FRACTURE OF THE FOREARM AND WRIST
Radius and ulna, the bones of the forearm may be fractured across their shafts by a heavy blow. These fractures are often compound because the bones have little fleshy covering. The commonest fracture around the wrist is a Colles’ fracture, usually caused by a fall on the outstretched hand. It produces dinner fork deformity of the forearm and hand.
First-aid
1. Place the forearm at right angles to the upper arm, and place it across the chest, the palm over the chest and the thumb facing upwards.
2. Roll a magazine or folded newspaper around the forearm and hand.
3. Apply one bandage above the fracture and the other over the wrist.
4 Support the limb by a broad arm sling.
FRACTURES OF THE HAND AND FINGERS
The hand is made up of many small bones with movable joints, which may be injured by direct or indirect trauma. Crush injuries cause multiple fractures in the hand. A fracture of the knuckle between the little finger and the hand may occur due to a misplaced punch. There may be severe bleeding and swelling. Sprains and dislocation may affect any fingers. The thumb is particularly prone to dislocation caused by a fall on to the hand.
First-aid
1. Control bleeding and treat any wounds.
2. Support the affected limb in an elevation sling. Give additional support by applying a broad bandage over the sling. Tie the knot in front of the uninjured side.
3. Shift him to a hospital in sitting position.
FRACTURE OF RIB
Rib fractures may be caused by direct force (a blow, vehicular accidents, or fall on the chest) or by indirect force e.g. compression of the chest from the front and back simultaneously. The condition is diagnosed by the following features.
1. There is pain at the injured area, increased on deep breathing and coughing.
2. The victim takes short and shallow breaths so that the ribs do not move and increase the pain.
3. Crepitus is usually felt.
4. There may be signs of internal bleeding.
5. The patient may be asphyxiated due to entry of air in the pleural cavity from injured lung. He may collapse.
6. Air is sucked in and blown out through an open wound.
7. There may be flail chest, in which there is isolation of a portion of the chest wall due to multiple rib fractures. This portion moves in when the victim breathes out and moves out when the victim breathes in. This produces severe respiratory embarrassment.
First-Aid
1. If the fracture is not complicated, apply two broad bandages round the chest. The center of the first should be below the area of pain and that of the other above it. The upper bandage should overlap the lower one by half its width. Ask the victim to breathe out fully, and then tie the knot firmly so as to support the broken rib. The knots should be tied nearer the front of the chest on the uninjured side. Support the arm on the side of injury in a sling. Shift him to a hospital immediately.
2. If the fracture is complicated, do not apply bandages, except in cases where air is sucked in through an open wound, in the chest. Place the patient with his head and shoulders raised, and turned towards the injured side. Apply sling to the arm in the injured side. Shift him to hospital immediately on a stretcher.