Bone and joint injuries

A fracture is a break or crack in the continuity of bone

Types of Fracture

• Complete fracture- fracture involves a break across the entire cross-section of the bone and is frequently displaced (removed from normal position).
• Incomplete fracture - the break occurs through only part of the cross-section of the bone. (e.g., greenstick fracture).
• A comminuted fracture is one that produces several bone fragments.
• Closed fracture (simple fracture) is one that does not cause a break in the skin.
• Open fracture (compound, or complex, fracture) is one in which the skin or mucous membrane wound extends to the fractured bone. Can be associated with infection.

Causes of fracture: Most of the causes are motor accidents, falling accidents, pathological, recreational or sports activities.

Signs and Symptoms of Fracture

• Pain, swelling, tenderness and difficulty of moving the injured part.
• Abnormal movement in an area of the body.
• Protrusion of the broken bone ends out of the skin.
• Causality may find it difficult or impossible to move the part normally.
• Crepitus or grating sensation of broken bones due to rubbing of bone fragments against each other.
• Shortening of the affected extremity, protrusion, deformities and discoloration.

Objectives of First Aid for Fracture

• To provide all necessary first aid care.
• To keep the broken bone ends and the adjacent joints from moving.
• To give care for shock.

First Aid Principles of Fracture

• Do not move the causality unless it is necessary to avoid further injury.
• Follow the steps:
  A. Clear the airway
  B. Check for breathing
  C. Circulatory assessment (check pulse)
  
• Control bleeding in an open fracture.
• Prevent movements of injured part and the adjacent joint.
• Elevate involved extremities if possible without disturbing the suspected fracture.
• If a fragment of bone is protruding, cover the entire wound with a sterile dressing.
• Don't replace any bone fragment.
• Do not wash, or do not insert your fingers into the wound.
• Apply splint (are devices applied to the arms, legs or trunk to immobilise the injured part when a fracture is suspected) and transport immediately.
• Use arm sling for an arm fracture. N.B splints should be well padded, rigid, and long enough to go along side the joint above and below the fracture.
• Splints protect against further injury.
• They have to be wide enough to fit the limb comfortably.

Dislocation

• Dislocation Is a displacement of a bone end from the joint particularly at the shoulder, elbow, fingers or thumb usually as a result of a fall or direct blow.
• Unless proper care is given, a dislocation may occur repeatedly.

Signs and Symptoms of Dislocation

• Swelling.
• Obvious deformity.
• Pain upon movement.
• Tenderness to touch.
• Discoloration.

First Aid Measures of Dislocation

• Splint and Immobilize the affected joint.
• Apply a sling if possible.
• Elevate the affected part if a limb is involved.
• Never attempt to reduce a dislocation.
• Seek medical help.
• N.B- Never attempt to reduce a dislocation

Sprain

• Sprain Is an injury to ligament, muscle or tendon in the region of the joint as a result of sudden wrenched or torn of these structures. Commonly occurs on ankle, knee, wrist and finger.
  

Signs and Symptoms of Sprain

• Swelling.
• Tenderness.
• Pain up on motion.
• Discoloration.

It is difficult to differentiate a sprain from a closed facture without an X- Ray.

First Aid Measure:

• Rest and support the injured part.
  
• Elevate the injured part.
  
• Apply cold compress.
  
• Support with a bandage and seek medical care.
  

First Aid Measures of Sprain

• If ankle or knee is affected, advice the victim not to walk.
• Raise the affected limb to prevent swelling.
• Apply a cold, wet pad.
• Splint/bandage simply.
• If swelling and pain persist, seek further medical attention.

Strains:

• Strains are injuries to muscles resulting from over stretching.
• Commonly strains occur on the back muscles due to improper lifting technique.

First Aid Measures of Strain

• Bed rest until there is no pain.
• Application of heat, warm pads.
• Use of a board under the mattress for firm support.
• Seek medical care for severe back strains.