What not to do in case of fractures. So that the bones grow together quickly. What to do if you have a fracture

A fracture is a violation of the integrity of a bone that occurs as a result of disease or mechanical stress. A fracture, unfortunately, is a fairly common occurrence from which no one is immune. Therefore, every person should have first aid skills for fractures. First, it is necessary to establish the fact of a fracture. You can get more detailed information on this issue here: “How to determine a fracture?” Everyone should know how to identify a fracture.

The patient’s speedy recovery and the absence of complications depends on how quickly and efficiently first aid for fractures is provided. Providing first aid for fractures consists of the following: providing the necessary assistance immediately after determining the fact of a fracture, preparing the victim for transportation and transportation to a medical facility.

What to do in case of a fracture?

After establishing the fact of a fracture, you should call an ambulance, and before it arrives, you must provide first aid to the victim. It is undesirable to move the patient again. This can only be done if it is not possible to provide first aid at the scene of the incident.
We determine the type of fracture: open or closed. With a closed fracture, the skin is not damaged, but with an open fracture, the integrity of the skin is compromised. In case of an open fracture, the skin should be treated with an antiseptic and an aseptic bandage applied. Severe bleeding is stopped by applying a tourniquet or pressure bandage. The tourniquet is applied for two hours in summer, and for one hour in winter. When applying a tourniquet, be sure to attach a note indicating the time it was applied.
To prevent the adverse effects of traumatic shock, the victim should be given hot tea and covered with a blanket.
To reduce pain, you can give the patient non-narcotic analgesics. Apply an ice pack to the injured area of the body.
To relieve neuropsychic stress, the patient can take soothing drops.
Before transporting to a medical facility, it is necessary to immobilize the injured part of the body as much as possible. For immobilization, special transport tires are used. In their absence, improvised means are used: boards, rods, skis, sticks, etc. For reliable immobilization of bones, two splints are used, which are fixed to the limb from different sides. You can also immobilize by bandaging the damaged part of the body to a healthy one.

Transport immobilization rules

the splints must securely fix the damaged area of the body;
before applying the splint, the damaged area should be covered with cloth;
it is necessary to fix two joints below and above and the fracture site;
You should not squeeze the limb too much, so as not to damage the nerves and disrupt blood circulation;
for hip fractures, all joints of the lower limb are fixed;
if the upper limbs are fractured, they should be fixed in a bent position and supported with a bandage;
if the fracture occurs in the ankle joint, apply a splint from the upper third of the leg to the foot on both sides of the leg, bandage a board to the foot;
in case of a fracture of the knee joint, one splint is applied from the back from the upper third of the thigh to the lower third of the lower leg;
If a rib fracture occurs, then you need to bandage the chest tightly.

It is advisable to transport the patient to a medical institution in a special ambulance. Patients with fractures of the upper extremities should be transported while sitting, and with fractures of the pelvic bones, lower extremities, and spine - in a lying position. Patients with fractures should be transported very carefully so as not to displace bone fragments.

Leg fracture: what to do?

The injured leg must be placed in the correct position. You should carefully pull your leg, holding your toes with one hand and the heel with the other. You should also remove your shoes. If the fracture is open, you should under no circumstances set the fragments yourself. Treat the wound with an antiseptic solution and apply a pressure bandage. Then we proceed to immobilization.

The splint must fix at least two joints. When a tibia is fractured, the knee and ankle joints need to be fixed. When a femur is fractured, the hip, knee and ankle joints are fixed. Before applying a splint, it must be adjusted to the size of the injured limb. Such patients should be transported to a medical facility on a stretcher.

Rib fracture: what to do?

Fractured ribs can occur when falling on a hard object, when the chest is compressed, or when hit. Fractures can be unilateral or bilateral, single or multiple. The danger of rib fractures comes from concomitant injuries to internal organs.

To eliminate pain, the patient should take an anesthetic. It is better to give an intramuscular injection of analgin. It is necessary to provide the patient with access to fresh air. If the ribs are fractured, a fixing pressure bandage should be applied to the victim’s chest. You can use a towel or bandage as a bandage. The bandage should be applied while exhaling.

To prevent traumatic shock, you need to cover the victim and give him a warm drink. Transportation of patients with rib fractures should be carried out half-sitting with legs bent at the knees. After studying this article, you will already know what to do after a fracture, and will be able to provide the victim with the necessary assistance if you witness such an incident.

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First (pre-hospital) aid for fractures:

First, call an ambulance!

