1) Carefully remove the injured part of the body from clothing. 2) Do not attempt to straighten or set a broken bone or dislocated joint. 3) Before splinting, cover open wounds clean bandages. 4) Always try to find a helper. One person should support the injured body part while another person applies the splint. Working together helps avoid additional injury. 5) Apply a splint to the bone so that it covers the joints above and below the injury. 6) When applying a splint to a joint, grasp the joint above and below the injury. For example, when applying a splint to the knee, you need to apply it to the hip and ankle joints. 7) If possible, splint both sides of the injured limb to prevent it from moving. 8) Place a pad (something soft, such as a towel or sheet) between the splint and the skin of the injured body part. This will prevent undue pressure on her. 9) Place pads under the knee, wrist, other natural depressions and around any injuries. 10) Do not tie the splint too tightly - this may cut off circulation and cause pain.
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A fracture is a break in the integrity of a bone. Fractures can be complete or incomplete, open or closed. A fracture that occurs from pressure or flattening is called a compression fracture. Most fractures are accompanied by displacement of fragments. This is explained by the fact that muscles, contracting after an injury, pull bone fragments and displace them to the side. In addition, the direction of the impact force also contributes to the displacement of fragments.
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With a fracture, the patient complains of severe pain, increasing with any movement and load on the limb, changes in the position and shape of the limb, inability to use it. You can also note the appearance of swelling and bruising in the area of the fracture, shortening of the limb and its abnormal mobility. When palpating the fracture site, the patient complains of severe pain; it is often possible to identify the uneven edges of bone fragments and a crunching sound (crepitus) when lightly pressed.
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The person providing assistance must act very carefully so as not to cause unnecessary pain to the victim and further displace bone fragments. At open fracture Sometimes a fragment of bone can be seen in the wound, which indicates an obvious fracture. First aid for fractures is critical to further treatment sick.
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Basic first aid for bone fractures is as follows: ensuring the immobility of the bone in the area of the fracture (immobilization); help with fainting, shock and collapse; rapid hospitalization to a medical institution.
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Immobilization. Fixation (immobilization) of bone fragments is necessary in order to prevent displacement of fragments, reduce the likelihood of injury to muscle bones, blood vessels, and nerves, and reduce the risk of painful shock. Such immobilization is achieved by applying splints from any auxiliary material (sticks, rods, boards, skis, cardboard, bundles of straw, etc.). The splint must be applied carefully so as not to cause unnecessary pain to the patient and to prevent displacement of the fragments. In no case is it recommended to try to correct the position of the damaged bone or compare the fragments yourself. Moreover, you should not push protruding fragments into the depths of the wound.
Man giving first first aid can: Assess the severity of the victim’s condition and the location of the damage. If there is bleeding, stop it. Determine whether the victim can be moved before qualified personnel arrive medical personnel. It is not recommended to carry or move a patient with spinal injuries or multiple fractures. In case of isolated injury, immobilize the damaged area and apply a splint. A splint can be any object that will prevent movement in the damaged limb (grabbing the joints above and below the fracture site). If there are no contraindications to movement, the victim is transported to medical institution. If access for medical personnel is difficult or impossible and there are contraindications to moving the victim, ensure as complete immobilization of the damaged areas as possible, after which a stretcher with a solid base is used, to which the victim is securely fixed.
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Bone fracture is a complete or partial disruption of the integrity of the bone under a load exceeding the strength of the injured skeletal area. Fractures can occur either as a result of trauma or as a result of various diseases, accompanied by changes in strength characteristics bone tissue.
Slide 3
Classification of fractures
- Due to the occurrence
- According to the severity of the lesion
- By complications
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Due to the occurrence
- Traumatic - caused by external influence.
- Pathological - occurring with minimal external influence due to destruction of the bone by some means pathological process(for example, tuberculosis, tumor or others).
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According to the severity of the lesion
- Full.
- Without displacement (for example, under the periosteum).
- With displacement of fragments.
- Incomplete - cracks and breaks.
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According to the shape and direction of the fracture
- Transverse - the fracture line is conditionally perpendicular to the axis tubular bone.
- Longitudinal - the fracture line is conditionally parallel to the axis of the tubular bone.
- Oblique - the fracture line runs at an acute angle to the axis of the tubular bone.
- Helical - rotation of bone fragments occurs, bone fragments"rotated" relative to their normal position.
- Comminuted - there is no single fracture line, the bone at the site of injury is crushed into separate fragments.
