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 per-
missible and may be all that is necessary
to get the limb back into position.
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 con-
siderable 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 sever-
ity of shock, or cause extensive damage to
the blood vessels, nerves, muscles, and
other tissues around the broken bone.
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 con-
trol are discussed in the section on wounds
of this chapter. Use a tourniquet as a last
After you have stopped the
bleeding, treat the fracture.
Now that we have seen the general rules for
treating fractures, we turn to the symptoms and
emergency treatment of specific fracture sites.
Fracture of the Forearm
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.
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 frac-
ture 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
Fracture of the Upper Arm
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.
Figure 4-53.First aid for a fractured forearm.