DEVELOPMENT CLASSES   Notes Injuries to BONES JOINTS TENDONS & LIGAMENTS     Archie Cuthbertson – Class Facilitator

 

Black Belt DEVELOPMENT

INJURIES TO BONES, JOINTS, TENDONS AND LIGAMENTS

 

CLASSIFICATION OF INJURIES

 

INJURIES TO BONES AND JOINTS

 

1.   FRACTURES   -   A break(s) in a bone

 

2.   DISLOCATION   -   The head of a bone becomes displaced at a joint

 

3.   STRAIN   -   Overstretching of a muscle or tendon

 

4.   SPRAIN   -   Wrenching or tearing of a ligament at a joint

 

 

FRACTURES

There are three types of fractures: -

 

     CLOSED                         OPEN                  COMPLICATED

 

 

CLOSED

                Where the skin over the site of a fracture is not broken

 

OPEN

            Where there is a wound leading down to a fracture

 

 

COMPLICATED

                               Where there is an associated injury to important structures (organs, blood vessels or nerves), or when the fracture is associated with a fracture, of when the bone is broken into several small pieces, or when the broken ends are impacted together.

TYPES OF FRACTURES

 

GREENSTICK    -   common in children

TRANSVERSE    -  Clean break usually by direct blow

OBLIQUE            -   Fracture line crosses the bone at oblique angle

COMMINUTED  -   Bone is fragmented into two or more pieces

                                   And is a result of very powerful direct forces.

IMPACTED         -   Broken ends of bones are jammed together,

                                   Impaction occurs from indirect force.

SPIRAL                -   Result from twisting injuries

 

 

CAUSES

 

DIRECT FORCE   -   Where the bone breaks at the point where the force is

                                      Applied, for example from kick or blow.

 

INDIRECT FORCE   -   Where a bone breaks at some distance from the spot where

                                           Force has been applied, e.g., collar bone is fractured

                                          Although the force was applied to the hand during a fall.

 

MUSCULAR ACTION   -   Where there is a violent contraction of muscles

 

PATHOLOGICAL   -   Disease or degeneration of the bone tissue has weakened the

                                        Bone to the extent that it collapses under stress.

INJURIES TO BONES, JOINTS, TENDONS AND LIGAMENTS

 

SIGNS AND SYMPTOMS

Pain at or near the site of injury, made worse by movement

 

Tenderness or pressure over affected part or on touch

 

Swelling as result of blood loss into tissue

 

Bruising or discolouration of the skin

 

Deformities such as the shortening of a limb, angulation or rotation of the limb

 

Irregularities lumps or depressions on the surface of the bone

 

Loss of function with the patient unable to move the affected part normally

 

Unnatural movement and loss of control

 

CREPITUS, a cracking sound or grating feeling may be felt or heard; never seek crepitus, it can be caused by improper handling where the two broken ends of bone are allowed to move together on each other.

 

MANGEMENT OF FRACTURES

If in doubt always assume a fracture

 

Treat a fracture before moving the patient unless conditions dictate

 

Administer entonox before starting immobilization

 

Support and immobilize the injured part, straight limbs if possible

 

Avoid direct pressure to the injury site, dress any wounds - open fractures

 

If it is not possible to apply a splint, place in comfortable position

 

Place the patient in a comfortable position, raise affected part if possible

 

Passing bandages under the natural hollows of the body, secure on opposite side

Of fracture.

 

Check for swelling, circulation or nerve impairment below the site of the injuy.

 

INJURIES TO BONES, JOINTS, TENDONS AND LIGAMENTS

 

DISLOCATIONS

 

A dislocation is a displacement of one or more bones at a joint. It may also be accompanied by a fracture.

 

CAUSES

Direct force as with a fracture

 

Indirect force, for example, during a fall where a person lands on a hand of an outstretched arm and dislocates the shoulder joint.

 

Pathological, where the ligaments containing the joint become weakened as a result of old age, disease, or previous injury.

 

SIGNS AND SYMPTOMS

As for a fracture, except where there is a fixation of a joint and therefore no movement. Often it is impossible to distinguish between a fracture and a dislocation if the injury is near a joint.

 

MANAGEMENT OF A DISLOCATION

·        Management as for a fracture

·        Not attempting to move or straighten the injury

·        Immobilizing by the best means possible

·        Improvising if necessary

 

 

STRAINS AND SPRAINS

 

STRAIN

Overstretching or tearing of a muscle and/or tendon. Caused when excessive tension or force is applied to a muscle, for example field sports or overstretching.

 

SPRAIN

Overstretching or tearing of a ligament at a joint. Caused when the joint moves beyond it’s normal range. For example, a sprained ankle may be caused by slipping off a kerb.

 

 

 

INJURIES TO BONES, JOINTS, TENDONS AND LIGAMENTS

 

 

STRAINS and SPRAINS (continued)

 

SIGNS AND SYMPTOMS

 

·        Swelling, severe with sprain

·        Severe cramp with a strain

·        Bruising

·        Pain which increases during movement

·        Tenderness

 

 

MANAGEMENT OF SRAINS AND SPRAINS

 

·        Resting and supporting the injured areas

·        Providing plenty of soft padding

·        Applying firm pressure to the site of the injury

·        Apply cold compress to reduce swelling and reduce pain

·        Administer entonox (if trained to do so).

 

 

 

 

…………………………………………………………………………………………