Secondly, during a fracture, a complete or partial disruption of the integrity of the bone occurs. There are many types of fractures, but traumatologists will deal with this. What citizens should know is that fractures are divided into open and closed:

with an open fracture, damage to the skin occurs and the bone protrudes from the outside;
with a closed fracture there is no damage to the skin.

Signs of a fracture:

change in limb length;
pain in the area of injury;
bruising in the area of injury;
swelling;
a crunch is heard;
previously unusual mobility of the limb (fracture area).

And thirdly, this is taking into account the characteristics of the fracture site itself in the body.

Let's consider the provision of first (pre-hospital) aid for fractures in a step-by-step manner:

Proper first aid for fractures plays an important role in the treatment of the victim in the future. When providing first aid, you must act very carefully. Firstly, you may increase the pain, and secondly, there is a risk of damage to vital blood vessels and passing nerves at the site of the fracture.

What not to do in case of fractures:

First of all, you cannot ignore the injury. If signs such as swelling and pain appear, which only intensifies several hours after the injury, then you should go to the hospital.
Under no circumstances should a patient be transported with an unfixed injured limb.
Never try to set a bone yourself, you can only cause harm.
Do not use any ointments yourself for bruises and other nonsense. Painkillers are given for severe pain to prevent shock.

So, if there is even the slightest suspicion that this is a fracture, act as if it is a fracture. Fractures without pronounced displacement of bone fragments are very often perceived by victims as bruises, and periarticular fractures as dislocations. Accordingly, there are cases when people ask to pull a damaged limb with all their might in order to straighten a non-existent dislocation, or try to walk on a broken leg, thinking that it is a bruise and it will resolve itself in a couple of days. The result is a deterioration in the condition of the fracture, various complications, subsequent surgical intervention where it could have been avoided, and an increase in the period of disability.

Be sure to call an ambulance! And it is necessary to call her for fractures in all cases except the mildest ones (for example, a closed fracture of the upper limb with the possibility of independent transportation). Can you say that calling an ambulance is obvious, and it wasn’t even worth writing about? But, as practice shows, people often begin to rush around, calm the victim, perform first aid procedures, and only after that call an ambulance, which can aggravate the situation.

After calling an ambulance, we determine whether we can provide further first aid directly at the site of injury, or whether it is necessary to move the patient to more acceptable conditions for providing first aid. Unnecessary movements of a patient with a fracture are extremely undesirable, except in cases where external conditions make any further manipulations with the victim impossible (rain, snow, the patient being on a busy road, or in a puddle, mud, etc.). If it is cold outside, then the victim must either be carefully covered, or, if this is not possible, also decide to move to a warm room, since the traumatic shock that occurs immediately after a fracture makes the victim very sensitive to hypothermia.

The victim should be moved with extreme caution. During movement, it is necessary to maintain the position of the injured limb in the same position in which it found itself after the fracture. This can be achieved by supporting the parts of the limb above and below the fracture. You cannot hold onto the fracture site itself. When moving, you should not try to remove or push protruding, damaged bone into the wound; this can cause bleeding and additional infection of the bone and soft tissue.

We remind you once again that if there is at least some opportunity to wait for transportation to a medical facility directly at the site of the injury, then you need to take advantage of this opportunity!

In case of an open fracture, the damaged skin must be lubricated with a handy antiseptic. If sterile material is not available, the wound should be covered with any clean cotton cloth. If there is heavy bleeding from a wound, methods of temporarily stopping bleeding should be used (pressure bandage, application of a tourniquet, twist or rubber bandage).

In case of arterial bleeding, the tourniquet is applied above the wound - on the shoulder (in case of injury to the upper extremities) and on the thigh (in case of injury to the lower extremities). A tourniquet is NOT applied to the forearm (distance from the elbow to the bone). This is the most common mistake even by ambulance workers. In case of venous or capillary bleeding, a pressure bandage is applied. Then a sterile dressing is applied. And only after these measures can splints be applied.

Next, it is necessary to take measures to prevent the negative consequences of traumatic shock; this is achieved by correctly immobilizing the damaged organ, i.e., fixing it in a position in which the least amount of pain occurs.

Excessive fussiness, loud and harsh conversation, and discussion of the existing injury and his condition in front of the victim have an extremely unfavorable effect on the patient. Cooling predisposes to the development of shock, so the patient must be covered warmly and given hot tea or coffee.

