fracture are almost always present. A fracture just
above the ankle is often mistaken for a sprain. If both
bones of the lower leg are broken, an open fracture is
very likely to result.
If the fracture is open, stop the bleeding and treat
the wound. Carefully straighten the injured leg. Apply
a pneumatic splint if available; if not, apply three
splints, one on each side of the leg and one underneath.
Be sure that the splints are well padded, particularly
under the knee and at the bones on each side of the
A pillow and two side splints work very well for
treatment of a fractured lower leg. Place the pillow
beside the injured leg, then carefully lift the leg and
place it in the middle of the pillow. Bring the edges of
the pillow around to the front of the leg and pin them
together. Then place one splint on each side of the leg
(over the pillow), and fasten them in place with strips
of bandage or adhesive tape. Treat the victim for shock
and evacuate as soon as possible. When available, you
may use the Hare or Thomas half-ring traction splints.
The following first aid treatment should be given
for a fractured kneecap (patella):
Carefully straighten the injured limb. Immobilize
the fracture by placing a padded board under the
injured limb. The board should be at least 4 inches
wide and should reach from the buttock to the heel.
Place extra padding under the knee and just above the
heel, as shown in figure 4-38. Use strips of bandage to
fasten the leg to the board in four places: (1) just below
the knee; (2) just above the knee; (3) at the ankle; and
(4) at the thigh. Do not cover the knee itself. Swelling
is likely to occur very rapidly, and any bandage or tie
fastened over the knee would quickly become too tight.
Treat the victim for shock and evacuate as soon as
A person with a fractured clavicle usually shows
When the victim stands, the
injured shoulder is lower than the uninjured one. The
victim is usually unable to raise the arm above the level
of the shoulder and may attempt to support the injured
shoulder by holding the elbow of that side in the other
hand. This is the characteristic position of a person
with a broken clavicle.
Since the clavicle lies
immediately under the skin, you may be able to detect
the point of fracture by the deformity and localized
pain and tenderness.
If the fracture is open, stop the flow of blood and
treat the wound before attempting to treat the fracture.
Then apply a sling and swathe splint as described
below (and illustrated in figure 4-39).
Bend the victims arm on the injured side, and
place the forearm across the chest. The palm of the
hand should be turned in, with the thumb pointed up.
The hand should be raised about 4 inches above the
level of the elbow. Support the forearm in this position
by means of a wide sling. A wide roller bandage (or
any wide strip of cloth) may be used to secure the
victims arm to the body (see figure 4-35).
figure-eight bandage may also be used for a fractured
clavicle. Treat the victim for shock and evacuate to a
definitive care facility as soon as possible.
Figure 4-37.Splint for a fractured femur.
Figure 4-38.Immobilization of a fractured patella.