FRACTURES AND SOFT TISSUE INJURIES

FRACTURES A broken or cracked bone Great forces are required to break a bone, unless it is diseased or old Bones that are growing or under repair are similar to a twig- they may split, bend, and crack easily

CAUSES OF FRACTURES Direct force- bones break at site of impact Indirect force- bones break some distance from impact Muscular force- violent muscular contraction Twisting force- caused by twisting Fatigue- Repeated strain on the same bone Pathological- diseases that weaken the bone

CLASSIFICATION OF FRACTURES Open fracture Bone exposed at surface of skin (wound might be present) Possible bleeding or shock High risk of infection Closed fracture Skin above fracture is not damaged Bone fragments might cause damage to nearby tissues and blood vessels

CLASSIFICATION OF FRACTURES Stable Broken parts are not displaced (moved) easily Bones not completely broken Most common at the wrist, shoulder, ankle and hip. Minimal risk of bleeding or further damage Unstable Broken parts are easily moved by muscle contractions or movement Risk of damage to nearby tissue, organs, and blood vessels present May occur in cases of badly broken bones or torn ligament

CLASSIFICATION OF FRACTURES 5 types of fracture Comminuted Greenstick Transverse Oblique Spiral

COMMINUTED Bone is broken in several parts Unstable Partial break in the bone Bone Bent More common in children Stable GREEN STICK

TRANSVERSE Break perpendicular to the bone’s length Unstable if bone is fully broken Break at an angle across the bone Unstable if bone is fully broken OBLIQUE SPIRAL Break caused by twisting force

SIGNS AND SYMPTOMS Deformity, swelling, or bruising Pain/ tenderness Shortening, bending, or twisting of the limb Coarse grating (Crepitus) heard/ felt Signs of shock, especial in cases of femur or pelvis fracture Possible loss of function, sensation, or strength May be presence of a wound, with bone ends protruding

TREATMENT Ensure ABC Splint and Immobilize injured part, and ask casualty to keep still (cover joint above and below site of fracture) Place padding around injury for extra support Send to hospital for arm injury (tie arm sling if necessary), call 995 for ambulance for leg injury Prevent/ Treat shock, do not elevate injured limb Check circulation to injured limb at least every 10 minutes Monitor LOC and vital signs, at least every 5 minutes All cases of spinal, neck and lower limb fractures must be transported by stretcher

DO NOT… … Move the casualty until injured part is immobilized, unless faced with immediate danger Allow casualty to eat or drink Press directly on any protruding bone ends Elevate an injured limb

SOFT TISSUE INJURY Cramps Sudden painful spasm in 1 or more muscles Strains Injury to a muscle or tendon in which the muscle fibers tear due to overstretching Sprains Injury in a joint caused by overstretched ligament

SIGNS AND SYMPTOMS Pain and tenderness Difficulty moving injured part, especially in cases of joins Swelling or bruising in the area

TREATMENT (CRAMPS) Stretch… …

TREATMENT (STRAINS AND SPRAINS) “RICE” procedure R  rest I  ice C  comfortable support E  Elevate the injured limb, if not constricted

NOTES Support bandage should extend from injured part to the next joint (Ankle injury: bandage should extend from the base of the toes to the knees) Check for circulation beyond bandages every 10 minutes Send to hospital if pain is severe or casualty is unable to use the injured part (otherwise, advice casualty to rest and seek medical advice) Treat for fracture, if unsure of severity

CLARIFICATION?

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