Traditional medicine

Which joints should be fixed in case of a hip fracture? Technique for applying immobilizing splints and bandages for injuries

Anyone can find themselves in an emergency situation. And in this case, knowledge of the rules of first aid can save lives. The main thing is to maintain clarity of thinking and not try to perform manipulations that require special training.

Rules for the provision of primary care

The task of the person who provides first aid is not to make the victim worse than he already is. It should relieve pain and provide rest to the damaged area. This is the main task (PMP) for fractures.

First of all, it is necessary to assess the severity of the victim’s condition and locate the location of the injury. Then, if necessary, stop the bleeding. It is not recommended to move a person until qualified help arrives, especially if he has a spinal fracture or damage to internal organs. In some emergency situations, evacuating the scene is vital. In this case, rigid stretchers or shields are used.

An isolated injury requires a slightly different approach. It is necessary to immobilize the injured limb with a splint, giving it the most physiological position. It is imperative to fix the joint before and after the fracture. If there are no other complaints, the victim is transported to a medical facility.

Open or closed fracture?

PMP for fractures depends on the shape, type and severity of the injury. During the examination of the victim, it is necessary to determine the type of fracture, since depending on this, first aid will be slightly different. Any diagnosis is based on certain criteria. In the case of a fracture, there are relative and absolute signs indicating the presence of injury.

Relative signs:

Pain. When tapping or trying to change the position of the injured limb, discomfort occurs.
Edema. It hides the picture of the fracture, is part of the inflammatory response to damage, compresses soft tissue and can move bone fragments.
Hematoma. Indicates that the integrity of the vascular network at the site of injury has been compromised.
Impaired function. Manifests itself in limited mobility or inability to withstand the usual load.

Absolute signs:

Strange, unnatural position of the bone, its deformation.
The presence of mobility where it never existed.
Presence of crepitus (air bubbles) under the skin.
With an open fracture, skin damage and bone fragments are visible to the naked eye.

This is how you can determine the presence and type of fracture without the use of complex technology.

Fracture of the bones of the upper limb

PMP involves giving the limb the correct position and fixing it to the body. To do this, you need to bend your arm at the elbow so that you get a right angle and press your palm to the victim’s chest. To apply a splint, choose a material that is longer than the forearm and hand. It is secured to the limb in the presented position, then the arm is suspended on a bandage, which is a piece of fabric tied with a ring and thrown over the neck to eliminate possible stress.

A shoulder fracture requires slightly different tactics. The position of the limb is also given at an angle of ninety degrees, but two splints are applied:

outside the shoulder so that it falls below the elbow;
along the inner surface of the arm from the armpit to the elbow.

The splints are first bandaged individually and then secured together. The hand also needs to be hung on a belt, scarf or any piece of material that is at hand. The victim should only be transported while sitting to the hospital.

Fracture of lower limb bones

In order to provide emergency medical treatment, you need to stock up on a large number of long and wide tires (boards, pickets, etc.). When immobilizing a limb in case of a hip fracture, the first splint should go from the outside, with the upper end resting against the armpit cavity, and the other reaching the foot. The second splint runs from the perineum to the foot, protruding slightly beyond it. Each of them is bandaged separately and then together.

If materials for a splint are not available, the injured limb can be bandaged to the uninjured leg.

A fracture of the tibia requires the same fixation as a fracture of the femur. The victim is taken to the hospital only lying down.

Fractures of ribs and jaw

Since when the ribs are fractured there is nothing to fix them, a tight bandage is applied to the chest. The victim is recommended to breathe exclusively using the abdominal muscles, without loading the chest. If there are not enough bandages, you can use pieces of fabric or scarves. It is important that a person does not lie down under any circumstances, since sharp fragments of ribs can damage the lungs, heart, and pierce the diaphragm.

Most often the result of a fight or a fall. Therefore, it is quite reasonable to assume that the victim also has a concussion. First aid in this case is to cover the person's mouth, give him analgesics and fix the jaw with a bandage, tying its ends on the top of the head. The main thing is to monitor the position of the tongue so that it does not block the airways. If the victim is unconscious, then it is necessary to lay him on his side or face down. Transport immobilization for head fractures should be in a horizontal state. This will help avoid stress on damaged bones and prevent asphyxia.

First aid for an open fracture

PMP for an open fracture should be provided as quickly as possible. In such a situation, the risk of complications such as collapse and massive bleeding increases significantly.

Therefore, the algorithm of actions is as follows:

Examine the victim and assess his condition.
Give him a painkiller to prevent traumatic shock.
Treat the skin around the wound with peroxide solution, iodine or any other antiseptic.
Use a sterile gauze pad to gently dry the bottom and edges of the wound.
Folded several times, apply to the wound, but do not press.
Perform immobilization using improvised means.
Do not set the fragments under any circumstances!
Call an ambulance.

