f. Crepitation. The fracture bones may make a crackling sound (crepitation) if
they rub together when the casualty moves.
Do not ask the casualty to move the injured body part in order to test for
g. Loss of Motion. The casualty may not be able to move the injured limb. If a
spinal injury is present, paralysis may exist, especially paralysis of the legs.
h. Loss of Pulse. If the fractured bone is interfering with blood circulation, there
may be no pulse distal to (below) the site of the fracture.
i. False Motion. There may be motion at a point where there is normally no
motion. This movement at the fracture site is called false motion.
Fractures may be discovered either during the primary or secondary survey of
the casualty. Take measures to maintain or restore breathing and heartbeat, control
major bleeding, and control shock before treating a fracture. The general procedures
for treating a fracture of an extremity (arm or leg) are given below.
Procedures for restoring breathing and heartbeat are given in Subcourse
MD0532, Cardiopulmonary Resuscitation. Procedures for controlling external
and internal bleeding and controlling shock are given in Subcourse MD0554,
Treating Wounds in the Field. Procedures for treating a spinal fracture are
given in Lesson 2 of this subcourse.
Do not move the casualty before splinting the fracture unless you must
remove the casualty (and yourself) from immediate danger (escape from
a burning vehicle, move out of the line of fire, and so forth).
a. Reassure Casualty. Tell the casualty that you will take care of him.
b. Expose the Limb. If you suspect the casualty has a fractured limb, gently
remove the casualty's clothing from the injured limb and check for signs of a fracture.
Loosen any clothing that is tight or binds the casualty. DO NOT remove the casualty's
Do not expose the limb if you are in a chemical environment (chemical
agents are present and the "all clear" signal has not been given).
c. Locate Site of Fracture. The site of the fracture is normally found by
identifying the site of the deformity, false motion, bruise, wound, and/or point
tenderness. To determine point tenderness in a conscious casualty, gently palpate the
area with your fingers to determine the location of maximum discomfort.