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$Title{Emergency First Aid:  FRACTURES, DISLOCATIONS, SPRAINS, AND STRAINS}
$Subtitle{}
$Author{
Editors of Consumer Guide
Siegfried, Donna M}
$Subject{FRACTURES DISLOCATIONS SPRAINS STRAINS Fracture break crack bone
accident accidents fall falls falling blow blows dislocation injury injuries
joints ligament ligaments joint bones displaced sprain stretch stretched torn
tendon tendons blood vessels strain muscle muscles snap snapping sound breaks
protruding protrude protrudes deformities deformity grating movement pain
tender tenderness moving difficulty swelling discoloration stiff stiffness
Shoulder collarbone elbow Finger Arm wrist hand Pelvis Knee Leg ankle ankle
Foot Toe}
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Bent Elbow:  Step 3*0029305.tif
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Straight Elbow:  Step 2c*0029308.tif
Finger:  Step 3*0029309.tif
Finger:  Step 4*0029310.tif
Arm, Wrist, and Hand:  Step 1*0029311.tif
Arm, Wrist, and Hand:  Step 3*0029312.tif
Arm, Wrist, and Hand:  Step 4*0029313.tif
Pelvis:  Step 3*0029314.tif
Pelvis:  Step 4*0029315.tif
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Leg and Ankle:  Step 1*0029317.tif
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The New Parents' Question & Answer Book


FRACTURES, DISLOCATIONS, SPRAINS, AND STRAINS


CAUSES

Fracture:  A fracture is a break or a crack in a bone.  A fracture can be
caused by an accident, a fall, or a blow.

Dislocation:  A dislocation is an injury to a joint and the ligaments around
the joint, in which the ends of the bones are displaced from their normal
positions.  A dislocation can be caused by an accident, a fall, or a blow.

Sprain:  A sprain refers to stretched or torn tendons, ligaments, and blood
vessels around a joint.  A sprain can be caused by an accident, a fall, or a
blow.

Strain:  A muscle strain refers to a stretched or torn muscle.  Strains can be
caused by excessive physical effort or, in the case of back muscles, improper
lifting technique.


SIGNS AND SYMPTOMS

Fractures and dislocations:

  -  a snapping sound as the bone breaks (fracture)
  -  bone protruding from the skin
  -  detectable deformity of a bone
  -  abnormal or unnatural movement of the bone
  -  grating sensation during movement
  -  pain; tenderness to touch
  -  difficulty in moving the affected part
  -  swelling; discoloration

Sprain:

  -  pain in joint area; tenderness to touch
  -  swelling; discoloration

Strain:

  -  pain
  -  stiffness
  -  swelling


EMERGENCY TREATMENT

Fractures:

1. SEEK MEDICAL ATTENTION IMMEDIATELY.  Call 911 or operator, or transport
   victim to emergency room after immobilizing affected area.  DO NOT attempt
   to transport child with suspected head, back, or neck injury; wait for
   ambulance.
2. Suspect back or neck injury if child is unconscious or has head injury,
   neck pain, or tingling in arms and legs.  If neck or back injury suspected,
   DO NOT move child unless necessary to save child's life.  See BACK AND NECK
   INJURIES (previous section).
3. Straighten ONLY severely angled fractures of long bones in arm or leg.
   Immobilize other bones in position found.  DO NOT try to push protruding
   bone back into body.  DO NOT let child move affected area.
4. Control any bleeding through direct pressure, but DO NOT elevate affected
   area.  See BLEEDING (previous section).
5. If bone is protruding, cover with clean cloth once bleeding is controlled.
6. Observe for shock.  See SHOCK (later section).
7. DO NOT give child anything to eat or drink.
8. Immobilize injured area (see Immobilizing Fractured Bones, later in this
   section) and, if no open wound present, apply ice pack wrapped in clean
   cloth.

Dislocations:

     It is sometimes difficult to tell the difference between a dislocation
and a fracture until an X ray has been performed.  Therefore, treat a
suspected dislocation as a fracture.

1. SEEK MEDICAL ATTENTION IMMEDIATELY.  Call 911 or operator, or transport
   victim to emergency room after immobilizing affected area.  DO NOT attempt
   to transport child with suspected head, back, or neck injury; wait for
   ambulance.
2. Suspect back or neck injury if child is unconscious or has head injury,
   neck pain, or tingling in arms and legs.  If neck or back injury suspected,
   DO NOT move child unless necessary to save child's life.  See BACK AND NECK
   INJURIES (previous section).
3. Straighten ONLY severely angled long bones in arm or leg.  Immobilize
   other bones in position found.  DO NOT try to push protruding bone back
   into body.  DO NOT let child move affected area.
4. Control any bleeding through direct pressure, but DO NOT elevate affected
   area.  See BLEEDING (previous section).
5. If bone is protruding, cover with clean cloth once bleeding is controlled.
6. Observe for shock.  See SHOCK (later section).
7. DO NOT give child anything to eat or drink.
8. Immobilize injured area (see Immobilizing Fractured Bones, later in this
   section) and, if no open wound present, apply ice pack wrapped in clean
   cloth.

