This document provides information on fractures, dislocations, sprains and strains, including definitions, signs and symptoms, and treatment methods. It defines an open fracture as a break in the bone where the skin is broken, and a closed fracture as a break where the skin remains intact. Signs and symptoms listed for fractures, dislocations and sprains/strains include deformity, pain, swelling and bruising. Reasons for immobilizing injuries are given as preventing further damage and reducing pain. Splinting and immobilization techniques are described for various body parts like the shoulder, arm, leg, ankle and pelvis.

1. 1
UDIT KUMAR DIXIT
KHARAGPUR

2. 1. Define an open fracture and closed fracture, and
list four signs and symptoms.
2. Define a dislocation, a sprain, and a strain and list
four signs and symptoms.
Upon completion of this lesson you will be able
to:
Objectives

3. 3. Give two reasons for immobilizing a fracture, a
sprain or a strain on a patient.
4. Demonstrate the pre-hospital treatment of
fractures and dislocations of the extremities,
hips and shoulder.
...cont’d.

4. 4

6. CERVICAL-7
LUMBER-5
SACRUM-5
THORACIC -12
COCCYX-4

7.  Provides a framework for the body
 Protects vital organs
 Provides for body movement
 Produces red blood cells
7

8.  Adult skeleton is composed of
206 bones
 Two divisions : the axial and the
appendicular
8

9. Consist of 80 bones
 Skull
 Thorax
 Vertebral (Spinal) column
9

10. Consist of 126 bones
 Shoulder :
Clavicle and scapula
 Upper extremities :
Arms, hands, fingers
 Pelvis (hips)
 Lower extremities :
legs, feet, toes
10

11.  Immovable joints
 Slightly movable
 Freely movable :1.Hinge
2. Ball and socket
11

12. Any break in the
continuity of a bone.

13.  Closed injury : in which the overlying
skin is intact
 Open injury : in which the skin has
been broken either from the
inside or from the outside
13

14. Injury in which a bone is moved out
of its normal position in a joint and
remains that way.
Sprain
Injury in which ligaments are
stretched or partially torn, commonly
associated with joint injuries.
Strain
Injury in which a muscle, or a muscle
and tendon, are over-extended.

15. Fractures, Dislocations and Sprains
Signs and Symptoms
• Deformity or angulation
• Pain and tenderness
• Crepitus (grating)
• Swelling
• Bruising or discoloration
• Exposed bone ends
• Joint locked in position
• Numbness or paralysis
• Compromised circulation

16. Splinting
Applying a device to stabilize any
painful, swollen or deformed body part

17. Reasons for Splinting
• Prevent motion of bone fragments
or dislocated joints
• Reduce pain and suffering
• Minimize damage to soft tissues
• Prevent closed fracture from
becoming open fracture
• Minimize blood loss or shock

18.  Rigid splint : Requires limb to be in anatomical
position. Ideal for long – bone injuries ( ex:
cardboard, wood)
 Conforming splint : can be moulded to
different angles or surrounds the extremity
(Ex :air or vacuum splints)
18

19.  Traction splint : Used specifically for femur
fractures
 Sling and swathe : Two triangular bandages
used to hold an injured arm in place against
the body
 Improvised splints : a book , cardboard, pillow
or blanket, etc.
19

20. TYPES OF SPLINTS
TRACTION SPLINT
SLING & SWATH RIGID SPLINTS
AIR SPLINT

21.  Always communicate your plans
 Before immobilizing , expose and control bleeding
 Always cut away clothing around the injury site
 Assess PMS
21

22.  Do not attempt to push protruding bone ends back
into place
 For patient comfort & proper immobilization, pad
voids between the body & the splint
 Pad a splint before applying it
 If a joint is injured, immobilize it & the bones
above & below
22

23. GENERAL RULES OF SPLINTING
Expose injury siteStabilize and check PMS

24. 24
Apply dressing &
bandage Control bleeding

25. 25
Pad the splint
Secure splints,
check PMS

26. 26

27. Pre- Hospital Treatment
for suspected
fractures, dislocations and
sprains/ strains
1.Initial assessment: identify and
treat life-threatening problems
2.Physical examination
3.Stabilize injury

28. 4.Expose injury
5.Treat open wounds
6.Prepare splinting materials
7.Splint injuries / immobilize body
8.Reassess P.M.S.
9.Apply cold packs or ice
10. Treat for shock

29. Shoulder and Clavicle
Signs and symptoms : Shoulder appears to be
“dropped”, deformity (asymmetry ), Pain.
Treatment :
Apply a sling and swathe. Provide padding to
fill voids between body and arm
29