If possible, anesthesia should be performed- spray with “freeze” or apply cold (ice, cold water) to the wound, give 1-2 tablets of any of the non-narcotic analgesics available on hand, such as analgin, ketamine (ketalar).

The administration of narcotic analgesics by a non-specialist in case of shock is undesirable, as this can cause respiratory depression, a further drop in blood pressure and other dangerous phenomena.

If possible, accessible relief from neuropsychic stress (which also aggravates shock) should be provided: give 1-2 tablets of any available tranquilizer or 40-50 drops of Corvalol, Valocordin. A small amount of strong alcohol has a beneficial effect, but it should be remembered that the doctor may decide that the injury was sustained while intoxicated and make a corresponding note on the sick leave certificate, which may give reason to refuse to pay for it. Before the ambulance arrives, you should urgently stay with the patient in order to stabilize his neuropsychic state, since the victim in a state of shock often behaves inappropriately, may attempt to move independently and commit other rash acts.

Preparing for transportation to a medical facility

Before transportation, it is necessary to immobilize (immobilize) the injured limb. If transportation is carried out by ambulance, then immobilization will be carried out by its employees. If independent transportation is necessary, then before it it is necessary to immobilize yourself.

It is most convenient to immobilize the lower limb using professional transport immobilizing splints (Diterichs splint, Kramer splint, pneumatic splint, etc.). But rarely can an ordinary person have them at hand.

If there are no ready-made transport tires, then immobilization should be carried out using any available materials (boards, skis, guns, sticks, rods, bundles of reeds, straw, cardboard, etc.) - improvised tires. For strong immobilization of bones, two splints are used, which are applied to the limb from opposite sides. In the absence of any auxiliary material, immobilization should be carried out by bandaging the damaged limb to a healthy part of the body: the upper limb - to the torso using a bandage or scarf, the lower - to the healthy leg.

When carrying out transport immobilization, the following rules must be followed:

The splints used for immobilization must be securely fastened and well fixed in the area of the fracture;
The splint cannot be applied directly to a naked limb; the latter must first be covered with cotton wool or some kind of fabric;
To create immobility in the fracture zone, it is necessary to fix two joints above and below the fracture (for example, in case of a tibia fracture, the ankle and knee joints are fixed) in a position convenient for the patient and for transportation;
For hip fractures, all joints of the lower limb (knee, ankle, hip) should be fixed; In case of a fracture in the ankle joint, two splints are applied on both sides of the lower leg from the upper third of the lower leg to the foot and a board is bandaged to the foot;
If the ribs are fractured, the chest is tightly bandaged with a wide bandage; the victim must exhale deeply and hold his breath while applying the bandage;
In case of a fracture in the knee joint, either one splint is applied from the back from the upper third of the thigh to the lower third of the lower leg, or two side splints are applied along the inner and outer surfaces of the thigh and lower leg at the same level;
If the arms are broken, they should be fixed in a bent position and supported by a bandage.
In case of severe bleeding from the wound, when there is a need to use a hemostatic tourniquet, it is applied before the splint is placed and is not covered with a bandage. You should not overtighten the limb with individual parts of the bandage (or its substitute) for “better” fixation of the splint, because this may cause poor circulation or nerve damage. If, after applying the transport splint, it is noticed that constriction has occurred, it must be cut or replaced by applying the splint again. At the same time, if the splint fits poorly or is insufficiently secured, it does not fix the damaged area, slips and can cause additional injuries.
In winter or in cold weather, especially during long-term transportation, after applying a splint, the damaged part of the body is wrapped warmly.
It is better to transport the patient to a medical institution in a special ambulance; if it is not available, you can use any type of transport (passing car, cart, stretcher, etc.).
Patients with fractures of the upper extremities can be transported in a sitting position, with fractures of the lower extremities, pelvic bones, and spine - in a lying position. Transportation and especially repositioning of the patient must be extremely gentle, and it must be taken into account that the slightest displacement of bone fragments causes severe pain; in addition, bone fragments can become dislodged, damage soft tissues and thereby lead to new serious complications.

A fracture is a complete or partial disruption of the integrity of a bone resulting from injury. Fractures can be open or closed. With an open fracture, there is a violation of the integrity of the skin. A wound surface is formed and infection can occur. Naturally, this leads to various complications and slower recovery. Injuries can also cause bone cracks and tears of the bone tubercles to which the muscles are attached. A combination of fracture and dislocation is possible.

