Chapter 7

Bone, Joint, and Muscle Injuries

Lesson Objectives

• Describe fractures, sprains, dislocations, strains, and contusions.

• Assess and explain how to treat bone injuries.• Assess and explain how to treat joint injuries,

including dislocations and strains.• Assess and explain how to treat muscle injuries,

including strains and muscle cramps.

Bone, Joint, and Muscle Injuries

• Open or closed fracture

• Sprains• Strains• Dislocations• Contusions

Bone Injuries (1 of 5)

• Assessment– Signs and symptoms

• Deformity• Open wound• Tenderness• Swelling

– When in doubt, treat as a fracture.

Bone Injuries (2 of 5)

• Assessment– Ask how the injury occurred.– Look at the injury for deformity, open wounds,

and swelling.– Feel for tenderness and grating sensations.

Bone Injuries (3 of 5)

• Treatment– Control bleeding and treat for shock.– Expose the injury.– Check for damage to blood vessels and

nerves:• Circulation• Sensation• Movement

Bone Injuries (4 of 5)

• Treatment– Realign deformities if medical care will be delayed.– Splint the fracture to stabilize it.– Limit swelling and pain (RICE):

• Rest• Ice • Compression• Elevation

Bone Injuries (5 of 5)

• Open fractures– Clean wound and irrigate bone end.– Gently try to correct deformities.– Cover wounds with dry, sterile dressings.– Splint and wrap extremity.

Joint Injuries (1 of 4)

• Dislocations– Signs and symptoms:

• Deformity• Severe pain• Inability to move the joint

Joint Injuries (2 of 4)

• Dislocations– What to do:

• Evaluate and manage dislocations similar to fractures.

• If care is delayed or circulation compromised, attempt to reduce dislocations.

Joint Injuries (3 of 4)

• Sprains: What to look for– Pain– Tenderness– Swelling– Stiffness – Decreased function– Bruising– Joint that moves in abnormal directions

Joint Injuries (4 of 4)

• Sprains: What to do– Evaluate and manage similar to fractures.– If care is delayed or circulation compromised,

attempt to reduce dislocations.– Apply RICE procedures.– Splint or tape for support.

Muscle Injuries (1 of 4)

• Strains and tendon injuries– What to look for:

• Limited movement• Tenderness• Swelling• Bruising• Grating or cracking sensation

with tendonitis

Muscle Injuries (2 of 4)

• Strains and tendon injuries– What to do:

• Apply RICE procedures.• Stretch affected muscle gently.• Give anti-inflammatory medications.• Splint if pain is severe.

Muscle Injuries (3 of 4)

• Muscle cramps– What to look for:

• Sudden onset of severe pain• Spasm that prevents movement• A firm area that may be tender

Muscle Injuries (4 of 4)

• Muscle cramps– What to do:

• Have the victim stretch.• Apply steady pressure over the muscle.• Apply ice.• If caused by heat exertion, give mildly

salted water or sports drink.