Fractures & Sprains – When There Is No Doctor

Oops it could happen anytime, anywhere, without advance warning, even to the fit, the active, and the healthy. A slip or a fall and – ouch – you're landed (sometimes literally), with a fracture or a sprain. An expert orthopedic surgeon outlines emergency procedures to help a victim until he can be got to a doctor.

The basic mistake that people make in the handling of fractures and sprains is that both are given the wrong kind of importance. Sprains tend to be treated as a minor disability that time and home remedies will heal; fractures, on the other hand, generally result in the pressing of all panic buttons. Both approaches are faulty.

"A neglected sprain could result in permanent instability of the joints which may require a major operation later," warns orthopedic surgeon. A sprain occurs when soft tissues such as ligaments, joint capsules, muscles and tendons are stretched beyond their limit, mainly as a result of lifting heavy weights, exercising in fits and starts or playing a strenuous game like badminton after a long interval.

On the other hand, people over-play fractures. Because of the immediate and often unbearable pain they generate they are looked upon as a dire emergency and it is believed that if urgent treatment is not given, it will result in the permanent disability or loss of the limb. So, in sheer panic, the patient is rushed to the nearest doctor who, if inexperienced or incapable or plain mercenary, may perform an unnecessary operation "because it could develop into gangrene." A corollary myth is that all fractures require surgery when in fact most fractures can be treated without an operation.

When is it a fracture and when is it a sprain?

When a person suffers a fracture, ie a break in the bone, he experiences a shooting pain, and the affected limb is incapacitated. In a sprain, the pain may not be so powerful. The exception is a spinal column sprain which could cause severe pain and result in a stiff back.

In children, it's usually the elbow and legs that suffer fractures whereas in adults, it's the thigh, hip and spinal column. The parts most likely to suffer a sprain are the ankles (especially in women who wear high-heeled shoes), wrists, lower back and the neck.

Don't …

"Till a definite diagnosis is made by a good orthopaedist, don't give in to the temptation of resorting to a home remedy such as using a turmeric powder pack, it may only worsen the condition," advises orthopedic surgeon.

And do's …

Both, sprains and fractures are best treated by lightly pressing an ice pack on the area to reduce the swelling and / or bleeding. Next, tie a firm bandage on the affected part, preferably reinforcing it with a handy splint like a foot-rule or a wad of newspapers or cardboard. The victim should be reassured and kept calm and made to rest while arrangements are made to take him to the doctor. Pain-killers may be given.

However, if the accident occurs on the road or playground, the victim should be lifted by four to six persons, their bodies serving as cushions as far as possible and made to rest nearby. If the upper limbs or neck is injured, the victim can be helped to walk to a cab or other available transport. However, if it is the legs that are injured, he should be either carried or placed on a stretcher, if it's available, all the time making sure he does not exert pressure on the affected limb.

A child is less tolerant of pain and his agitated parents could alarm him further. Calmly reassure him with a drink until he can be got to medical attention. Tincture of iodine, or an antiseptic ointment or lotion could be used in case of an abrasion or cut.

Any upper limb injury should be put in a sling (available at the chemist or you can make one at home).

Making a sling

A square meter of cloth (in an emergency a bedsheet or even a towel could do) cut diagonally across will make two slings. Support the hand by placing the widest angle pointing towards the elbow. The other two ends will go around the neck and are tied into a secure double knot at the nape.

Head injuries

Head injuries are usually caused by violent road accidents or by a fall from a height. This is a serious problem which requires quick action. The patient may become unconscious immediately or may gradually lose consciousness. If he is unconscious, do not let him lie flat on his back or he could choke if he swallows his saliva or blood (if he is bleeding in the mouth). Slowly turn him on to his side in ahead low position (without a pillow), so the secretions if any can flow out. Call the doctor or get an ambulance.

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