Chapter 14Bone, Joint, and Muscle

Injuries

Bone InjuriesFractures

• Fracture and broken bone both mean a break or crack in a bone.

• Two categories:• Closed—the skin is

intact. • Open—the skin has

been broken.

Types of Fractures (1 of 2)

• Traverse—cut across the bone at right angles • Greenstick—incomplete fracture• Spiral—usually result from a twisting injury

Types of Fractures (2 of 2)

• Oblique—cross the bone in a slanting direction

• Comminuted—the bone is fragmented into more than two pieces

• Impacted—the broken ends are jammed together

Recognizing Fractures

When in doubt, treat the injury as a fracture.•Use DOTS

• Deformity• Open wounds• Tenderness• Swelling

Recognizing FracturesAdditional Signs and Symptoms

• Loss of use• Guarding• Crepitus—a grating

sensation• History

Care for Fractures (1 of 6)

• Check for life-threatening conditions first.

• Gently remove clothing covering the injured area.

• Examine the area by looking and feeling for DOTS.

Care for Fractures (2 of 6)

Check blood flow and nerves using the mnemonic CSM.•C—Circulation

• For arm injury, feel for radial pulse.

• For leg injury, feel for posterior tibial pulse.

Care for Fractures (3 of 6)

•S—Sensation• Lightly touch or

squeeze one of the victim’s toes or fingers.

Care for Fractures (4 of 6)

•M—Movement• Have the victim

wiggle his or her toes and fingers.

Care for Fractures (5 of 6) • Stabilize injured

part.• For an open

fracture:• Do not push on

protruding bones. • Cover wound

with a dressing without applying pressure.

Care for Fractures (6 of 6)

• If possible, apply an ice pack. • Seek medical care.

Joint Injuries

A joint is where two or more bones come together.

Dislocations

A dislocation occurs when a joint comes apart and stays apart with the bone ends no longer in contact.

Recognizing Dislocations

• Deformity (the main sign)

• Severe pain• Swelling• Inability of the

victim to move injured joint

Care for Dislocations• Check the CSM. • Use the RICE procedures:

• Rest• Ice• Compression• Elevation

• Use a splint to stabilize the joint.• Do not try to reduce the joint.• Seek medical care.

SprainsA sprain occurs when a joint is twisted or stretched beyond its normal range of motion.

Recognizing Sprains

Show similar signs and symptoms to a fracture. • Severe pain• Pain prevents the victim from moving or using the

joint.• Swelling• Skin around the joint may be discolored.

Care for Sprains• Follow the RICE procedures.

• Apply ice pack for 20 minutes.• Apply compression for 3 to 4 hours.• Repeat the cycle.• Raise the injured part.

• Use cold promptly.

Muscle Injuries

Muscle injuries pose no real emergency.

Strains

• Also known as a muscle pull• Occurs when a muscle is stretched

beyond its normal range of motion and tears the muscle

• Inflammation begins immediately after an injury.• Can take 24 to 72 hours for pain and

stiffness to begin.

Recognizing Strains• Sudden, sharp pain in affected muscle• Extreme tenderness when touched• Swelling• Weakness and inability to use injured

part• Stiffness and pain when victim moves

the muscle• After a few days, the skin around the

injury may be discolored.

Care for Strains

Follow the RICE procedures.

Cramps

• Occurs when a muscle goes into an uncontrolled spasm and contraction

• Associated with diabetes, atherosclerosis, and physical activity

• Two categories:• Night cramps

• Occur at night or at rest• Heat cramps

• Related to dehydration and electrolyte imbalance

Recognizing Cramps

• Sudden, severe pain, usually in the legs

• A knotting of the muscle• Restricted movement

Care for Cramps• Gently stretch the muscle. • Relax the muscle. • Apply an ice pack. • Pinch the upper lip hard. • Drink lightly salted cool water. • Drink a commercial sports drink.

Muscle Contusion

A muscle contusion or bruise results from a blow to the muscle.

Recognizing Contusions

• Swelling• Pain and tenderness• After a few days, the skin in the area may

become discolored.

Care for Contusions

• Follow the RICE procedures.