tape, clothing, or other suitable materials. If
possible, one person should hold the splints in
position while another person fastens them.
Although splints should be applied snugly,
they should NEVER be tight enough to interfere
with the circulation of the blood. When you are
applying splints to an arm or a leg, try to leave
the fingers or toes exposed. If the tips of the
fingers or toes become blue or cold, you will know
that the splints or bandages are too tight. You
should examine a splinted part approximately
every half hour and loosen the fastenings if the
circulation appears to be impaired. Remember
that any injured part is likely to swell, and splints
or bandages that are applied correctly may later
become too tight.
INJURIES TO BONES
A break in a bone is called a FRACTURE.
There are two main kinds of fractures. A
CLOSED FRACTURE is one in which the injury
is entirely internal; the bone is broken but there
is no break in the skin. An OPEN FRACTURE
is one in which there is an open wound in the
tissues and the skin. Sometimes the open wound
is made when a sharp end of the broken bone
Figure 4-52.Closed and open fractures.
pushes out through the flesh; sometimes it is made
by an object such as a bullet that penetrates from
Figure 4-52 shows closed (A) and open (B)
Open fractures are more serious than closed
fractures. They usually involve extensive damage
to the tissues and are quite likely to become in-
fected. Closed fractures are sometimes turned into
open fractures by rough or careless handling of
It is not always easy to recognize a fracture.
All fractures, whether closed or open, are likely
to cause severe pain and shock; but the other
symptoms may vary considerably. A broken bone
sometimes causes the injured part to be deformed
or to assume an unnatural position. Pain,
discoloration, and swelling may be localized at the
fracture site, and there may be a wobbly move-
ment if the bone is broken clear through. It may
be difficult or impossible for the victim to move
the injured part; if able to move it, there may be
a grating sensation (crepitus) as the ends of the
broken bone rub against each other. However, if
a bone is cracked rather than broken through, the
victim may be able to move the injured part
without much difficulty. An open fracture is easy
to recognize if an end of the broken bone pro-
trudes through the flesh. If the bone does not pro-
trude, however, you might see the external wound
but fail to recognize the broken bone.
If you are required to give first aid to a per-
son who has suffered a fracture, you should
follow these general rules:
If there is any possibility that a fracture has
been sustained, treat the injury as a frac-
ture until an x-ray can be made.
Get the victim to a definitive care facility
at the first possible opportunity. All frac-
tures require medical treatment.
Do not move the victim until the injured
part has been immobilized by splinting
unless the move is necessary to save life or
to prevent further injury.
Treat for shock.
Do not attempt to locate a fracture by
grating the ends of the bone together.
Do not attempt to set a broken bone, unless
a medical officer will not be available for
When a long bone in the arm or leg is frac-
tured, the limb should be carefully straight-
ened so that splints can be applied unless
it appears that further damage will be