1. Musculoskeletal injuries
Presented by
P.SUDARSAN REDDY, PC 118
APSDRF

2. Objectives
Upon completion of the lesson the participants will be able to learn
about:
• Musculoskeletal System.
• Define open and Close Fracture.
• Define Dislocation, Sprain, Strain etc. and their Sign & Symptoms.
• Define Splinting and General Rules for Splinting.
• Pre Hospital Treatment for Fracture, Dislocation, Sprain and Strain.
• Demonstrate the pre-hospital treatment of fracture of upper and
lower extremities

3. SKELETAL SYSTEM
Human skeletal system is composed of 206 bones.
It consists of two main divisions –
• The axial skeleton
• The appendicular skeleton.

8. FUNCTIONS OF SKELETAL SYSTEM
• Skeletal system provides
support and framework
to the body .
• Also provides some
protection to vital organs
against injury.
• Skeletal system also
precipitates movement.
• Muscles would not be
able to perform without
skeletal support &
connection

9. JOINTS (ARTICULATIONS)

11. Musculoskeletal Injury Types
• Fracture
-Broken bone
• Dislocation
– Disruption of a joint
• Sprain
– Joint injury with tearing of ligaments
• Strain
– Stretching or tearing of a muscle

12. FRACTURE
• Any break in the continuity of a bone.
• Fracture can be open or closed.
⮚ Closed fracture- A fracture that does not break the skin.
⮚ Open fracture- External wound associated with fracture.

13. Fracture Signs and Symptoms
• Deformity
• Tenderness
• Swelling
• Creptus
• Exposed bone ends
• Pain
• Locked joint

14. Dislocation
Injury in which a bone is moved out of its normal position in a joint and
remains that way. It sometimes causes the tearing of ligaments and soft
tissues if stretched far beyond the normal range of motion. The
shoulder, elbow, fingers, hips and ankles are the joints most frequently
affected.

15. Dislocation Signs and Symptoms
• Marked deformity
• Swelling
• Pain
• Tenderness on palpation
• Virtually complete loss of joint function
• Numbness or impaired circulation

16. SPRAIN
• Injury in which ligaments are stretched or partially torn, commonly
associated with joint injuries.

17. Signs and Symptoms of a Sprain
• Point tenderness can be elicited over injured ligaments.
• Swelling and ecchymosis appear at the point of injury to the
ligaments.
• Instability of the joint is indicated by increased motion.
• Pain

18. STRAIN
Injury in which a muscle, or a muscle and tendon are overextended.

19. Specific Injury Types
• Shoulder and clavicle
• Humerus and shoulder
• Forearm and wrist
• Hands and fingers
• Pelvic injuries
• Hip injuries
• Femoral injuries
• Knee injuries
• Tibia and fibula injuries
• Ankle and foot injuries

20. SPLINTING
Applying a rigid or flexible device to stabilize any painful, swollen or
deformed body part in order to immobilize adjacent joints and bone ends.
REASONS FOR SPLINTING-
• Prevent close fracture from becoming open fracture.
• Minimize blood loss or shock.
• Minimize damage to soft tissues.
TYPES OF SPLINTS-
1. Rigid splint- requires limb to be in anatomical position. Ideal for long-bone
injuries.
2. Conforming splint- can be moulded to different angles to surround the
extremity.
3. Traction splint- used specifically for femur fracture.
4. Sling and swathe- two triangular bandages used to hold an injured arm in
place against the body.
5. Improvised splint- a book, cardboard, pillow or blanket etc.

21. TYPES OF SPLINTS
TRACTION SPLINT
SLING & SWATH RIGID SPLINTS
AIR SPLINT

22. General rules of splinting
• Always communicate your plans with your patient , if possible.
• Before stabilizing an injured extremity, expose and control bleeding.
• Remove all jewellery from the site and below it.
• Assess PMS.
• Do not attempt to push protruding bone ends back into place.
• Pad a splint before applying a splint.
• If a joint is injured, immobilize it and the bones above and below.

23. GENERAL RULES OF SPLINTING
Apply dressing & bandage Pad the splint Secure splints,check PMS
Expose injury site Control bleeding
Stabilize and check PMS

24. Pre-hospital treatment
• Scene safety
• Determine mechanism of injury (MOI).
• Initial assessment : treat life threatning problems.
• Focus physical exam. Administer oxygen if required.
• Stabilize and expose injury.
• Treat open wounds.
• Prepare splinting material.
• Splint injuries/ immobilize body.
• Assess/ reassess neurovascular status.
• Apply RICE method.
• Treat for shock.

25. APPLYING A SLING AND SWATH
pad between the arm & the chest Support injured arm with a sling
Immobilize the arm with a swath

26. SPLINTING OF FRACTURED UPPER EXTRIMITIES
Splinting of Humerus injury

27. SPLINTING OF FRACTURED UPPER EXTRIMITIES
Splinting of Elbow (Bent) injury
Splinting of elbow (Straight)

28. Splinting of high femur/pelvis injury Splinting of Lower leg injury
Splinting of knee (Bent) injury Splinting of Ankle injury
SPLINTING OF FRACTURED LOWER EXTRIMITIES

29. Review
On completion of this lesson now the participants are able to learn :
• Musculoskeletal System.
• Open and Close Fracture.
• Dislocation, Sprain, Strain etc. and their Sign & Symptoms.
• Splinting and General Rules for Splinting.
• Pre Hospital Treatment for Fracture, Dislocation, Sprain and Strain.
• Pre-hospital treatment of fracture of upper and lower extremities.