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Fractured Forearm

Scenario:
A fracture of the arm usually occurs from a fall, with the biker trying to land on the outstretched hands. Breaking the arm from a direct blow is much less likely.

Description:
Most fractures of the arm occur an inch or two above the wrist. Next most likely is the elbow area. The arm will be painful to move. Swelling will usually develop rapidly. Children with minor greenstick fractures may not swell until the next day.

This girl fell off her bike, catching herself on her hands. She's cradling her right arm to keep it from moving. When you see this behavior, the arm is ALMOST ALWAYS broken. Note the puffiness of the wrist area.

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How do you know if you should see the doctor? Fractures will show one or more signs of severe injury, such as:
    deformity or severe swelling
    the part can't be used normally after an hour of rest
    you can't move the injured part fully
    continued severe pain
    numbness or weakness below the injured area.

Compare the injured arm to the normal one. Deformity isn't always as easy to see as you'd think. It can be subtle.

This girl fell off her bike. She has a both-bone fracture.

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fx-arm5.jpg (11826 bytes) Some types of swelling are suspicious. For example, if you see a local bulge in the wrist joint on the thumb side or deep firm swelling on the palm side of the forearm just up from the wrist, there'll almost always be a fracture.

This biker had tumbling fall and has pain in the wrist area.

Immediate care:
Your role in the immediate care of a fracture is "ICE:" Immobilize, Cool, and Elevate. If you're in the woods, wrap the arm up in a biking shirt and cradle the arm with the uninjured one while you hike out. When you reach the car, immobilize the injured area with a splint, sling, pillow, or whatever works. Elevate the extremity. Apply a cold pack. Go get medical attention.

Hint: To splint a forearm fracture, roll a magazine around the injured arm and tie it in place with a triangular bandage (the cheap sling found in first aid kits).

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An upper arm, shoulder, or elbow injury will be more comfortable with a sling for support. Here a sling has been made from a triangular bandage, with an ace wrap overtop so the arm doesn't rock back and forth during transportation to the hospital.

Ongoing care:
For the first 48 hours, repeat ice and elevation 1/4 of the time (for example, 30 minutes of ice every two hours). Follow the doctor's orders.

Watch for:
Swelling from a fracture can sometimes cut off the circulation. Watch the area "downstream" from the injury for numbness, inability to move, severe pain, swelling, and either paleness or purple congestion.

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