PMP for a closed fracture will have similar stages, with the exception of those points that talk about wound treatment.

Immobilization

Immobilization is the immobilization of an injured part of the body. It is necessarily performed in case of fractures of bones and joints, rupture of nerve and muscle fibers, and burns. Due to pain, the patient may make sudden movements, which can aggravate his injuries.

Transport immobilization involves keeping the victim immobile while he is transported to a medical facility. Since some shaking is inevitable during movement, good fixation of the patient avoids aggravating the situation.

There are rules that, if followed, will make splinting the least painful for the victim.

The splint must be large enough to support the joint above and below the fracture site. And if the hip is damaged, the entire leg is immobilized.
A splint is formed either on the victim’s healthy limb or on oneself, so as not to cause additional inconvenience to the patient.
The splint is applied over clothing to avoid infection of the wound.
To avoid bedsores in areas where the bone is close to the skin, soft material is placed under the splint.
The splint is not fixed on the side where the broken bone protrudes, because it is strictly prohibited to set it before arriving at the hospital.

Types of medical splints

A medical splint can come in several modifications, depending on the purpose of its use. There are prosthetic splints that both hold the affected area in one position and replace the missing section of bone.

The following types of immobilization splints are distinguished:

A Kramer splint is a lattice made of thin wire, which is covered on top with several layers of bandage or soft fabric. The frame can be given any shape that is necessary in a particular case, this makes it universal.
Dieterichs tire - consists of two wooden boards with holes drilled in them through which belts or fabric are pulled. The kit also includes a small flat bushing that is inserted into the hole, fixing the tire at the desired level.
medical is a sealed chamber into which the injured limb is placed. Then air is pumped between its walls, and the body part is securely fixed.
The Shants splint is a fixation collar used for diseases of the spine, as well as for the prevention of displacement of the cervical vertebrae during back injuries.

PMP for bleeding

Bleeding is a consequence of a violation of the integrity of the vessel wall. It can be external or internal, arterial, venous or capillary. The ability to stop bleeding is essential for human survival.

PMP for bleeding requires compliance with certain rules.

It is necessary to wash a bleeding wound only if caustic or toxic substances have entered it. In case of other contaminants (sand, metal, earth), the damaged area cannot be washed with water.
Do not lubricate the wound under any circumstances. This prevents healing.
The skin around the wound is mechanically cleaned and treated with an antiseptic solution.
Do not touch an open wound with your hands or remove blood clots, as these clots will inhibit bleeding.
Only a doctor can remove foreign bodies from a wound!
After applying a tourniquet, you must immediately call an ambulance.

Applying a bandage

The bandage is applied directly to the wound. To do this, use a sterile bandage or clean cloth. If you doubt the sterility of the material, it is better to drip iodine onto it so that the stain becomes larger than the wound. A roll of bandage or cotton wool is placed on top of the fabric and bandaged tightly. When the bandage is applied correctly, the bleeding stops and the bandage does not get wet.

Attention: in case of an open fracture and a protruding bone, it is prohibited to tightly bandage and set the bone! Just apply a bandage!

Applying a tourniquet or twist

A hemostatic tourniquet can both help in the fight against bleeding and aggravate the severity of the victim’s condition. This manipulation is resorted to only in case of very severe bleeding that cannot be stopped by other methods.

If you don’t have a medical device at hand, a regular thin hose will do. In order not to pinch the skin, you can put a twist on your clothing (sleeve or pant leg) or place a piece of any dense fabric. The limb is wrapped with a tourniquet several times, so that the turns do not overlap each other, but there are also no gaps between them. The first one is the weakest, and with each subsequent one it is necessary to tighten it more strongly. The hemostatic tourniquet can be tied when the bleeding stops. Be sure to record the time the tourniquet was applied and secure it in a visible place. In the warm season, you can keep it for up to two hours, and in the cold - only an hour.

The principles of applying a splint for a hip fracture are studied in biology lessons at school, but few people remember which joints it should fix. Experience shows that an unprepared person in most cases has many questions. However, first of all it is necessary to establish whether a hip fracture actually occurred.

First aid is the key to recovery

A hip fracture is characterized by the following symptoms:

Pain in the hip joint area, radiating to the groin.
The shape and sometimes the length of the leg changes (may be shortened).
Swelling, sometimes bruising at the site of injury.
The leg is partially or completely immobilized.
Sometimes there is excessive mobility at the fracture site.

First aid for a person with a femur fracture consists of the following actions:

stopping bleeding;
pain relief (if necessary);
applying a bandage (if there is a wound);
transport immobilization.

