Travel Reference
In-Depth Information
Figure 11-4. Figure-eight bandage for splinting a fractured collarbone
Collarbone
Fractures of the collarbone (clavicle) usually can be felt by running a finger along the
bone. Such fractures are less uncomfortable if the shoulders are held back. The shoulders
can be splinted in this position by webbing or rope that passes over the shoulder and under
the armpit on opposite sides, forming a figure eight (
Fig. 11-4
). The strapping should be
applied over the clothing, and the shoulders and armpits must be padded. However, an ex-
cellent alternative is using a backpack as a figure-eight splint. It is also an excellent splint
for an acromioclavicular (shoulder) separation. The person may carry lightweight items in
the pack. In all cases, it is important to document the injury, the neurovascular status, and
the treatment rendered.
SPECIFIC FRACTURES OF THE LOWER EXTREMITY
Foot and Toe
Fracturesofthesmallbonesinthefootmaybedifficulttodiagnose.Somefracturesres-
ult from accidents that seem insignificant, such as stepping off a curb, and are associated
with relatively little pain. If pain persists for several weeks, the person should consult a
physician. Injuries of the toe and foot can be splinted by a well-fitting shoe or boot. Since
climbers or skiers are usually wearing a boot when injured, fractures below the ankle are
uncommon among them.
Fractures of the heel (calcaneus) result from a jump or fall when the individual lands
flatfooted or on the heels on a hard surface. Pain usually prevents bearing weight on the
injured foot during evacuation.
Ankle
Fractures of the ankle are often difficult to differentiate from sprains if the ankle is not
dislocated.Swellingiscommonlymoreseverewithsprains.Ifpaininaninjuredankledoes
notbegintosubsideintwoorthreedays,thepresenceofafractureshouldbeassumeduntil
X-rays can prove otherwise.
Ankle fractures can best be immobilized with a U-shaped splint that passes around the
bottom of the foot and extends up along both sides of the leg. A flexible splint, such as a
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