long Bone

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 Splinting a Joint
– Manually stabilize the bone.
– Assess pulse, sensory, and
motor functions below the
injury site.
– Immobilize injury in the
position found.

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 Splinting a Joint
– Measure the splint.
– Splint should immobilize
the bones above and
below the joint

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THANK YOU