Sprains and Strains:

1. If you are not sure if injury is a sprain or a fracture, treat injury as a
   fracture.
2. If injury occurs during physical activity, have child stop activity
   immediately and rest affected area.
3. Apply cold compress or ice pack wrapped in cloth to affected area.
4. Elevate affected area.
5. If pain and swelling continue for more than 2 days, consult doctor.


Immobilizing Fractured Bones:

Shoulder and collarbone:

1. Place child's forearm at right angle across chest, with hand raised above
   elbow level.
2. Apply sling, and tie sling at back of child's neck.
3. Bind arm to child's body by placing towel or cloth over sling and around
   upper arm and chest; tie under child's opposite arm.
4. Check fingers often.  If fingers turn blue or swell, loosen towel or
   cloth.

Bent elbow:

1. DO NOT straighten elbow.
2. Splint arm in position found:
   a) Use board, rolled newspaper or magazines, broomstick, or rolled blanket
      for splint.
   b) Wrap splint in cloth, towels, or blanket for padding.
   c) Bind splint to arm above and below elbow using neckties, cloth, belts,
      or rope.
3. Place forearm in sling, if possible, with hand raised above elbow level;
   tie sling at back of child's neck.
4. Bind arm to child's body by placing towel or cloth over sling and around
   upper arm and chest.  Tie towel or cloth under child's opposite arm.
5. Check fingers often.  If fingers turn blue or swell, loosen towel or
   cloth.

Straight elbow:

1. DO NOT bend elbow.
2. Apply padded splint extending from armpit to hand:
   a) Use board, rolled newspaper or magazines, broomstick, or rolled blanket
      for splint.
   b) Wrap splint in cloth, towels, or blanket for padding.
   c) Bind splint to arm above and below elbow using neckties, cloth, belts,
      or rope.
3. Check fingers often.  If fingers turn blue or swell, loosen binding.

Finger:

1. DO NOT straighten finger.
2. Remove rings or other jewelry from injured finger.
3. Apply splint to finger in position found:
   a) Use stick, unsharpened pencil, or tongue depressor for splint.
   b) Wrap splint in gauze or cloth for padding.
4. Tie splint to finger above and below break using strips of cloth.

Arm, wrist, and hand:

1. Place padded splint under lower arm and hand:
   a) Use board, rolled newspaper or magazines, broomstick, or rolled blanket
      for splint.
   b) Wrap splint in cloth, towels, or blanket for padding.
   c) Bind splint to arm using neckties, cloth, belts, or rope.  DO NOT bind
      directly over break.
2. Check fingers often.  If fingers turn blue or swell, loosen binding.
3. Place splinted arm in sling, with hand above elbow level.
4. Bind arm to child's body by wrapping towel or cloth over sling and around
   upper arm and chest; tie towel or cloth under child's opposite arm.

Pelvis:

1. Lay child down on rigid support, such as ironing board, table leaf, or
   board.
2. Place thick padding between child's thighs
3. Gently wrap pelvic area with cloth or bandage.
4. Tie child to support with sheets, cloth, or belts placed across child's
   chest, thighs, and ankles.  DO NOT bind directly over pelvis.

Knee:

1. Splint knee in position found.  If knee is straight, place padded splint,
   extending from heel to buttocks, under child's leg.  Use extra padding
   under ankle and knee.  If knee is bent, place splint on side of leg:
   a) Use board, broomstick, rolled newspaper, or rolled blanket for splint.
   b) Wrap splint in cloth, towels, or blanket for padding.
   c) Bind splint to leg at thigh and lower leg.  DO NOT tie over kneecap.
2. Check toes often.  If toes turn blue or swell, loosen bindings.

Leg and ankle:

1. Immobilize leg and ankle with padded splints placed on sides of leg.
   Splints should extend from below heel to above knee:
   a) Use board, rolled newspaper or magazines, broomstick, or rolled blanket
      for splint.
   b) Wrap splint in cloth, towels, or blanket for padding.
   c) Tie splints together in 4 or 5 places using neckties, belts, cloth, or
      rope.  DO NOT tie directly over break.
2. If splint is not available, place padding, such as folded blanket, between
   legs.  Then, tie legs together.  DO NOT tie directly over break.
3. Check toes often.  If toes turn blue or swell, loosen bindings.

Foot and Toe:

1. Remove shoe, even if you must cut it away.
2. Wrap pillow, towels, or blanket around foot as a splint.  Be careful not
   to bend foot or toe.
3. Tie padding firmly around foot.
4. Check unbroken toes often.  If toes turn blue or swell, loosen bindings.