As people age, their bones become lighter and thinner. Thus, a seventy-year-old person has a skeleton that is about a third lighter than a forty-year-old person. This decrease in bone density, or osteoporosis, occurs when the balance between natural bone breakdown and repair is disrupted. Almost all older people suffer from osteoporosis, but in different forms: the disease is more severe in people who are thin and sedentary, especially if their relatives are also affected by osteoporosis. Many people do not realize they have osteoporosis until they break a wrist or femur in a simple fall. Such a fracture can leave an elderly person bedridden and even be fatal.

The younger and stronger the body, the faster bone healing occurs during fractures. Therefore, in children and young people everything returns to normal much faster than in old people. There are no standards for bone healing after fractures. For some, the bones heal in a few weeks (3-4 weeks), for others in 2 months, and for others with the same fracture, the bones will heal for 1.5 years.

For fractures without bone displacement, outpatient conservative treatment is usually prescribed. The principles of fracture treatment are simple, with restoration of bone integrity being the most important. The patient is given a fixing bandage, usually a plaster cast. This allows you to reduce pain and ensure limb immobility. For fractures with complications, for severe fractures with bone fragments, with displacement, surgical intervention is performed. In the most severe cases, fixation with metal knitting needles is used.

Is it possible to speed up bone healing during fractures?

Is it possible to somehow speed up the process of bone fusion? Yes, it can be influenced. Below are some useful tips:

Follow all doctor's instructions. If he said to wear a cast for a month, you shouldn’t think that after 2 weeks it will be possible to remove it.
Try not to move or put pressure on the injured limb and avoid excessive strain. Otherwise, the bones will shift, or the fragile callus will break.
Calcium is needed to strengthen bones. You can get it from sesame seeds, dairy products and small fish, which can be eaten with bones. Cottage cheese is especially rich in this microelement, so lean heavily on it.
Vitamin D 3 is also necessary, which allows calcium to be properly absorbed. It is found in fish oil and fatty fish (herring, trout).
You can’t do without vitamin C either, as it promotes collagen synthesis. Collagen, in turn, is the basis of many tissues. Eat citrus fruits, kiwi, greens, sauerkraut.
Many doctors advise patients with fractures to use gelatin. Jellied meats are especially useful, as they are also very nutritious.
If fusion is very slow, then the doctor may recommend a certain drug that has a positive effect on this process.

Physiotherapy for bone fractures

To speed up the process of bone fusion, physiotherapy is prescribed. Physiotherapy should begin on the 2-5th day after the injury. For pain relief, elimination of edema, resorption of hemorrhages and acceleration of bone regeneration, the following are used: UHF therapy, which has an analgesic effect, reduces tissue edema, low-frequency magnetic therapy, and interference currents.

For a long time, bone tissue was viewed as a very passive substance, incapable of generating electrical potentials. And only in the middle of our century, researchers discovered that electrical processes take place in bones, as well as in other organs. A change in the nature of electrical signals was also observed when metal screws were introduced into the bone, which are usually used to fix metal structures used to treat fractures.

Interestingly, the property of producing biopotentials under load was also preserved in bones removed from the body, and even in specially treated bone, in which only the “bare” crystalline base, the so-called matrix, remained. Analyzing these data, experts came to the conclusion that bone tissue contains structures that act as unique piezocrystals.

Weak currents can have a noticeable effect on bone tissue regeneration; available information allows specialists to use electrical stimulation in the clinic to target bone tissue.

Doctors know that the lack of load on the injured limb and its long-term inactivity slow down the formation of a full-fledged bone adhesion after a fracture. Therefore, it is recommended to move the injured limb, naturally, within reasonable, permissible limits. But there are times when even minimal movement is impossible. If in such a situation the damaged limb is exposed to an electric current, the frequency of oscillations of which coincides with the frequency of oscillations of the biocurrents that arise in the bone during physical activity, positive dynamics are observed. At the same time, immobility is maintained and the bones receive the load they need. As a result, the process of bone adhesion formation occurs faster.

Domestic scientists, back in the Soviet period, developed methods that make it possible to use directed electric current in fresh fractures, when for some reason the fusion of bone fragments is disrupted, as well as in cases of formed non-united fractures, false joints, and some bone defects. Clinical observations have shown that in many cases that doctors call difficult, electrical stimulation gives good results.

