caused by such a maneuver. Never attempt to straighten the limb by applying force or traction with an improvised windlass or any other device. Pulling gently with your hands along the long axis of the limb is permissible and may be all that is necessary to get the limb back into position.
8. Apply splints. If the victim is to be transported only a short distance, or if treatment by a medical officer will not be delayed, it is probably best to leave the clothing on and place emergency splinting over it. However, if the victim must be transported for some distance, or if a considerable period of time will elapse before treatment by a medical officer, it may be better to remove enough clothing so that you can apply well padded splints directly to the injured part. If you decide to remove clothing over the injured part, cut the clothing or rip it along the seams. In any case, BE CAREFUL! Rough handling of the victim may convert a closed fracture into an open fracture, increase the severity of shock, or cause extensive damage to the blood vessels, nerves, muscles, and other tissues around the broken bone.
9. If the fracture is open, you must take care of the wound before you can deal with the fracture. Bleeding from the wound may be profuse, but most bleeding can be stopped by direct pressure on the wound. Other supplemental methods of hemorrhage control are discussed in the section on wounds of this chapter. Use a tourniquet as a last resort. After you have stopped the bleeding, treat the fracture.
There are two long bones in the forearm, the radius and the ulna. When both are broken, the arm usually appears to be deformed. When only one is broken, the other acts as a splint and the arm retains a more or less natural appearance. Any fracture of the forearm is likely to result in pain, tenderness, inability to use the forearm, and a kind of wobbly motion at the point of injury.
Figure 4-53.First aid for a fractured forearm.
If the fracture is open, a bone may show through. If the fracture is open, stop the bleeding and treat the wound. Apply a sterile dressing over the wound. Carefully straighten the forearm. (Remember that rough handling of a closed fracture may turn it into an open fracture.) Apply a pneumatic splint if available; if not, apply two well-padded splints to the forearm, one on the top and one on the bottom. Be sure that the splints are long enough to extend from the elbow to the wrist. Use bandages to hold the splints in place. Put the forearm across the chest. The palm of the hand should be turned in, with the thumb pointing upward. Support the forearm in this position by means of a wide sling and a cravat bandage, as shown in figure 4-53. The hand should be raised about 4 inches above the level of the elbow. Treat the victim for shock and evacuate as soon as possible.
The signs of fracture of the upper arm include pain, tenderness, swelling, and a wobbly motion at the point of fracture. If the fracture is near the elbow, the arm is likely to be straight with no bend at the elbow.