Immobilization of fractures of the lower limb (1974) Pt 2 of 3

a characteristic sign of fracture of the FEMA is the abnormal position of the foot which is most frequently turned out sometimes the injured limb is shortened by muscle traction make sure that the fractured limb has not received any other injury and if the fracture is not an open one gently bring the uninjured limb into alignment with the injured one slip a wide bandage under the ankles without disturbing the injured limb place a splint between the legs extending from the foot to the crutch padding it well at that point pad carefully at the level of the knees and ankles take firm hold of the injured Limb and exert traction on it while carefully turning it back into its proper position hold the splint in place with the bandage already prepared tying it in figure of eight fashion round the ankles and feet after laying Six Wide bandages in position between the calves and the upper thorax place a second well padded splint against the injured limb extending from the feet to but not into the axilla fix the top of this splint in place with the bandage placed in position at the upper thorax untie the first bandage from round the ankles and feet and tie it again to hold the bottom of the second splint immobilization is completed by tying the other bandages to the splint in the following order number three round the pelvis at the level of the hips number four round the calves number five round the thighs above the fracture number six round the thighs below the fracture number seven round the knees the patient is now ready to be transported by stretcher but watch out for the appearance of shock in fractures of the patella keep the patient's head and trunk well raised using for example a well- padded chair turned upside down place a padded splint below the injured limb extending from the buttock to the heel keep the lower end of the splint well raised with a box or other form of support hold the injured limb raised above the splint and add extra padding in the hollow behind the knee and under the ankle and gently place the injured limb on the splint hold the splint in place with one bandage tied in figure of eight around the ankle and foot with a second wide bandage round the hip and with a third below the knee the patient should be transported in this position which reduces muscular tension but always watch out for shock a closed fracture of the the tibia fibula or both can easily be located by the swelling which is always very visible the whole lower limb must be immobilized prepare a well- padded splint extending from the foot to the crutch while the patient is being placed on his back and a wide bandage is being carefully slipped under his ankles place the padded splint between his legs alongside the injured limb carefully bring his uninjured limb into alignment with the injured one hold the splint in place with the bandage already prepared tying it in figur of eight fashion round his ankles and feet then complete the immobilization by putting on four bandages which you will tie on the side of the uninjured limb in the following order number two round the thighs number three round the knees number four round the legs above the fracture number five round the legs below the fracture the patient is now ready for transport but watch out for shock immobilization of the lower limb can be achieved by improvised means thus when the leg is fractured an umbrella will serve as a splint place it alongside the injured limb padding it with a shirt a scarf a towel or any similar material that is available carefully bring the uninjured limb into alignment with the injured one and complete the immobilization with a neck tie a belt or anything similar that is wide enough not to constrict the circulation fractures of the ankle and foot affecting one or several bones cause acute local pain and severe swelling which should be kept within Bones by a cold compress but only when there is no open wound never attempt to correct a displacement hold the compress in place with a wide bandage tied firmly in a figure of eight round the ankle and foot after having slipped three bandages under the ankle and foot pad with a rug folded into a thick wad or with a folded cushion and immobilize with the three bandages never forget that shock May supervene at any moment after a fracture it must be treated before any other treatment is undertaken for