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Signs and symptoms

  • Deformation.
  • Bone fracture
    • Closed fracture: skin is intact.
    • Open fracture: open wound. Possible exposed bone ends.
  • Pain and swelling at a joint suggest dislocation.
  • Pain and tenderness.
  • Crepitus.


  • Spinal immobilization if spinal injury suspected.
  • Cold packs to reduce pain and swelling.
  • Elevate the injured extremity.
  • Remove or cut away clothing to completely expose site of injury.
  • Dress wounds.
  • Align any deformities with gentle traction. Stop if pain, resistance or crepitus increases.
  • Splinting
    • Check PMS (pulse, motor, sensation) before and after splinting, and every 15 minutes afterwards.
    • Immobilize the joint above and below any bone injury.
    • Immobilize the bone above and below any joint injury.
  • Traction splint: for femur fractures and some fractures below the knee.
  • PASG: for pelvic fractures.
  • Sling and swathe: for elbow injuries.
  • Fix splint: for humerus injury.
  • Tongue depressor can be used to splint finger injuries.
  • Other splints include the air splint and make-shift splints such as the blanket roll.

Trauma and mechanisms

  • Sprain: joint injury with possible damage of the ligaments.
  • Dislocation: displacement of bone from its normal position in the joint.
  • Compartment syndrome: when injuries cause swelling and bleeding in the space between tissues, it can cut off circulation. This leads to hypoxia of cells called the compartment syndrome. The hypoxic cells will release chemicals that cause more swelling, and worsen the hypoxia. Patients experience severe pain or burning sensation (pins and needles), and paralysis.


  • Tendons: connective tissue that connects muscle to bone.
  • Ligaments: connective tissue that connects bone to bone.