Immobilization is a set of measures aimed at creating special conditions for fixing the damaged area. For hip fractures, immobilization is a necessary condition, since all movements of the victim (possibly unconscious) can aggravate the situation.

Transport immobilization means immobilization until a person is delivered to a medical center. This is dictated by the peculiarities of human biology.

Transport immobilization allows you to avoid many complications, namely:

tissue damage from particles of destroyed bone;
heavy bleeding:
traumatic shock.

Transport immobilization is performed using specially manufactured industrial devices:

made of wood;
made of wire;
made of plastic;
with a vacuum operating principle.

In the absence of special devices, any suitable objects (slats, skis, etc.) are used. It is better to transport by placing a soft cushion under your foot. Patients with such injuries should be hospitalized.

Principles of splinting

What main joints should a splint fix for a hip fracture? In case of a hip fracture, it is necessary to fix all the joints of the leg and the segments adjacent to the hip. That is, the tire is applied in the following areas:

hip;
shin;
foot;
axillary area.

This is necessary to ensure that the damaged joint is completely immobilized.

It is also important to follow the following rules:

If necessary, administer anesthesia to avoid painful shock.
If the fracture is open, the wound is disinfected with iodine solution and a bandage is applied.
Splinting is carried out without removing clothing. If necessary, it is cut in several places.
Place cotton wool or any soft material in areas where the tire and joints come into contact.

It is easier to do immobilization not alone: one person carefully lifts the leg, and the second wraps bandages and belts.

Due to ease of use and reliable fixation, Kramer or Dieterichs splints are most often used.

How to apply a Kramer splint?

The Kramer tire design is a wire lattice that resembles a ladder. The lattice is flexible, and based on the characteristics of the fracture, it can be given different shapes. It is important to know how to prepare it correctly. Preparation is carried out as follows:

Two or three ladder segments are firmly fastened together to form an outer portion that should be as long as the armpits of the end of the heel. Under the heel, it bends and runs across the foot in the shape of an “L.”
The length of the back of the device is equal to the distance between the buttock and the heel. It is applied to the foot at a right angle, passes through the entire foot and protrudes slightly beyond the toes.
The third splint will run along the inside of the limb from the groin area to the edge of the foot. It also curves under the foot in the shape of the letter "L".

After all three structures have been modeled, a Cramer splint is applied for a hip fracture. It should be applied as follows:

All three components are superimposed on the corresponding zones.
Any soft material should be placed under the bony protrusions.
The curved ends of the outer and inner segments, passing under the foot, are fastened together.
A long tire is tied to the body in several places.
Each of the three splints is alternately fixed to the thigh (upper section) and lower leg, then fixed to the ankle.
The splints are tightly bandaged with bandages.
Also wrap the foot with parts of the tires under it in a “figure of eight” fixing bandages.

If the fracture is open, then no bandages are applied to the area where the bone protrudes.

Important! You should “adjust” it to the tire, that is, give the parts the desired size and shape, otherwise you can worsen the condition of the injured leg.

If there are neither Kramer tires nor any available materials, you can try simply taping the injured leg to the healthy one. However, you should understand that this method is not very reliable, so it is better to use it as a last resort.

How to apply a Dieterichs splint?

The Dieterichs splint for a hip fracture allows you to immobilize the leg using the traction method. It consists of two wooden strips, long and short, with holes drilled along the entire length at equal distances. Each plank can be moved apart. In this way, its length can be adjusted depending on the height of the person. Each bar is equipped with a crossbar on top, with which they rest against the groin and armpit area (similar to crutches). Traction is done using a ready-made wooden sole, which is bandaged to the foot.

First you need to prepare the length of the device:

The outer bar is extended so that the length is equal to the distance from the heel to the armpit.
The length of the inner strap is from the groin to the foot.
The upper end of the outer crutch should rest against the armpit, and the lower crutch should rest against the groin.
It is necessary that both bars extend beyond the level of the foot by 8-12.
The resulting length is fixed by securing the pegs (protrusions on the slats) in the corresponding holes.

At the pegs that fix the length of the bars, it is better to wrap the moving parts of each crutch with a bandage. This way they will be tightly fixed and will not move during transportation.

For reference! Splinting can be made easier by first placing a structure of two fastened Kramer splints under the leg and torso (from the lower third of the shin to the shoulder blade).

This will immobilize the limb and speed up subsequent splinting.

A soft cotton-gauze pad (or just cotton wool) is bandaged to the inner surface of both bars and to the oval crossbars of the crutches.
Without removing the victim’s shoes, first, using bandages, fix the “sole” with a cord to the foot, paying special attention to fixing the heel area. If the fixation is insufficient, the bandage may slip and proper stretching will not occur.
The long bar is placed on the outside of the body and leg, the short bar is placed inside the thigh and lower leg. Both bars are pressed tightly against the leg.

