Types of Fractures and Broken Bones
There are basically two types of fractures: open and closed. With an open (or compound) fracture, the bone protrudes through the skin and complicates the actual fracture with an open wound. Any bone protruding from the wound should be cleaned with an antiseptic and kept moist. You should splint the injured area and continually monitor blood flow past the injury. Only reposition the break if there is no blood flow.
The closed fracture has no open wounds. Follow the guidelines below for immobilization and splint the fracture.
The other types of bone fractures (Buckle, Greenstick, Displaced, Non-Displaced, Hairline, Single, Segmental, Comminuted) are basically variations or subsets of the open and closed fracture types.
Signs, Symptoms, and Dangers of Fractures
The dangers with a fracture are the severing or the compression of a nerve or blood vessel at the site of fracture. For this reason minimum manipulation should be done, and only very cautiously. If you notice the area below the break becoming numb, swollen, cool to the touch, or turning pale, and the victim showing signs of shock, a major vessel may have been severed. You must control this internal bleeding.Reset the fracture and treat the victim for shock and replace lost fluids.
Traction and Splinting a Fracture
Often you must maintain traction during the splinting and healing process. You can effectively pull smaller bones such as the arm or lower leg by hand. You can create traction by wedging a hand or foot in the V-notch of a tree and pushing against the tree with the other extremity. You can then splint the break.
Splinting a Broken Finger
- Secure material for the splint. It should be straight and firm. A small stick or rolled up cloth will suffice.
- Place the splint under the finger. Make sure it is long enough to extend into the palm of the hand.
- Tie a strip of cloth above and below the fracture, around the finger and splint, and around the finger next to it for stability. Do not tie the splint too tightly and do not tie it directly over the fractured bone.
Splinting a Broken Arm
Try to keep the broken arm from moving as much as possible.
- Adjust your arm to its natural position.
- Secure material for the splint. Sturdy cardboard or more likely, two sticks, will serve as splint material. They must be long enough to extend past the wrist and elbow joint. If not sticks can be found, any straight object will suffice.
- Use a clean shirt or other material to pad the arm. Using single layers, wrap it around the arm twice. This padding is more for comfort than stability. Make sure you have enough material left to wrap the splint.
- Place the sticks on both sides of the arm, equal distances from each other. With forearm fractures the sticks should extend beyond the wrist. With upper arm fractures, the sticks should extend beyond the elbow.
- Wrap the cloth around the sticks at least six inches above and six inches below the fracture. Tie the ends in a secure knot. Do not tie the splint too tightly. You should be able to slip two fingers under the wrapping.
- A sling is required to prevent the arm from moving and causing further damage. Fold a piece of cloth in half to find its center. Place the arm in the middle of the sling.
- Pull both sides of the sling up and around the neck and adjust the length until the forearm is in a flat, horizontal position. The elbow should be at a 90 degree angle. If this causes pain, lower the forearm until you find a comfortable position. Tie the sling around the neck.
Splint a Broken Hand
- Secure splint material. Material must be rigid enough to immobilize the hand, flexible enough to fold, and long enough to extend from the wrist to the end of the fingers.
- Make sure the wrist is straight and the hand is in a normal position, slightly opened.
- Place a wad of cloth in the palm of the hand. You will need enough cloth to ensure the hand stays in its normal position with the fingers slightly opened.
- Place the splint on the underside of the wrist and hand so it extends from above the wrist to the end of the fingers.
- Fold the splinting material up and around the sides of the wrist.
- Secure the splint with gauze by wrapping the gauze around the wrist and hand from one end of the splint to the other end of the splint.
- Tape the gauze in place so it does not unravel.
- Stuff padding in the space between the splint and the wrist and hand.
Splint a Broken Foot
- This splint requires a piece of cardboard or hard plastic. Use a straight, rigid surface to bend the cardboard. Make two creases, lengthwise, so the cardboard is marked in thirds (lengthwise).
- Place cloth or other padding over the cardboard for padding.
- Place the splint under the leg and foot. The splint should extend halfway to the knee and far enough under the foot to immobilize the foot and ankle.
- Fill in the space between the ankle and the splint with a wad of cloth.
- Fold the sides of the cardboard up and secure them in place with tape.
- Pad any space between the splint and leg, ankle, or foot with wads of cloth.
- If ice is available, place ice over the fracture to reduce swelling. Do not leave the ice on any longer than 20 minutes.
Splint a Twisted Ankle with a Pillow
- Place a pillow under the injured ankle. The pillow should extend halfway to the knee and below the ankle.
- Wrap the pillow around the ankle and tape above and below the fractured ankle.
Traction Splint on a Broken Leg
Very strong muscles hold a broken thighbone (femur) in place making it difficult to maintain traction during healing. You can make an improvised traction splint using natural material as explained below.
- Get two forked branches or saplings at least 5 centimeters (2 inches) in diameter. Measure one from the patient’s armpit to 20 to 30 centimeters (8 to 12 inches) past his unbroken leg. Measure the other from the groin to 20 to 30 centimeters (8 to 12 inches) past the unbroken leg. Ensure that both extend an equal distance beyond the end of the leg.
- Pad the two splints. Notch the ends without forks and lash a 20- to 30-centimeter (8- to 12-inch) cross member made from a 5-centimeter (2-inch) diameter branch between them.
- Using available material (vines, cloth, rawhide), tie the splint around the upper portion of the body and down the length of the broken leg. Follow the splinting guidelines.
- With available material, fashion a wrap that will extend around the ankle, with the two free ends tied to the cross member.
- Place a 10- by 2.5-centimeter (4- by 1-inch) stick in the middle of the free ends of the ankle wrap between the cross member and the foot. Using the stick, twist the material to make the traction easier.
- Continue twisting until the broken leg is as long or slightly longer than the unbroken leg.
- Lash the stick to maintain traction.
NOTE: Over time, you may lose traction because the material weakened. Check the traction periodically. If you must change or repair the splint, maintain the traction manually for a short time.