Fractures about Wrist and Hand are caused by blows or other injuries. There is pain, swelling, irregularity in the outline of the bones and crepitus. The limb must be bandaged to a flat board or splint, and supported by sling.
Fractures of Femur or Thigh-bone (fig. 24) are caused by blows or falls, and pain and loss of power is instantly felt with crepitus, shortening, or the broken ends may be felt and the foot turned out.
Fractures (both of the leg or thigh).—First straighten the limb if bent, then tie a handkerchief round the fractured part, after which place a splint made of a broad lath, or something like it, from one joint to the other—say from the knee to the hip, if it is a broken thigh—and then tie handkerchiefs above and below the fracture, near the ends of the splint, tie the limbs together at the ankles, knees, and elsewhere, so that one supports the other. The object is to prevent motion of the fracture while the injured person is being moved, either to home or hospital. In doing this care should be taken to avoid jolting or shaking, as far as possible.
Fracture of Patella or Knee-Cap (fig. 33) may be caused by blows, or excessive muscular action, and the person is made to stand upon leg first. Fragments can also be felt. Raise limb to a position at right angles to body, and apply a figure-of-eight bandage around the knee, including the fragments.
Fractures of Bones of the Leg (fig. 28), are frequent from blows, falls, crushing weight, such as wheels passing over the limb. There is pain and loss of power; alteration in shape; crepitus, and the broken ends may be felt. Apply two splints, one inside and one outside the limb, as directed above, and elevate limb.
Fractures about Foot and Ankle. These are various results of blows or other injuries—(see figs. 30, 31, 36, and 37)—pain, swelling; alteration in outline of bones; crepitus. Treatment.—Elevate foot; apply cold water.
It must be remembered that the treatment for fractures here given is only temporary, to enable the patient to be moved without further injury, which might result in the loss of the limb or even life, till advice can be had.
When the fractured bone protrudes through the flesh, and there is much bleeding, first straighten the limb and close the wound, and tie a handkerchief tightly round over the wound, until a pad can be made, then as quickly as possible make a pad by folding old rags or cloth, or anything of the kind to be got closely together, of some thickness, and broad enough to cover the wound well, then remove the handkerchief already tied on, and place the pad over the wound and tie it lightly, so that the pad presses hard upon the wound and stops the bleeding; the bandage or handkerchief cannot well be too tight. Many a life might be saved, which is now lost if this or a similar method were adopted promptly. The materials are almost always at hand, and the application of them easy and simple. Immediately after the bleeding is stopped remove the sufferer, and call in professional advice without delay.
The stoppage of bleeding from arteries is taught practically in the ambulance classes, and though it forms no part of the Bone-setter’s art, yet many a life may be, and has been saved by this little knowledge, so I subjoin the directions given in the hand-book of the order of St. John, by the lamented Surgeon-Major Sheppard, whose humanity cost him his life after the battle of Isandula.