What to do to make your bones heal faster

Currently, there is a tendency to prolong the healing time of fractures. This is associated, first of all, with the widespread insufficient consumption of elements such as calcium, phosphorus, etc. And also, the spread among the population, especially in people over 50 years of age, of vitamin D deficiency, which ensures the flow of calcium from the intestines into the blood and then into the bone .

In addition, vitamin D enhances the formation of a number of substances that are necessary for normal fracture healing.

Preparations based on calcium carbonate (purified chalk) + Colecalciferol (vitamin D3) will help speed up the healing of damaged bones. In this case, an acceleration of fracture healing by 30% is observed.

Calcium is also involved in the regulation of nerve conduction, muscle contractions and is a component of the blood coagulation system. Vitamin D3 regulates the exchange of calcium and phosphorus in the body (bones, teeth, nails, hair, muscles). Reduces resorption (resorption) and increases bone density, replenishing the lack of calcium in the body, necessary for the mineralization of teeth.

Vitamin D3 increases calcium absorption in the intestines. The use of calcium and vitamin D3 interferes with the production of parathyroid hormone (PTH), which is a stimulator of increased bone resorption (leaching of calcium from the bones).

During the recovery period after a fracture, a full set of vitamins and microelements is necessary.

Nutrition for fractures

To help bones heal faster, your diet should have enough calcium, vitamin D and protein. Every day it is advisable to drink a glass of any fermented milk drink - kefir, yogurt and eat 100 grams of low-fat soft cottage cheese. In order for calcium to be better absorbed, the food must also contain vitamin D. There is a lot of it in cod liver and fatty fish. During fractures, the body needs protein, because it is one of the building materials of bone. Hard, low-fat cheese, lean poultry, meat, fish, and eggs are rich in protein. It is healthier to eat poultry and meat boiled.

For fractures, you need to eat products with gelatin (jellied meat).

If you have broken bones, you don’t need to limit sweets. The human body cannot do without sweets. Sugar contains sucrose, which promotes rapid healing of bones after fractures.

Physical activity for fractures

Physical activity is necessary for bones to heal faster. However, thinning bones require a number of restrictions in the exercise program.

You will need to consult an exercise specialist and a physiotherapist. You can try doing exercise in a group.

You can walk for half an hour 3-5 times a week. During the recovery period after fractures, it is important to speed up recovery and relieve pain associated with the fracture.

Exercise will not only speed up the recovery process, but will also help reduce the risk of subsequent injury (fracture) in the event of a fall, and will also improve balance, posture, flexibility and coordination.

Make walking a mandatory part of your daily life. Bad weather or slippery streets don't have to be an obstacle: you can walk at home, in large stores or other indoor areas. If physical exercise is difficult for you, you can do it every other day. Always listen to your body.

Physical activity improves physical well-being: Physically active people have more energy and don't get tired as quickly as less active people. In other words, physical activity helps you feel better and get more out of life.

To summarize, we can say that bone fusion is a complex process that is influenced by many factors. But our tips will help your bones heal faster.

During accidents, emergencies and natural disasters, people get injured. Most often these are fractures, which are accompanied by painful shock. The success of further treatment largely depends on how timely and correctly first aid was provided for open and closed fractures.

Main types of fractures

Most often, fractures are divided into closed and open. In the first case, the skin is not damaged, in the second, the skin is torn, and parts of the bone can protrude beyond the wound. With an open fracture, tissue infection occurs, which means recovery takes longer.

Based on the nature of damage to bones and adjacent tissues, the following types of fractures are distinguished:

comminuted - the bone is destroyed with the formation of many fragments;
complicated - nerve fibers and internal organs are affected along with the bone;
displaced - bone fragments are displaced relative to each other;

The fracture can also be partial in the form of a crack. This violation of bone integrity is more common in children due to the elasticity of bone tissue.

Principles of providing first aid

Let's consider the algorithm of actions and rules of first aid for a broken limb:

Look around and make sure there is no danger to yourself and the victim.
If a person is without signs of life, take resuscitation measures and only then provide assistance for a fracture.
Call the emergency services team.
If arterial is present, take measures to stop it.
Try not to change the position of the victim’s body and limbs, especially if a spinal fracture is suspected. If you need to remove clothes or shoes, do it carefully, starting with a healthy limb.
Take measures to prevent painful shock.
Provide immobilization.

Until the ambulance arrives, you need to stay next to the victim, monitor breathing, pulse and consciousness, and also try to calm him down.

