Fractures and dislocations

Terminology

• Closed fractures - where skin has not been broken.
• Open fractures – bone exposed to outside, hence a greater risk of infection.

Considerations

• History of events, direction of impact, forces involved may all suggest a fracture is likely. The sure way to know if there is a fracture is X-ray.
• The aim of the first aid is to manage the pain and prevent complications.
• Multi-trauma casualties may have limb fractures, dislocations or soft tissue injuries. On their own these are rarely immediately life-threatening but can distract from the priorities at the scene – do no let the distress of a painful limb distract from the primary survey. ‘Life before limb’
• Leave dislocations as found and await medical help.

Recognition features

• Pain – common symptom, subjective.
• Deformity – bone or joint not in normal position
• Shortening – compare one limb with the other
• Unnatural movement
• Loss of function
• Tenderness – pain upon touching
• Crepitus – grinding of bone end against each other

The treatment principles for limb injuries are straightforward – keep them still!