Each plank is guided from below through the sole bar brackets.

After this, the tires are secured:

Using the included straps, the outer splint is attached to the body at the thoracic and lumbar areas.
After this, the outer splint is bandaged on the thigh.
The inner splint is fixed to the thigh and lower leg.
Using a crossbar with a hole, connect the lower parts of the tires that are located under the heel.

After the splints are secured, the foot is stretched:

The cord from the wooden “sole” is passed through a special hole.
The cord is twisted with a pole threaded through the loop of the cord. This produces traction.
In this position, the foot is fixed to the transverse lower crossbar with a gauze bandage.

Traction of the leg cannot be done with an open fracture, or if the person is in pain shock. This is worth remembering from biology lessons.

After the splints are applied and the leg is stretched, it is necessary to finally fix both straps. To do this, they are tied with bandages to the torso and limbs in a circular motion. After this, the victim must be transported.

For reference! If long-term transportation is required, then special plaster rings must be additionally used. The victim is given five rings: two on the body, three on the leg (in the upper third of the thigh, on the shin and on the ankle).

After applying the Dieterichs splint, it is advisable to additionally overlap the Kramer splint around the pelvis. This will increase the degree of fixation and facilitate transportation.

Knowing how to administer first aid and splint for an injury as serious as a hip fracture is essential. In such situations, it is very important to act quickly and correctly, since any delay or incorrect actions can pose a serious threat to the health of the victim, and sometimes even cost life. This is why it is important to study human biology in order to know how to react in emergency situations.

In case of damage to the fingers, hand, or wrist joint, the splint should cover the entire forearm and hand with fingers. The physiological position of the fingers is achieved by placing a tightly rolled cotton-gauze roller into the hand. The forearm is suspended on a scarf or bandage, the ends of which are tied around the neck.

Damage, fracture of the forearm and elbow joint

If the forearm and elbow joint are damaged, the splint is taken such a length that one end reaches the upper third of the shoulder, and the other reaches the fingertips.

The arm is bent at the elbow joint at a right angle with the palm facing the stomach, the fingers are bent.

A standard splint is modeled (preferably on a healthy arm), lined with cotton wool and a bandage and applied along the outer surface of the forearm, bending over the elbow joint and then along the outer back surface of the shoulder. In this form, the splint is fixed with a wide bandage, and the hand is suspended on a scarf.

If there are no standard tires, then improvised means are used.

In this case you can:

hang your hand on a scarf or belt, and bandage your shoulder to your body;
fasten the sleeve in the forearm area to the shirt with safety pins, after bending your arm at the elbow;
Place your forearm in the hem of the shirt and fasten the edge of the hem to the shirt with pins.

Damage, fracture of the humerus and shoulder joint

For injuries of the humerus and shoulder joint, standard large ladder splints are used. The arm is bent at the elbow joint at an angle with the palm facing the stomach, the fingers are bent. A ball of cotton wool is placed in the armpit. The splint is modeled so that it starts from the healthy shoulder blade, passes through the back along the suprascapular area of the sore side, then along the back outer side of the shoulder, forearm and ends at the base of the fingers.

If standard tires are not available, you can use two planks or other suitable items. One of the planks is placed on the inside so that its upper end reaches the armpit, and the other on the outside, so that its upper end protrudes beyond the shoulder joint. The lower ends of the planks should protrude beyond the elbow. The forearm is suspended on a scarf; in extreme cases, the arm bent at the elbow is placed on the scarf and then bandaged to the body.

Damage, fracture of the femur and hip joint

In case of injuries to the hip and hip joint, which are the most severe, particularly careful immobilization is required. For this purpose several large ladder tires are used. Two stair splints are tied together to form a splint that extends from the armpit to the inner edge of the foot, curved in the shape of the letter G. The length of the second splint should be equal to the distance from the gluteal fold to the tips of the toes and is also curved. On the inside, a third splint is additionally applied, running from the perineum to the edge of the foot.

In the absence of available and standard means, the damaged lower limb can be immobilized by bandaging it to the healthy leg.

Damage, fracture of the tibia and knee joint

For injuries to the lower leg and knee joint, use a large ladder splint, which is modeled after the healthy leg in the shape of the letter G. The foot is fixed at a right angle to the lower leg. The length of the splint should be equal to the distance from the middle of the thigh to the tips of the toes. You can put a small ladder rail on the sides.

From available means, it is best to use two boards, which are laid on the outer and inner surfaces, starting from the upper half of the thigh. As a last resort, the affected leg is bandaged in two or three places to the healthy leg.

For injuries to the ankle, foot, and toes, it is sufficient to apply a ladder splint from the toes to the knee joint. The splint is bent so that the foot is at an angle of 90° in relation to the shin.

