Broken Bone

Okay, so maybe you weren't thinking. I mean, you are 17...for all intents and purposes (except maybe voting), an adult. You should have known better than to try to climb to your bedroom window by shinnying up the drainpipe. But you didn't, and now you're lying on the ground with intense pain radiating from your left leg, a.k.a. your landing site. "I'll bet anything it's broken," you think with a small inner grin, remembering that lucky kid whose crutches and gym pass were the envy of all. A sharp pain quickly dissolves those bittersweet memories, as you remember that there is no such thing as a gym pass in summer and right now you have, no doubt, a couple of painful hours to go before you will be the envy of anyone. Wincing in a unique combination of embarrassment and outright pain, you bite the bullet: "Mommy!" Better hope Mommy's read up...

What did I do?

Your body consists of over 200 bones of all different shapes and sizes. All of these bones in addition to muscles and the tendons and ligaments that put them together form the skeleton, which serves to protect many of the organs your body uses to function normally. Bones are dense and very strong, and they tend not to break easily, except in elderly people who have developed osteoperosis, a gradual weakening of the bones. Bone injuries are often quite painfull, and they may bleed, as all bones have an ample amount of blood and nerves. The two types of bone injuries are fractures, which may be open or closed, and dislocations, which involve muscles and joints as well. The body has over 600 muscles, which are soft tissue. Injuries to the brain, the spinal cord or nerves can affect a person's muscle control, and when a muscle is injured, a nearby muscle may take over for the injured one. A joint is formed where the ends of two or more bones come together in one place. The bones are held together by ligaments, which tear when a joint is forced beyond its normal range of movement. A sprain is the tearing of ligaments at a joint. A strain is a stretching and/or tearing of muscles or tendons.

An open fracture occurs when an arm or a leg twists in such a way that the broken bone ends tear through the skin, causing an open wound. In a closed fracture the skin is not broken; this type of fracture is much more common than an open fracture. An open fracture brings with it a chance of infection and also severe bleeding. Fractures can be life-threatening if they sever an artery, affect breathing, or occur in very large bones such as the femur in the thigh. A motor vehicle accident or any fall from a height may cause a fracture.

A dislocation is typically more noticeable than a fracture. A dislocation occurs when a bone moves away from its normal position at a joint. A violent force tears the ligaments that hold the bone in place at a joint, and the joint will no longer function. Usually, the displaced bone causes an obviously abnormal bump, ridge or hollow.

Sprains may swell but typically heal quickly. Pain may be minimal and the victim may be active soon, in which case the joint won't heal properly and will remain weak. It is likely to be reinjured more severely, possibly involving a fracture or dislocation of the bones at the joint. The most easily injured joints are at the ankle, knee, wrist and fingers.

Strains are frequently caused by lifting a very heavy object or working a muscle too hard. They usually involve muscles in the neck, back, thigh or back of the lower leg. Strains tend to reoccur, especially those located in the neck or back.

An x ray is the best way to assess the extent of damage to a bone, muscle or joint. However, you may be able to judge how serious the injury is by its appearance. The area may be red, bruised, swollen, twisted, or have bumps, ridges or hollows. The area may be painful to touch as well as to move, or the victim may be unable to move it. If you compare an injured body part with an uninjured one, you may be able to locate any abnormalities; this works well with an arm, a leg, a shoulder, a knee...you get the idea. Sometimes the victim may have heard a snap, crackle or a pop when the injury occurred, or he or she may feel bones grating. Also, the victim's hands and fingers or feet and toes may tingle or feel numb.?)

What do I do?

It does not matter whether the injury was to a bone, muscle or joint-you don't need to know specifically what the injury is in order to care for it! The formal for proper care is rest, ice and elevation. Make the victim as comfortable as possible, and apply ice to reduce pain and swelling. Minimize movement of the injured part by supporting it with something like a pillow.

Do not try to move a patient with a severely broken bone unless it is absolutely necessary. Calling EMS is the best cause of action in this case. However, if you must move the patient you must immobilize the injured body part. One way is to splint it, but do this only if it can be done without hurting the victim, and always attempt to splint the part in the position you found it. Splint the injured area and the joints above and below the injured area. You may use another body part, like an injured leg to an uninjured one, or an injured arm to a chest; this is called an anatomic splint. Make a soft splint from folded blankets or towels, or use a triangular bandage to make a sling, another type of soft splint, which is used to support an injured arm, wrist or hand. Use folded magazines and newspapers, cardboard or metal strips to support the injured body part with a rigid splint. Use several folded triangular bandages to secure the injured body part to the splinting material, tying them securely but not too tightly. Apply ice and raise the injured part, and prevent the victim from getting chilled or overheated. Remember to be reassuring!

Call EMS If:

• the victim has sustained injuries to the head, neck or back
• the victim is having trouble breathing
• the victim is unable to move or use the injured body part without experiencing pain
• the injury appears to be a severely broken bone.

If you think the victim may have a head or spine injuries, DO NOT move him or her; leave the victim lying flat. EMS will be able to move and treat the patient without causing further injury to the victim.

Beware of signs that indicate head and spine injuries. These include:

changes in consciousness; vision and breathing problems; nausea and vomiting; inability to move a body part; steady headache; tingling or loss of sensation in hands, fingers, feet or toes; blood in the ears or nose; seizures, severe pain, pressure or bleeding in the head, neck or back; bruising of the head; and loss of balance

If you see these signs in a victim, call EMS immediately, and DO NOT attempt to move the victim or you may injure him or her further. Minimize movement of the head and spine, maintain an open airway (use a chin lift but NO head tilt unless you want to paralyze the victim!!!), check consciousness and breathing control any bleeding, and prevent the victim from getting chilled or overheated.