FRACTURE OF THIGH BONE
Fractures of the neck of the thigh bone (femur) at the hip joint are common in the elderly women, whose bones become more brittle after menopause. A fracture of the shaft of the femur develops due to severe force e.g. road accidents, or falls from heights.
1. Pain at the site of the injury.
2. Inability to walk.
3. A patient with impacted fracture of the neck of femur may be able to walk around for some time after the fracture develops.
4. There may be shortening of the thigh, as powerful muscles pull broken bone ends towards each other.
5. Knee and foot are turned outwards.
6. Signs of shock may be present.
First-aid
1. Treat shock. Do not raise the legs.
2. Immobilize the thigh by bandaging it to the sound limb up to below the knee. Alternatively a well-padded splint may be applied between the legs from the groin to the foot. Insert padding between the thighs, knees, and ankles.’Tie the feet and ankles to the splint with a figure of eight bandage.
3. Apply a long well-padded splint from axilla to foot, tying 7 bandages at chest, below the arm pits, pelvis, hip joints, thigh, and ankles.
4. Shift him to a hospital immediately.
5. If the victim has to be transported over a long distance, a sturdier support is needed for the leg. A femoral traction splint e.g. Thomas’ splint, is ideal. But it can be used only by trained personnel. During transport, keep the foot of the stretcher raised to minimize swelling and shock.
FRACTURE OF THE KNEE JOINT
The knee joint is supported by strong ligaments and muscles. The knee cap lies in front of it. Any of these structures may be injured by direct blow, strain, or violent twist. The condition is diagnosed by the following features.
1. History of a recent trauma to the knee.
2. Pain in the knee joint.
3. Acute pain on attempting to straighten a bent, locked knee.
4. Rapid swelling of the knee joint.
First-aid
1. Place the victim in supine position, with the knee and leg in the most comfortable position.
2. Bandage a soft padding around the knee.
3. Shift him to a hospital immediately on a stretcher.
4. Do not let the victim walk.
5. Do not attempt to force the knee straight.
6. Do not give the victim anything to eat or drink.
FRACTURE OF KNEE CAP (PATELLA)
It is a small bone in front of the knee joint. It forms the point of attachment of the large muscles of the thigh. It may be fractured from direct blow or as a result of muscular pull. The condition is diagnosed by the following features.
1. Pain on the front of the knee joint.
2. Tenderness at knee.
3. Loss of movements at knee joint.
4. Swelling and bruising at knee.
5. Crepitus over the patella.
First-aid
1. Place the casualty on the back with the head and shoulders elevated, supported by rolled blankets.
2. Place a splint below the injured leg, extending from below the buttocks to below the heel. Place padding under the knee to fill the hollow, and under the heel so as to raise it off the splint. Apply a figure of eight bandage around the ankle, foot and the splint. Tie the knots against the sides of the splint.
3. Shift him to a hospital immediately. □ FRACTURE OF LEG BONES
One of the leg bones (tibia) is quite sturdy and usually requires a heavy blow to fracture it. The other (fibula) is thinner and can be broken by twisting force, as during twisting of the ankle. Since the weight-bearing is done by the tibia, a fracture of the fibula does not cause much problem for the victim. The condition is diagnosed by the following features.
1. There is pain in the leg.
2. Swelling and bruising are seen at the site of the fracture.
3. Angulation and twisting of the leg may be present at the site of the fracture.
4. An open wound is often present.
5. Unable to walk.
6. There may be an open wound, through which the fractured ends of the bones may project.
7. Features of shock may be present.
First-aid
1. Place the victim in lying down position, supporting the injured leg.
2. Clean and dress the wound.
3. Straighten the leg using gentle traction in the line of the leg.
4. Splint the leg to the other leg. Place extra padding on either side of the leg from upper thigh to the foot.
5. Shift him to a hospital immediately.