It should be remembered that with fractures of tubular bones, the severity of the condition is aggravated by hemorrhage into the surrounding tissues.

In victims with transport immobilization, it is necessary to monitor blood circulation in the injured limb: is the pulse detectable, is there any coldness, numbness, a feeling of “crawling goosebumps,” or cyanosis. If necessary, find the area of the constriction and loosen it.

V.P. Dyadichkin

“Splinting for fractures of various bones” article from the section

When providing first aid in cases of injury, it is especially important to create rest for the damaged organ and prepare the patient for transportation.

Rest reduces or eliminates pain and thereby prevents the development of traumatic shock or reduces its severity; reduces the risk of additional damage to soft tissues and internal organs from bone fragments, increases tissue resistance to infection, prevents the spread of infection beyond the wound and other serious complications.

One of the temporary measures to create peace in case of injuries is the application of splints when transporting the victim from the scene of the incident to a medical facility. This time is calculated in minutes, but can reach several hours and even days. Therefore, a well and correctly applied splint, creating rest for the damaged organ, acquires special value.

Indications for splinting: damage to bones, joints, blood vessels and nerves; extensive soft tissue damage, etc.

Rest for the damaged organ is created using special standard splints from Kramer, Dieterichs, etc. In the absence of standard splints, immobilization is provided with improvised means (plywood, boards, slats, sticks, skis of the required size and strength), and in special circumstances (when there are no materials at hand), you can fix the injured arm to the body, the injured leg to the healthy limb.

The type of immobilizing splints and bandages depends on the location of the injury. The technique of applying splints is simple, but it will require certain knowledge, skills and abilities.

When creating rest for a damaged organ, it is necessary to follow a number of rules:

Ensure reliable immobilization. Remember that usually for fractures of the extremities, the fracture site and 2 nearby joints must be recorded, one above, the other below the fracture site; When a hip is fractured, three joints are immobilized: the hip, knee and ankle.
Before immobilization, you need to prepare the splint - lay it all over with cotton wool and gauze or put a special cover on it; cover the protruding parts of the bones with cotton-gauze pads to avoid the formation of bedsores.
When applying a splint, place the injured limb in a mid-physiological position that relieves muscle tension. This is achieved by slightly bending the large joints at an angle of 5-10°.
For closed bone fractures, before applying a splint, carefully stretch the limb along the axis, and apply the splint over clothing and shoes.
In case of open fractures, traction and reduction of bone fragments cannot be performed. They should be fixed in the position they acquired as a result of injury.
In case of open fractures, it is necessary to apply a pressure bandage to the wound, if necessary to stop bleeding, a tourniquet, and then a splint. The tourniquet is applied over clothing (it must be visible), and the time of its application is indicated on the accompanying sheet. The tourniquet can be kept on the limb for no more than 1 - 2 hours.
If it becomes necessary to remove clothing from the victim, it is removed first from the healthy arm or leg, and then from the damaged one. Put the clothes on in the reverse order - first on the injured limb, and then on the healthy one.
When removing or putting on clothes, do not lift or sit down the victim.
When transferring a patient onto or from a stretcher, an assistant must support the injured limb.
Do not bend the splint according to the shape of the patient’s limb.
Splints must be applied very carefully (preferably with assistants) so as not to cause unnecessary pain to the victim or cause additional damage.

The simplest and most accessible means of creating rest for skull injuries can be a self-made dense cotton-gauze roll in the shape of a “donut”. To do this, take a strip of gray cotton wool up to 5 cm thick, 10-12 cm wide, 45-50 cm long, twist it into a tight rope and wrap it with a bandage. The ends of the roller are connected and stitched.

The resulting cotton “donut” is carefully placed under the head and bandaged with circular turns of bandage. The cushion can be made of a towel, diaper or other (preferably cotton) fabric. For these purposes, a small or medium-sized pillow or a weakly inflated rubber backing circle is also used.

Having prepared the victim for transportation, he should be placed on a wooden board or on a stretcher and transported lying down to the hospital.

To create rest for neck injuries, a cardboard-gauze collar is used. Take a sheet of thick cardboard, from which a figured blank measuring approximately 435X145X80 mm is cut out. The workpiece is wrapped in a layer of cotton wool and gauze or some kind of fabric. Two ribbons are sewn to the ends of the cardboard blank, and the collar is ready for use.

The technique of applying a collar is simple: raise the victim’s head, place a cardboard and gauze collar under the neck and tie the ribbons in front of the neck.

There is another accessible way to create rest for neck injuries - using a cotton-gauze collar. Take a layer of cotton wool up to 20 cm thick, 40 cm wide, 90 cm long, wrap it in gauze and place it around the neck. The cotton wool is strengthened with turns of bandage with slight tension so that there is no compression of the neck (breathing should be free).

