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Care and treatment of fractures relies on immobilisation and adequate splinting of the injury. However, if the fracture is particularly complex, the wound associated with an open fracture is difficult to control.
If the pulse to the end part of the limb (distal pulse) cannot be restored by gentle traction, then the limb should be stabilised in its current position. Urgent ambulance transport should be obtained. Do not waste time with splinting.
Generally, fractured limbs should be made immobile and left for medical aid. However, in remote areas or some time from medical aid, you may be required to treat as follows:
Fractured Forearm
check for pulse to the end part of the limb, if none - gentle traction until pulse returns
treat any wounds
pad bony prominences
apply adequate splint
secure above and below fracture, secure wrist
reassess pulse or return of colour/warmth
elevate injury with arm sling
Fractured Upper Arm
check for pulse to the end part of the limb, if none - gentle traction until pulse returns
treat any wounds
pad between arm and chest
apply ‘collar and cuff' sling, secure above and below fracture firmly against chest with triangular bandages
reassess pulse or return of colour/warmth
Fractured Leg
check for circulation and pulse to the end part of the limb (skin colour and temperature)
if no circulation apply gentle traction until pulse or colour returns
call ‘000' for an ambulance
treat any wounds
immobilise the limb
pad bony prominences
reassess circulation below injury
Fractured Pelvis
call ‘000' for an ambulance
check for pulses in both legs
bend legs at knees, elevate lower legs slightly and support on pillows or similar
support both hips with folded blankets either side
discourage attempts to urinate
Care must be exercised with a suspected fractured pelvis. This injury may have serious complications. The casualty should always be transported by ambulance and not by alternative means unless absolutely essential.
Fractured jaw
A common injury in certain contact sports is dislocation, or fracture of the lower jaw (mandible). The casualty will have pain in the jaw, be unable to speak properly, and may have trouble swallowing.
call ‘000' for an ambulance
support the jaw
sit the casualty leaning slightly forward
rest the injured jaw on a pad held by the casualty
DO NOT apply a bandage to support the jaw.
Observe the casualty carefully for signs of breathing difficulties and any indication that he or she is becoming drowsy or unconscious.
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