- Wedge-shaped - usually occurs with fractures of the spine, when one bone is pressed into another, forming a wedge-shaped deformity.
- Impacted - bone fragments are displaced proximally along the axis of the tubular bone or are located outside the main plane of the cancellous bone.
- Compression - bone fragments are small, there is no clear, single fracture line.
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According to the integrity of the skin
- Closed - without communication with the external environment.
- Open - communicating with the external environment.
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By complications
- Complicated:
- traumatic shock.
- damage to internal organs.
- bleeding.
- fat embolism.
- wound infection, osteomyelitis, sepsis.
- Uncomplicated.
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There are typical fracture sites
As a rule, they are located in those places where the bone experiences the greatest load, or where its strength is lower. The most common fractures include:
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1.Fracture radius in a typical place. In 70% of cases, the mechanism of injury is an extension fracture.
2.Fracture surgical cervix shoulder
3. A comminuted fracture of the tibia in the middle third - the so-called “bumper fracture” - is a widespread type of injury, usually occurring in road traffic injuries.
4.Fracture of the medial and lateral malleolus.
5. Fracture of the femoral neck. Difficult to heal, but quite common fracture, currently widespread in older people, most effective way treatment - installation of an artificial hip joint.
6. Various fractures of the skull bones.
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Usually, when a bone tissue is fractured, bleeding occurs, which is difficult to stop due to the fact that the vessels are fixed in the mineral part of the bone and cannot collapse. The amount of bleeding depends on the type of fracture and its location, for example, with fractures of the leg bones, the victim loses 500-700 ml of blood. As a result of this hemorrhage, a hematoma is formed, which subsequently surrounds the bone fragments.
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At the site of bleeding, edema occurs and fibrin threads fall out, which subsequently serve as the basis for the formation of the protein matrix of bone tissue. Stopping bleeding from bone tissue is not an easy task and, in case of complex comminuted open fractures, is possible only in an equipped operating room.
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- Relative signs of fracture
- Pain intensifies at the fracture site when simulating an axial load. For example, tapping the heel will sharply increase the pain of a broken tibia.
- Swelling - occurs in the area of damage, usually not immediately. Contains relatively little diagnostic information.
- Hematoma - appears in the area of the fracture (usually not immediately). A pulsating hematoma indicates ongoing intense bleeding.
- Impaired function of the damaged limb - implies the inability to put a load on the damaged part of the body and a significant limitation of mobility.
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Absolute signs of a fracture
- Unnatural position of the limb.
- Pathological mobility (in case of incomplete fractures is not always determined) - the limb is mobile in a place where there is no joint.
- Crepitus (a kind of crunching sound) - felt under the hand at the fracture site, sometimes heard in the ear. It is clearly audible when pressing with a phonendoscope on the site of damage.
- Bone fragments - with an open fracture, they may be visible in the wound.
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First aid
- A person providing first aid can:
- Assess the severity of the victim’s condition and the location of the damage.
- If there is bleeding, stop it.
- Determine whether the victim can be moved before qualified medical personnel arrive. It is not recommended to carry or move a patient with spinal injuries or multiple fractures.
- In case of isolated injury, immobilize the damaged area and apply a splint. A splint can be any object that will prevent movement in the damaged limb (grabbing the joints above and below the fracture site).
- If there are no contraindications to movement, the victim is transported to a medical facility.
- If access for medical personnel is difficult or impossible and there are contraindications to moving the victim, ensure as complete immobilization of the damaged areas as possible, after which a stretcher with a solid base is used, to which the victim is securely fixed.
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First aid
First medical assistance can be provided either on site or in an emergency room or hospital. At this moment, it is important to assess the severity of the victim’s condition, prevent or alleviate complications of injury, and determine the scope of further treatment.
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Immobilization rules
- When carrying out transport (temporary) immobilization of the limbs, the person performing it must comply with the following rules:
- Fix the limb in the position in which it is after the injury, but do not try to set the bone in place.
- Fix at least 2 joints (above and below the fracture). In case of injury to the hip and shoulder, fix 3 joints.
- If a splint is applied and there are wounds, first treat the wounds and stop the bleeding.
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In the event of a fracture, timely treatment is very important. medical care. Timely medical assistance can save the victim’s life and prevent the development of serious complications. Often, it is not the fractures themselves that are dangerous, but the accompanying ones pathological conditions, such as traumatic shock and bleeding.
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