If it is not possible to use these methods of neck immobilization, you can place a small pillow or a bundle of clothing under the patient’s neck and shoulders: the head is thrown back, which allows you to achieve extension of the cervical spine and prevent compression of the spinal cord.

Remember! When performing immobilization of a damaged organ or performing any manipulations, jolts, rough and sudden movements, and excessive bending of the cervical spine are unacceptable.

It is necessary to ensure reliable rest and prompt transportation of the victim to the hospital. Patient care during transport is important. The victim's head and torso should be slightly raised, and it is advisable to apply cold (ice pack or cold water) to the head. Make sure that the bandages do not impede breathing.

If vomiting occurs, the head should be turned to the side and the mouth should be cleared of vomit. In case of severe injuries, when the patient’s tongue sinks and breathing becomes difficult, he needs to open his mouth, grab the tip of his tongue with a napkin or handkerchief and, pulling it towards himself, hold it in this position. If the latter fails, you need to stitch the tongue along the midline with a needle and thread and attach it to the skin of the chin in a taut position.

To immobilize the thoracic and lumbar spine in the absence of standard splints, improvised means are often used - wooden slats, sticks, boards, skis, etc. The improvised material used for these purposes (the length of the victim’s height) is fastened together. The victim is carefully laid on the resulting shield (on his back), placing small bolsters under his lower back and knees. Then they fix him to the shield, without squeezing the body, and transport him to the hospital.

For fractures of the ribs and sternum, a spiral bandage with a “belt” is recommended to create rest for the chest. For this bandage, you can use a towel or sheet, folding them in three layers and rolling them into wide bandages. To prevent the bandage from slipping, you can sew shoulder pads to the tie (“belt”).

An adhesive plaster can be used to fix the damaged side of the chest. It is glued in a tiled pattern from the sternum to the spine.

The victim is transported sitting, half-sitting, or with the upper body slightly elevated.

To immobilize bone fragments in case of fractures of the clavicle, scapula, head and neck of the shoulder, a scarf bandage is convenient. Take a scarf with two long ends and one short. The middle of it is placed under the forearm bent at the elbow joint to 90°. One end of the scarf is placed between the forearm and the body and is led over the healthy shoulder, the other, located in front of the forearm, through the sore shoulder, and then both ends are tied at the back of the neck. The top of the scarf (its third end) is bent in the area of the elbow joint anteriorly and secured with a pin. A scarf can be made from any scarf by folding it from corner to corner.

For fractures of the collarbone and shoulder, they often resort to another method of immobilization - bandaging the damaged upper limb to the body. First, the injured arm is slightly taken to the side, a cotton-gauze roll is placed in the axillary area, and then, bent at a right angle at the elbow joint and pressed tightly to the chest, bandaged with circular turns of the bandage from the healthy side of the chest towards the patient, towards the torso .

Immobilization of the limb in case of fractures of the humerus is carried out using a wire (ladder) splint. To do this, the arm is slightly and carefully removed from the body, the forearm is bent at the elbow joint at a right or acute angle, placing a cotton-gauze roller in the armpit.

Then a cotton-gauze pad is placed on the back of the neck and shoulder, and a little cotton wool is placed on the palm, which the victim covers with his fingers. Take a sheathed long (1 m) wire splint and, having previously bent it according to the contours of the arm, apply it to the back surface of the injured arm, leading from the healthy shoulder through the back and girdle, shoulder and forearm to the base of the fingers. The splint is bandaged to the arm and partially to the torso. The hand is suspended on a scarf from the neck. The splint should be placed over clothing.

In the absence of a wire splint, improvised means can be used to immobilize the injured limb, for example, a bundle of brushwood of sufficient length (1 m or more). It is laid along the back surface of the entire upper limb and bandaged or tied to it with strips of material.

To splint a limb, you can use two planks. They are applied to the outer and inner surfaces of the shoulder and bandaged to it, and the hand is suspended on a scarf to the neck. Sometimes, to create peace, the limb is bandaged to the body.

Immobilization of a limb in case of fractures of the bones of the forearm and hand is achieved by using a short wire splint or improvised means. To do this, the forearm is carefully bent at a right angle at the elbow joint, a little cotton wool is placed on the patient’s palm and he squeezes it with his fingers. A wire splint covered with a cover is bent at a right angle, modeled along the contour of the arm, laid along the back surface of the shoulder from the upper third of it to the base of the fingers and bandaged with circular turns of the bandage to the arm. The hand is suspended on a scarf from the neck.

