M.Hakan DURAL M.D.

BONE, JOINT, AND

MUSCLE INJURIES

Some signs of serious muscle, bone or joint injuries: Significant deformity

Bruising and swelling

Inability to use the affected part normally

Bone fragments sticking out of the wound

Person feels bone grating after injury

Heard a snap or pop sound at the time of injury

The injured area is cold or numb

Cause of the injury suggests that the injury may be

severe

Fractures

any break in a bone

Dislocation

when one end of a bone making up a joint is pulled or

pushed out of place

Sprain

when a ligament is torn (ankle, knee, finger…)

Strain

stretching of a muscle or tendon or mild tearing of muscle

(neck, lower back…)

There are two categories of fractures:

Closed (Simple) fracture

○ The skin is intact and no wound exists anywhere near

the fracture site.

Open (Compound) fracture

○ The skin over the fracture has been damaged or broken.

○ The wound may result from bone protruding through the

skin.

○ The bone may not always be visible in the wound.

Fractures

Fractures What to Look for:

General signs and Symptoms:○Tenderness to touch. ○Swelling.○Deformities may occur when bones are broken, causing an abnormal shape.○Open wounds break the skin.○A grating sensation caused by broken bones rubbing together can be felt and sometimes even heard.Do not move the injured limb in an attempt to detect it.○Loss of use.

Fractures

Additional signs and symptoms include:

The history of the injury can lead to suspect

a fracture whenever a serious accident has

happened.

○ The victim may have heard or felt the bone

snap.

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Simple:

This is a clean break orcrack in the bone

Simple Fracture

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Comminute:

This is a type of fracturethat produces multiple bonefragments

Comminuted Fracture

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Green stick:

A split in a young, immaturebone. Most common in children

Green-Stick Fracture15

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Open:

In a open fracture, part ofthe bone breaks through theskin causing bleeding

The exposed bone isVulnerable to contamination

Wound

Open Fracture

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Closed:

The surrounding skin isunbroken.

Closed Fracture

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Open Fractures

Call for medical help. 112 If necessary, control bleeding by applying

continuous pressure above the fracture site. Cover wound with dry sterile dressing. Stabilize the injured area in position found.

Splint if necessary. Monitor and treat for shock if present. Nothing to eat or drink

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Dislocations

Partial or full displacement of bones at a joint

Tears ligaments Associated fracture External wrenching force Violent muscle contraction Do not attempt to replace joint

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Dislocations

Support injured part Secure injured part 112 Circulation

(10 minutes) N.B. Traction in extreme locations

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Soft Tissue Injuries - Sprains

Sprains are injuries due to: Stretching or tearing

ligaments or other tissues at a joint.

Caused by a sudden twist or stretch of a joint beyond it’s normal motion

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Soft Tissue Injuries - Sprains

The Symptoms of a Sprain are: Pain on movement Swelling Tenderness Discoloration

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Soft Tissue Injuries - StrainsThe Symptoms of a strain are; Intense pain Moderate swelling Painful movement Difficult movement Sometimes, discolouration

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Soft Tissue Injuries - Strains A strain is an injury to a muscle or

tendon caused by over-exertion. In severe cases muscles or tendons are

torn and the muscle fibres are stretched.

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Assessment of Injuries History: (Ask the casualty what happened)

Violent blow or fallSnapping soundSharp pain

Compare:One side of the body against another

Visualise:Try and imagine what happened

X-ray:Injury may not be obvious

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Assessment of injuries

Recognition; Difficulty moving limbs Pain made worse by movement Distortion Coarse grating at bone ends Shock (Femur, Ribcage, Pelvis) Shortening, bending or twisting

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IF IN DOUBT - TREAT AS A FRACTURE !

IF IN DOUBT - TREAT AS A FRACTURE !

Soft Tissue injuries Treatment (RICER)

Rest the injured part. Apply Ice or cold compress.

(15-20mins) Compress the injury. Elevate the injured part. Rehabilitate / Recuperation

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The most common indicator of the severity of the injury is the intensity of the pain. Also the area may be swollen, red and bruised. Follow the below mentioned general guidelines (RICE): Rest: Do not move or straighten the injury

Immobilize: Try to stabilize the person in the position he/she was found. Splint or sling the injured part only and caution to move the person; it should not be more painful.

Cold: Indirectly cool the part using ice for a maximum of 20 minutes. Remove it for 20 minutes and then cool the part again.

Elevate: Only elevate the part if it does not cause more pain.

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