Additionally read:

If the fracture is open, you need to carefully, without changing the position of the injured limb, stop the bleeding by choosing the most appropriate method. The area of skin around the wound should be treated with an antiseptic solution, then a clean bandage should be applied. After this, you can prepare a splint that must match the length and fix the injured limb. Before arrival, the victim must be kept calm. If the collarbone is fractured, you need to put a roller in the armpit, bend your arm at the elbow, hang it on a scarf and bandage it to the body.

Prevention of painful shock

Due to damage to soft tissues and nerve fibers, severe pain occurs during a fracture. If you do not provide assistance in this direction, traumatic shock may begin, which is life-threatening.

To avoid this condition, you need to:

give the victim 3-4 tablets of analgin or 1-2 tramadol (or another painkiller);
apply a cold compress to the injury site - ice, snow, etc.

The development of painful shock is facilitated by general cooling of the body, so during the cold season the victim must be covered. Immobilization also helps prevent shock.

Immobilization rules

Immobilization is a set of measures aimed at ensuring the immobility of the injured limb. For this, various tires are used, including those made from handy materials - sticks, boards, rods, etc.

First aid for a skull fracture

During various accidents, fractures of the skull bones are possible, but at first it is difficult to understand whether the brain is damaged. Therefore, the victim must be taken to the hospital as soon as possible.

The sequence of care for a skull fracture is as follows:

To create immobility of the head, use a cotton-gauze bag, a sling-shaped bandage or handy means (clothing, a blanket), forming them into a cushion around the head.
If a person is unconscious, empty the oral cavity of vomit and begin resuscitation measures.
To normalize heart function, if possible, give an infusion of Corvalol (up to 20 drops).

If the wound is in the back of the head or the victim is unconscious, he must be transported on his side. This position will prevent the development of suffocation due to vomit or retraction of the tongue.

If the victim has a fracture of the nasal bones, he must be transported in a “half-sitting” position. If the jaw is broken - in a sitting position, and for those who have lost consciousness - lying on their stomach. In case of a fracture, the lower jaw is immobilized with a sling-shaped bandage, and if the upper jaw is broken, a ruler or a piece of plywood is inserted between the jaws, which is fixed to the head.

First aid for pelvic fractures

A fall from a height, an accident or an impact can cause a fracture of the pelvic bone. First aid in this case is provided before the arrival of the emergency medical service team. To do this you need:

Take measures to prevent traumatic shock.
Place the victim on a hard surface.
Give your body a “frog” position. Bend your legs at an angle of 45 0 at the knees and hip joints, slightly apart to the sides. Place a soft cushion of clothing or blanket under your feet.

If necessary, a person can be transported in the “frog” position to a medical facility.

As is the case with other fractures, it is necessary to monitor physiological indicators, monitor the pulse rate and breathing. You need to talk to the victim, try to calm him down, and if he loses consciousness, turn his head to the side to prevent asphyxia from vomit.

General precautions

Often, eyewitnesses to the incident do not have special knowledge and therefore, when trying to provide first aid to the victim, they make gross mistakes. Incorrect actions can increase recovery time and, in the worst case, cost the victim his life.

Give something to drink or eat, except in cases of preventing painful shock.
Try to straighten the injured leg or arm.
In case of an open fracture, remove bone fragments from the wound.
Without the need to move the victim or change the position of the injured limb.
Set broken bones yourself.
Pour iodine, alcohol and other agents directly into the wound (they will cause a painful shock).
Use contaminated materials to treat wounds and dressings.

The arriving ambulance team must be informed about measures to prevent pain shock. Information about pain medications or alcohol may be helpful if general anesthesia is required for subsequent treatment of the fracture.

Bibliography:

Buyanov V.M., Nesterenko Yu.A. "First Aid" (7th edition, 2000)
D. V. Marchenko “First medical aid for injuries and accidents” 2009

It is no secret that when a fracture occurs, the integrity of the bone is disrupted under the influence of a traumatic factor, the strength of which exceeds the strength of the skeleton. It has become commonplace that first aid is provided by doctors, but they do not always appear immediately at the scene of an incident. Often, the function of emergency doctors and paramedics falls on random passers-by or relatives. Providing on time and correctly first aid for fractures

All injuries to skeletal bones can be divided into two large groups, the first includes traumatic and the other pathological fractures. The main causes of traumatic injuries are impacts, road accidents, and falls from a height. And the main condition is that the bone tissue must be healthy. Damage of the second type occurs against the background of a disease that leads to a decrease in strength. Examples include osteoporosis, tuberculosis, and tumor; fortunately, such fractures are less common.