When immobilizing the forearm and hand using improvised means, place a little cotton wool in the patient’s palm, then lay it on the back and palm surface from the elbow to the fingertips, for example, two strips of plywood (thick cardboard, planks, etc.), wrapped in cotton wool, bandage them in a circular manner rounds of bandage to the forearm, and the hand is suspended on a scarf to the neck.

To ensure rest for the injured arm, you can only apply a scarf (or the hem of a shirt) and bandage the limb to the body.

Immobilization of fragments in fractures of the bones of the lower extremities is especially important in preventing damage to blood vessels, nerves, traumatic shock and other complications.

Rest of the lower limb when its bones are fractured is best ensured by standard Dieterichs and Kramer splints. In the absence of standard splints, to immobilize the limbs, they resort to improvised means (sticks, skis, slats, boards, plywood, etc.). They must be long enough to support 3 joints (hip, knee and ankle).

Technique for immobilizing bone fragments in case of damage to the hip with splints made from available material: placing a thick layer of cotton wool on the bone protrusions, i.e. on the wing of the ilium, hip, knee and ankle joints (to prevent bedsores), take 2 slats of the appropriate length, wrap them with cotton wool or other soft materials and bandage the limb.

A longer strip is placed along the outer surface of the limb from the armpit to the foot, a shorter strip is placed along the inner surface from the crotch to the inner edge of the foot. The foot is set at an angle of 90°. Both slats are fixed to the torso and limbs with circular turns of bandage, belts or strips of material.

In the absence of available means to immobilize the injured limb, the simplest method of fixation is used - “foot to foot”. To do this, place the healthy leg next to the damaged one and tie them in several places with a towel or straps. Having finished splinting the leg, the victim is transported in a lying position to the trauma department.

Immobilization of a limb using improvised means in case of a fracture of the leg bones: a layer of cotton wool or soft fabric is placed around the ankle and knee joints (to prevent bedsores), objects used for splinting (for example, slats) are wrapped in cotton wool or fabric, then one slat is placed on the outer surface, the other on the inner surface of the thigh, lower leg and foot, capturing 2 joints (one above, the other below the bone fracture); Both slats are fixed to the limb with circular turns of bandage or strips of gauze. If the necessary splinting means are not at hand, you can (as with hip fractures) use the “leg to leg” fixation method.

Immobilization due to fractures of the ankles and foot bones is achieved by applying a wire (ladder) splint to the limb. To do this, place a cotton-gauze pad on the area of the ankles and heels. A shortened splint is modeled along the contour of the calf muscle, the heels and feet are placed along the back surface of the damaged leg from the upper third of the lower leg to the toes and bandaged to it, fixing the lower leg and foot.

For these injuries, you can also splint with strips of plywood, thick cardboard, planks, etc. The area of the ankles and heels is covered with cotton wool and wrapped in a soft cloth; then they take the material at hand and wrap it in the same way with cloth, then place one strip of splint on the outer and the other on the inner surface of the limb from the upper third of the lower leg to the edge of the foot, and both splints are tightly bandaged to the leg.

If you do not have the means at hand to splint a limb, you can apply a figure-eight bandage to the ankle joint and foot. Victims are sent to the hospital in a lying or sitting position.

Mastering the simplest methods of splinting for injuries will help you provide the necessary assistance to a person, and sometimes even save his life.

Immobilization for fractures is the main first aid measure to ensure bone immobility. The fact is that the movements, whether voluntary or not, that the victim makes during delivery to the doctor cause him serious harm. Immobilization allows you to minimize additional injury to soft tissues and blood vessels from sharp bone fragments at the fracture site, and reduces the possibility of shock, significant bleeding, or the development of an infectious complication. The timing of immobilization depends on the distance to the medical institution and ranges from several hours to 2-3 days.

Types of fractures and the need for first aid

It is customary to distinguish between pathological fractures, which occur as a result of various bone diseases, and traumatic ones, which occur as a result of the impact of a large dynamic load on the bone during injury. Chronic fractures occur somewhat less frequently when the load on the bone was, although not excessive, prolonged.

Traumatic fractures are usually divided into:

closed;
open, when in addition to a broken bone there is also a wound;
intra-articular, in which blood accumulates in the joint capsule.

Each of the types, in turn, can be with or without displacement of bone fragments.

There are obvious signs that can be used to determine whether a victim has a fracture:

severe pain at the site of injury;
in case of a limb injury - a change in shape and size compared to the uninjured one;
bone mobility at the site of injury, which was not observed in the normal state;
inability to move the injured limb.

Open fractures also pose a danger because pathogens can enter the wound and become infected. Damage to tissue from bone fragments causes bleeding, often significant. If the fracture is open, there is external bleeding, and if it is closed, internal bleeding develops, which is no less dangerous. If there are several fractures, or they are open and severe, traumatic shock often develops, requiring emergency medical measures. One of the important points in the treatment of fractures is qualified first aid, the main activities of which are:

anesthesia;
stopping bleeding if the fracture is open:
prevention of shock or measures to combat it;
ensuring immobility of the injury site by immobilization, reducing pain and preventing shock;
urgent delivery of the victim to a medical facility.

