Fractures and Soft Tissue Injuries: Causes, Classification, Treatment

1. Fractures and soft tissue injuries

2. Fractures • A broken or cracked bone • Great forces are required to break a bone, unless it is diseased or old • Bones that are growing or under repair are similar to a twig- they may split, bend, and crack easily

3. Causes of fractures • Direct force- bones break at site of impact • Indirect force- bones break some distance from impact • Muscular force- violent muscular contraction • Twisting force- caused by twisting • Fatigue- Repeated strain on the same bone • Pathological- diseases that weaken the bone

4. CLASSIFICATION OF FRACTURES • Open fracture • Bone exposed at surface of skin (wound might be present) • Possible bleeding or shock • High risk of infection • Closed fracture • Skin above fracture is not damaged • Bone fragments might cause damage to nearby tissues and blood vessels

5. CLASSIFICATION OF FRACTURES • Stable • Broken parts are not displaced (moved) easily • Bones not completely broken • Most common at the wrist, shoulder, ankle and hip. • Minimal risk of bleeding or further damage • Unstable • Broken parts are easily moved by muscle contractions or movement • Risk of damage to nearby tissue, organs, and blood vessels present • May occur in cases of badly broken bones or torn ligament

6. CLASSIFICATION OF FRACTURES • 5 types of fracture • Comminuted • Greenstick • Transverse • Oblique • Spiral

7. Comminuted • Bone is broken in several parts • Unstable • Partial break in the bone • Bone Bent • More common in children • Stable Green stick

8. Transverse • Break perpendicular to the bone’s length • Unstable if bone is fully broken • Break at an angle across the bone • Unstable if bone is fully broken Oblique spiral • Break caused by twisting force

9. Signs and symptoms • Deformity, swelling, or bruising • Pain/ tenderness • Shortening, bending, or twisting of the limb • Coarse grating (Crepitus) heard/ felt • Signs of shock, especial in cases of femur or pelvis fracture • Possible loss of function, sensation, or strength • May be presence of a wound, with bone ends protruding

10. Treatment • Ensure ABC • Splint and Immobilize injured part, and ask casualty to keep still (cover joint above and below site of fracture) • Place padding around injury for extra support • Send to hospital for arm injury (tie arm sling if necessary), call 995 for ambulance for leg injury • Prevent/ Treat shock, do not elevate injured limb • Check circulation to injured limb at least every 10 minutes • Monitor LOC and vital signs, at least every 5 minutes All cases of spinal, neck and lower limb fractures must be transported by stretcher

11. DO NOT… … • Move the casualty until injured part is immobilized, unless faced with immediate danger • Allow casualty to eat or drink • Press directly on any protruding bone ends • Elevate an injured limb

12. Soft tissue injury • Cramps • Sudden painful spasm in 1 or more muscles • Strains • Injury to a muscle or tendon in which the muscle fibers tear due to overstretching • Sprains • Injury in a joint caused by overstretched ligament

13. Signs and symptoms • Pain and tenderness • Difficulty moving injured part, especially in cases of joins • Swelling or bruising in the area

14. Treatment (cramps) • Stretch… …

15. Treatment (strains and sprains) • “RICE” procedure • R rest • I  ice • C  comfortable support • E  Elevate the injured limb, if not constricted

16. Notes • Support bandage should extend from injured part to the next joint (Ankle injury: bandage should extend from the base of the toes to the knees) • Check for circulation beyond bandages every 10 minutes • Send to hospital if pain is severe or casualty is unable to use the injured part (otherwise, advice casualty to rest and seek medical advice) • Treat for fracture, if unsure of severity

17. Clarification?

18. Thank You