30. APPLYING A SLING AND SWATH
pad between the arm & the chest Support injured arm with a sling
Immobilize the arm with a swath

31.  Humerous ( Shoulder)
Signs& symptoms : Pain swelling and
deformity
Treatment :
Rigid splints to out side of arm and
pad voids. Than apply sling and
swathe
31

32. SPLINTING OF FRACTURED UPPER EXTRIMITIES
Splinting of Hummers injury

33.  Elbow
Signs And Symptoms : Pain Swelling And
Deformity
 Treatment
 if arm is bent at elbow splint with sling and
swathe alternate is pillow or blanket .
 If elbow is straight , splint entire arm, armpit to
finger tips both sides
33

34. SPLINTING OF FRACTURED UPPER EXTRIMITIES
Splinting of Elbow
(Bent) injury
Splinting of elbow
(Straight) injury

35. Fore arm and wrist
 Sign And Symptoms :Pain
Swelling And Deformity
 Treatment :
 splint area with arm board than
sling and swath
35

36. Hands & Fingers:
 Sign and Symptoms : Pain , Swelling and
Deformity
Treatment :
If one finger is fractured, tape it to an adjacent
finger .
Hands & Fingers:
 If more than one finger is fractured than splint the
entire hand in the position of function.
 Place a roll of bandage in palm of hand or other
object then wrap entire hand and place on arm
board
36

37. SPLINTING OF FRACTURED UPPER EXTRIMITIES
Splinting of phalanges
injury
Splinting of forearm,
wrist or hand

38. Pelvis :
 Pelvic injury can be life threatening due to massive
blood loss
 Suspect shock
 Any force strong enough to injure the Pelvis can
also injure the spine
Signs and symptoms :
 Pain, especially when pressure is applied to iliac
crests or pelvic bones
 Inability to lift legs while lying on back
38

39.  Minimize patient movement
 Do not roll or lift with pelvis unsupported
 Place a folded blanket between patient’s legs
from groin to feet and bind together with
cravats (2 upper leg ,2 lower leg )
 Place the patient on long back board
 Treat for shock
39

40. Hip Injuries
Signs and Symptoms.
 Pain, swelling and discoloration.
 Inability to move legs.
 Possible foot rotation (outwards or inwards)
40

41.  Bind legs together with a folded blanket
between patient’s legs
 Support the hip with pillows
 Stabilize patient on long back board
 Secure with cravats
41

42. Femoral Injuries
Signs and Symptoms :
 Pain (often intense)
 Deformity
 Rigidity
 Shortened limb
42

43.  If you find the leg in a straight
position, use two padded boards -
1. one along the inner thigh from groin to the foot
2. the other along the outer thigh from the armpit to
the foot.
3. Secure with cravats
43

44. 44

45. Knee Injuries
 Signs and symptoms :
Pain , Swelling and Deformity
 Bent position-
Immobilize in the position found . the bones
above & below it should be splinted with short
padded boards
45

46. Knee Injuries :
 Straight position
 Use two padded long boards, the first on the inner
thigh from groin to beyond foot .
 Place the second on the outer thigh from hip to
beyond foot.
 Secure with cravats.
46

47. Tibia or fibula injuries :
Signs and Symptoms :
Pain, swelling and deformity
Treatments:
- Pneumatic splint
- two padded long boards - groin to foot and thigh
to foot.
- Secure with cravats .
- Alternative method for a closed injury to the tibia
or fibula is to use a circumferential splint
47

48. 48

49. Ankle and foot injuries
Signs and symptoms :
Pain, swelling and deformity
Treatments :
 Stabilize, remove shoes and socks if possible
(expose injury).
 Circumferential splint or formable splint such
as a pillow secured with cravats is
recommended
- Alternative :Padded boards to mid thigh
49

50. 50

51. 1. Define an open fracture and closed fracture, and
list four signs and symptoms.
2. Define a dislocation, a sprain, and a strain and list
four signs and symptoms.
Upon completion of this lesson you will be able
to:
Review

52. 3. Give two reasons for immobilizing a fracture, a
sprain or a strain on a patient.
4. Demonstrate the pre-hospital treatment of
fractures and dislocations of the extremities,
hips and shoulder.
...cont’d.

53. 53
EVALUATION
Q - Adult skeleton is composed of bones?
A – 206
Q - Injury in which a muscle or a muscle
and tendon are over extended?
A - Strain

54. 54
THANKS