Using splints for fractures

Types of splints for fractures

Standard ready-to-use tires vary in size and design features. They are often intended for immobilization of the upper or lower extremities, and in some cases for their traction.

Standard tires are made from various materials:

made of steel mesh or wire, such as flexible ladder-type Kramer tires;
wood: from slatted wooden structures, such as Dieterichs tires;
plastics;
thick cardboard.

If transport immobilization is required for a relatively long period, plaster bandages or splints are used. The peculiarity of such tires is that they are made individually for each victim. They fix bone fragments well and fit snugly to the body. A relative disadvantage of this immobilization option can be considered the difficulty of transporting a victim in frosty weather, while the tire is still wet.

It often happens that ready-made standard tires are not at hand. In this case, it makes sense to use scrap materials located nearby. Usually boards or thick rods are used; thin rods can be tied in the form of a bundle for convenience.

It must be borne in mind that if rescuers or a medical team are already on their way to help the victim, there is no need to construct an improvised splint from scrap material; it is more advisable to wait for professional help.

Rules for applying a splint for immobilization

Algorithm for applying an immobilization splint to the upper limbs

the injured arm is bent at an angle of 90 degrees;
under your arm, in the axillary fold, you need to place a roll of clothing or soft material, about 10 cm in size;
if a bone in the shoulder is broken, it is most convenient to use a flexible standard Kramer splint; in its absence, available hard materials are used;
fix the shoulder and elbow joints with one improvised hard and hard splint, and the second – the elbow and wrist joints;
the bent arm needs to be suspended on a scarf.

When the bones of the forearm are fractured, the elbow and wrist joints are fixed with a splint, a roller measuring 8-10 cm is placed in the armpit. The arm is bent at an angle of 90 degrees and suspended on a scarf. Sometimes it happens that a solid object for making an improvised tire cannot be found. In this case, the broken forearm bone can be fixed by bandaging it to the body.

If the upper limbs are fractured, it is better not to bandage the fingertips, as it is more convenient to control blood circulation.

Immobilization for other types of fractures

In case of a fracture of the femur, one splint is applied to the inside of the damaged limb, fixing the knee and ankle joint. Such a splint should reach the groin, where a soft pad with a diameter of about 10 cm must be placed. On the outside of the leg, the splint is placed so as to fix all three joints: the hip, knee and ankle. Joints should be grasped to prevent movement in them; otherwise it will be transmitted to the area of the broken bone. In addition, such fixation prevents dislocation of the head of the damaged bone.

This is how a splint is applied for a hip fracture

In case of a tibia fracture, splints are also applied along the inner and outer surfaces of the damaged limb, fixing the knee and ankle joint. If it is not possible to find material at hand to construct an immobilization splint, the injured leg can be fixed by bandaging it to the uninjured leg. However, such a measure is considered not reliable enough and is used in extreme cases.

It is unacceptable to transport victims with fractures, even over short distances, without immobilization.

If the clavicle is fractured, you need to hang the victim’s arm in a scarf. If you get far enough to a medical facility, you need to apply a figure-of-eight bandage to pull the shoulder girdle back and fix it in this position.

If immobilization is required for rib fractures, a tight fixing bandage is applied to the chest, after first anesthetizing the victim. The chest is bandaged as you exhale, while the contracted ribs make only minimal movements during breathing. This reduces pain and eliminates the risk of additional soft tissue injury from debris. Uncomplicated rib fractures heal quickly, but complications when internal organs are injured by broken ribs pose a serious danger.

When the foot is broken, a flexible Kramer splint is applied to the upper third of the lower leg, modeling it along the contour of the posterior surface.

First aid for severe fractures

Fractures of the pelvic bones are a severe, life-threatening injury to the victim, characterized by severe pain, the inability to walk, stand, or raise a leg. To provide first aid, the victim is placed on a rigid stretcher with his back down, while his legs are left in a bent state. Soft cushions should be placed under the knees.

The most severe injury is considered to be a fracture of the spine, which can occur with a strong blow to the back or during a fall from a height. The victim experiences acute pain, swelling and protrusion of the damaged vertebrae occurs.

When providing assistance, you need to be extremely careful, since displacement of the vertebrae often leads to damage to the spinal cord and its rupture.

The victim is placed on a hard surface, doing this on command, and without allowing kinks in the spine. Then they are secured with wide straps. In case of a fracture of the upper spine, it is necessary to place soft cushions in the neck area.