From left to right, an intra-articular, open and closed fracture is shown.

Types depending on severity

There are several types of injuries that determine the severity and tactics of further treatment. They also influence the tactics of providing first emergency aid. Highlight:

Closed fractures, in which there is no violation of the integrity of the skin. Such damage can occur without displacement and with a violation of the location of the fragments. The danger is that the fragments can injure surrounding formations and tissues.
Open fractures are characterized by a violation of the integrity of the skin and nearby organs or formations. With such injuries, bone fragments are visible in the wound. Also, the damage can be secondary open, when initially the skin was not damaged, but as a result of improperly provided first aid or transportation, the fragments lead to the appearance of a wound.
Separately, intra-articular fractures are distinguished, which can also be open or closed. When damaged, the integrity of the bone sections that form the joint is compromised.
Compression fractures are common in the spinal column. Since the structure of the body of any vertebra is spongy, its compression is called compression.

Symptoms

A preliminary diagnosis can be made based on characteristic symptoms. Common ones among them are:

severe pain at the site of injury;
the normal anatomical shape of the damaged area is disrupted;
the site of injury swells;
the limb lengthens or becomes shorter;
characteristic crunch of fragments upon palpation;
mobility at the site of injury is sharply impaired.

With open damage, massive bleeding from an artery or vein often develops. In this regard, special attention will be paid to PMP for open fractures. Bleeding occurs with a closed injury; depending on the bone, it has a different volume.

In case of any injury, one can identify the basic principles of action in relation to the victim. First medical aid for a fracture begins with the fact that the site of injury must be anesthetized.

A cold object, which is wrapped in cloth and placed at the site of injury, will allow this to be done. You need to stand for about 20 minutes, after which a break is taken for 10. If the item is from the freezer, you can repeat the procedure no more than three times to avoid frostbite.

An analgesic tablet or an anesthetic injection into the muscle is indicated for damaged limbs. Fractures of the pelvis, ribs, and spine may be accompanied by a violation of the integrity of internal organs, and pain relief disrupts the clinical picture, complicating further diagnosis. An open fracture is characterized by bleeding that must be stopped.

This can be done using a standard tourniquet, using any available means (clothing, fabric, wire, rope) or simply applying a pressure bandage. In case of arterial bleeding, the tourniquet is applied above the site of injury; when a vein is bleeding, the tourniquet is applied below the wound. Be sure to attach a note with the time of application; you can write it on the body, in a visible place. The duration of application of the tourniquet is no more than 2 hours in summer, 1.5 in winter. If the hospitalization time exceeds the above periods, the tourniquet is slightly loosened. In some cases, finger pressure of the artery is indicated, however, it cannot be performed for a long time.

Bleeding from an artery is characterized by a gushing stream of bright red blood (due to oxygen). With venous blood loss, the stream is sluggish and has a dark cherry color.

Transport tires

After the bleeding has temporarily stopped, first aid for bone fractures includes immobilizing the site of injury. For these purposes, ready-made transport tires can be used or improvised materials can be used. You can find ready-made tires in an emergency room, a first-aid post, a trauma department, or when calling an ambulance. A simple person can use any material at hand, after wrapping it in cloth or bandage. To do this, you can use branches, skis or their sticks, boards, cardboard, metal rods, small diameter pipes, and much more.

The standard ones are:
Dieterichs tire;
Kramer wire tire;
vacuum or pneumatic tires;

Any splints are applied over clothing, and a roll of cotton wool or fabric is placed on the bony protrusions. Providing first aid for a fracture of the lower limbs or arms with a wound includes treating it with a solution of hydrogen peroxide, applying a sterile bandage if possible, and cutting the clothing in this area. The main thing is to immobilize at least two joints, and in case of a fracture of the shoulder or hip - three. It is strictly prohibited to straighten any curvatures or fragments!

Immobilization for head and neck injuries

When the head and neck are injured, the danger lies in damage to the brain, large blood vessels, and nerves.

The subtlety is that along with the head, the neck and the upper half of the torso must be fixed. To achieve the goal, a standard Elansky tire can be used. The victim's head is placed on the hole and secured with straps, which ensures reliable fixation.

If the ambulance team does not have an Elansky splint, then the technique proposed by Bashmakov will help get out of the situation. The head fixator is prepared from standard Kramer wire splints, wrapped in cotton wool and a bandage. The essence is the same as in the previous version. After which the victim can be taken to a medical facility.

