Dealing with bone fractures

Ottoshot

Ottoshot

Joined
Sep 13, 2007
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I was reading some of the first aid sticky and I got to thinking. Ive been focusing on emergency field situation first aid lately. I belive the two major issues in regards to fist aid in a fishing, hunting or camping scenario are;

1- Stopping serious life threatening bleeding, ie Arterial bleeding and,

2- stabilizing serious life threatening bone fractures or fractures that will result in the loss of a limb or appendage.

least concern is small cuts, abrasions or burns. these situations can be dealt with by immediate evac by yourself to safety if it is even necesary, so I belive the first two take priority when while I gain knowledge and build my first aid kit.

However, this thread is not really about the contents of a kit. It is about dealing with bone fractures, the different types and how to deal with them.

I understand that complete fractures need to be put in manual traction to restore blood flow thus saving the limb. Should this ever be attempted in a first aid senario assuming there was no immediate help closeby? what if you knew it could be hours or even days before help arrived or you could get to help.

What about manually setting a partial fracture to restore blood flow to the extremity? Should this ever be attempted in a field senario?

Im confident I could do my best to stop serious bleeding, but this bone fracture stuff kinda makes me nervous. I wouldnt want to do more damage, but at the same time I dont want to remain ignorant about the subject. If I can do something to save the limb of myself or my friends I want to learn how. Im sure some of you have dealt with bone fractures before. I would appreciate your input.
 
To awnser your question w/o writing a book...

You need to evaluate circulation in the affected limb by evaluating pulses. If there is comprimise of vessels, then you need to restore bloodflow through manual traction(aside from internal ruptures of vessels, those can only be fixed through surgical intervention) to save the limb from necrosis. If there is no vessel comprimise, you could end up doing more harm then good by attempting to set a fracture in the field. Just splint it above and below, and monitor pulses in affected extremity for changes...
 
If there no pulse can be detected beyond the fracture give yourself 1 attempt at reallgining before you splint... if a pulse distal to the fracture sight is detected splint as is... most fractures that I have seen that have resulted in loss of a pulse distal to the extremity have been open fracture, (where the bone ends come through the skin) these bleed ALLOT focus on stabilizing the ontrol extremity including immpobilizing the joint above and below but always controll the bleeding first... dragging a perfectly spinted deadbody out of the woods is no good for anyone. Good luck in your quest for knowledge feel free to PM me if there is anyway I can help
 
Right on John.... Good post. :thumbup: You are right, most I have seen(if not all:confused:) have been the result of an open fx..
 
Thanks for the input.

So priority is to identify the type of fracture, the worst case scenario being an open complete fracture that is causing restricted blood flow (no or very weak pulse distal to the fracture).

if the fracture is open and is causing life threatening bleeding, then the priority is to stop the bleeding and imoblize the fracture above and below and that will help keep the bleeding under control, correct?

so if you have had to stop serious bleeding on an open fracture, you would not want to attempt manual traction. only attempt to set a fracture that does not have a risk of serious bleeding attached to it.
 
I'm a climber and did several falls in the winter walls.
Fortunately I suffered no serious bone fracture but a buddy of mine had in his left foot.
A good pair of winter mountaineering boots provides quite a good support for bone fracture
and makes things less hard.

I had several bone fractures while riding a bike. Typical collarbone fracture.
Quite annoying but basically they are no serious wound.
 
Controlling bleeding in that scenario is top priority untill in is under controll do not collect 200 dollars do not pass go... basic steps to controll bleeding would be elevation of the estremity, direct pressure, a pressure dressing and using pressure points.. I won't go into tourniquets I would not attempt traction unless the fracture was to the mid shaft of the femor or to the corresponding bone of the upper arm (embarrassing but I can't remember the name of it) when thes bones fracture the thick muscle around them contracts into a ball and spasms these spasms can cause the jagged bone ends to cut into vascualture and cause life threatening bleeding providing traction helps to prevent this.. but if it;s any other bone just splint and evacuate
 
You've got top-shelf advice already from the ALS guys, so I wont bother repeating it. One thing I will add though: it's pretty important to check the pt's circulation (as was previously mentioned), along with motor function and sensation before -and- after you splint the fracture. :thumbup:
 
the book to the right of my keyboard says that would be the humerus. :D

Thanks Riley.
 
RescueRiley said:
Controlling bleeding in that scenario is top priority untill in is under controll do not collect 200 dollars do not pass go... basic steps to controll bleeding would be elevation of the estremity, direct pressure, a pressure dressing and using pressure points.. I won't go into tourniquets I would not attempt traction unless the fracture was to the mid shaft of the femor or to the corresponding bone of the upper arm (embarrassing but I can't remember the name of it) when thes bones fracture the thick muscle around them contracts into a ball and spasms these spasms can cause the jagged bone ends to cut into vascualture and cause life threatening bleeding providing traction helps to prevent this.. but if it;s any other bone just splint and evacuate
Click to expand...

Humerus? :D
 
My concerns about broken bones are in the ankles/feet/leg or in the wrist/hands/fingers category.

I've broken a few bones. One that relates to this group is a fractured left ankle bone with 2nd or 3rd degree sprain (don't remember specifically). My ankle blew up to the size of a cantaloupe in an instant.

It's an easy to happen, common injury usually from rolling/twisitng an ankle (especially when jumping from boulders, or hauling a heavy rucksack). The injury looked alot worse then it really was, but it affected my mobility greatly. I'd hate to have that happen again, many miles into the forest.

But concerns about bone breaks are low on my list. I try and follow some common sense rules that apply to me, and that will hopefully prevent encountering a disabling, bone breaking type scenerio.
 
Good solid advice above, so there's nothing much to add.

As far as first aid for hunting, fishing, camping, etc. what I've seen the most are tons of lacerations, sprains and strains, road rash from people falling on the trail, head injuries (which can be accompanied by convulsions and vomiting), burns, fractures, anaphylaxis, and then environmental issues: heat injuries and cold injuries. The injuries I've treated more than any others are probably hypothermia and sprains and strains. Major bleeds and fractures definitely happen a lot, but may not be the most common injuries you run into. A lot of my experience is from mountain guiding and the military so your particular activities may produce a different ratio of injuries.
 
if its a minor bone fracture, i would splint a leave it. I broke my radius and ulna in my right arm, and while I should have gotten x-rays, I didn't think it was broken, so I used am elastic bandage to support my wrist, and gutted it out. for a finger or something, I'd suspect most of us would do more harm than good.
 
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