First aid in illness and injury; Medicine, Popular
The most appalling accident that can befall a man isolated from skilled
surgical aid is the fracture of a limb, especially of the leg, and yet
this is one of the commonest of all woods misfortunes.
Before proceeding to the discussion of individual fractures, a brief
consideration of the classification and detection of fractures in
general is necessary. Surgeons divide fractures into: simple, those
where there is a simple separation of the bone without injury to the
flesh; compound, where in addition to the separation of the bone there
is laceration of the flesh and one or both ends of the bone are driven
out through the skin; and comminuted, where the bone is in several
fragments. A comminuted fracture may be either simple or compound,
according as it does or does not penetrate the flesh.
The symptoms of fracture are pain, loss of motion, change of position,
change of contour of the fleshy parts, and most important of all, a
light crackling sound when the limb is moved—crepitation the surgeons
call it.
Pain following an injury that _might_ produce a fracture is not
necessarily proof positive of the existence of a fracture. Pain may and
often does follow a bruise, sprain, or dislocation, in a greater degree
than that following a fracture. Loss of motion, too, is quite as marked
in dislocations and severe sprains as in fractures. Change of contour,
unless in the locality of prominent joints, is quite a valuable sign.
The fractured limb, except in certain rare cases, will show a change in
the appearance of its general outline.
By crepitation is meant that characteristic grating sound produced by
rubbing the two ends of the fractured bone together. It is the one
absolute sign of a fracture, and once heard can never be forgotten. It
may be likened to the sound produced by rubbing two or three coarse
hairs between the finger and thumb.
If a fracture is suspected let the patient himself, or some one for
him, grasp the limb above and below the site of the suspected fracture
and turn it in opposite directions. If a fracture is present it will be
manifested by a distinct grating sound, also by a jarring sensation as
the uneven fragments pass over each other.
A description of all the fractures of the different bones of the
body would be manifestly out of place in a book of this character,
so I shall confine myself to those most liable to be encountered in
the woods—that is, fractures of the leg, thigh, forearm, and arm.
Fractures of the leg or thigh will entail an enforced stay of from four
to six weeks in the woods, or the devising of some means to transport
the patient to a place where he can have proper care, an arduous task
in a country where there are no roads and the trails are difficult. If
a personal experience may be allowed, I will tell how I once treated
a man with fractured thigh and conveyed him with comparatively little
discomfort over sixteen miles of rugged mountain trail and some forty
miles of equally rugged mountain road.
Public-domain text, read in full here on John Shaqi.
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