Immobilization for fractures of the upper limbs and clavicle To provide primary care for a broken arm, a standard Kramer ladder splint is used.

It is located from the scapula of the healthy half of the body to the heads of the metacarpal bones of the affected limb. A splint is modeled on the healthy side of the victim.

The retainer is attached using a regular gauze bandage. The main indication for use is a fracture of the humerus and large joints (shoulder and elbow).

If the forearm is damaged, two joints must be fixed - the elbow and the wrist. The aforementioned Kramer tires or two wooden planks can be used. Correctly provided emergency care for limb fractures should include a certain position of the joints. At the elbow it is 90 degrees; in the palm there is a roller made of fabric or cotton wool or foam rubber. The absence of a fixator should not stop you; the limb can be bandaged to the body or a supporting bandage made of fabric can be used.

Improvised splints: a) for a fractured shoulder, b) forearm

To apply a circular (eight-shaped) bandage, the forearms are retracted as far back as possible, in this position they are fixed with bandages or thick fabric. When fingers are broken, the injured person is fixed to a healthy one or to a piece of cardboard.

Damage to the lower extremities and pelvis

First aid for fractures of the limbs with damage to the pelvic bones should be provided comprehensively.

Immediately after an injury, the victim should be moved as little as possible, as the risk of bleeding increases. It is not possible to immobilize this area with a splint; transportation is carried out on a stretcher or a hard surface (door or shield) in the Volkovich position. The legs are bent at the knees and spread apart, a blanket or rolled-up mattress is placed under them. The provision of first aid for a leg fracture in the hip area has special features.

Immobilization of this area is carried out using a Dieterichs splint made of plywood. The long part is located outside and reaches the armpit. The short part is placed from the inside from the groin to the foot. A plywood “sole” or footrest is attached to the foot, which is stretched by twisting. The splint, due to gradual stretching, allows you to immobilize three joints: ankle, knee and hip. Since large vessels and nerves can be damaged by fragments, the principle of operation allows them to be slightly shifted into place. In the absence of a Dieterichs fixator, first aid for fractures of the limbs can be provided with a long Kramer splint or any available means. Also, the injured limb can be fixed to a healthy one, and in this position the victim can be taken to a medical facility.

First aid for a fracture of the lower extremities in the shin area can be provided using the above-mentioned wire splint. Several of them are applied: two on the sides and one on the back with the obligatory grip of the foot along the plantar surface. The knee and ankle joints are immobilized, the angle at which should be 90 degrees, you can use improvised materials. Finger fractures do not need to be immobilized; it is enough not to step on them during transportation.

No less important than providing first aid for fractures of the limbs is the tactics of action for damage to the ribs and spine.

This is due to an increased risk of injury to vital organs and structures. Multiple and comminuted rib fractures can cause damage to the lungs and pleura. The result can be pneumothorax, in which air accumulates in the pleural cavity. With hemothorax, blood accumulates, leading to impaired breathing and cardiac function.

And if first aid for limb fractures begins with immobilization, then if the chest is damaged, such tactics may be erroneous and lead to injury to the lung or pleura. For multiple fractures, a circular bandage can be applied, but not a rigid one, as this may impair breathing. It is correct to bandage while exhaling, otherwise the retainer will not fulfill its purpose and will fall off. Recently, tying sheets or a towel is not used due to the risk of developing congestive pneumonia and injuries to internal organs.

When there is a wound through which air enters or exits, which is manifested by a characteristic whistle, a bandage is applied to it. But first, polyethylene (a sterile bandage wrapper) is placed on the wound, followed by a layer of cotton wool, which is fixed with a circular bandage. This will prevent air from entering the pleural cavity. The victim is transported to the hospital only in a half-sitting position. Actions after a spinal column injury have their own subtleties, knowledge of them

will prevent the development of disability. Any fracture of this area carries the risk of damage to the spinal cord or nerves, which leads to impaired mobility (paresis) or complete immobility (paralysis). Transportation is carried out only on a solid stretcher or shield, door.

For any fracture, first aid should include pain relief and bleeding control. Transport immobilization is mandatory; each part of the body has its own characteristics. If everything is done correctly, it is possible to prevent the development of hemorrhagic (associated with blood loss) and traumatic shocks, complications from the spinal cord or brain. As a result, the fusion process improves, the recovery period and the risk of disability are reduced.

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