How to Handle a Broken Bone on the Trail

hiking broken boneBro­ken bones aren’t a com­mon injury while hik­ing, but acci­dents can and do hap­pen. If you find your­self out in the back­coun­try with a frac­tured limb and no ER insight you’ll need to know some basic first aid to keep from wors­en­ing the wound. A bro­ken bone isn’t some­thing you can fix in a pinch, but you can take a few steps to keep it from ren­der­ing you help­less in the mid­dle of nowhere.

First, Iden­ti­fy the Injury
There are two pri­ma­ry types of bro­ken bones: a sim­ple or a com­pound frac­ture. If you’re unfa­mil­iar with the dif­fer­ences they’re quite easy to tell apart. A sim­ple frac­ture will leave your limb bruised, swollen, and pos­si­bly dis­col­ored. It might even become immo­bile. A com­pound frac­ture will usu­al­ly pierce the skin. On the rare occur­rence it doesn’t, look for signs of defor­mi­ty under­neath the skin. You’ll be able to feel and see the bone out of place. It gen­er­al­ly takes quite a fall to pro­duce a com­pound frac­ture and treat­ing one is much more difficult.

Sec­ond, Apply Trac­tion if Needed
Trac­tion is essen­tial­ly attempt­ing to place the bro­ken bone back into its nor­mal posi­tion. With com­pound frac­tures, this can be par­tic­u­lar­ly painful and, in some cas­es, dan­ger­ous to attempt. Do not attempt to set a com­pound frac­ture unless you have med­ical train­ing. To apply trac­tion on a sim­ple frac­ture, or set the break, you need to hold the prox­i­mal part of the limb or the part clos­est to the cen­ter of the body. On a leg, this would be the upper thigh, on an arm the part above the elbow. While hold­ing the prox­i­mal part of the limb firm­ly in place, gen­tly pull the low­er limb down until it slips back into the cor­rect anatom­i­cal position.

Truth­ful­ly, unless you’ve had prac­tice with this step your best bet might just be to leave it in the posi­tion you find it after the break. A splint will keep it there until a doc­tor can assess the damage.

Third, Decide on a Splint or Tourniquet
In most cas­es, you’ll like­ly skip the part where you apply trac­tion. Most small frac­tures can’t be eas­i­ly set in place by sight and com­pound frac­tures can bleed out when treat­ed incor­rect­ly. What you’ll need to do here is apply a splint or tourni­quet, depend­ing on the sever­i­ty of the damage.

Sim­ple Frac­ture = Splint
These can be made with mate­ri­als you should have on hand. Foam sleep­ing pads make for excel­lent splints, but a few stur­dy branch­es can do the trick in a pinch. Place the branch­es or pads on both sides of the leg or arm by the wound. Do not let your mate­ri­als touch the wound if it’s open. Secure them around your limb with rope, cord, or even a ban­dana. The splint needs to be tight, but not so firm that you’re cut­ting off cir­cu­la­tion to the limb.

Com­pound Frac­ture + Gush­ing Blood = Tourniquet
For a com­pound frac­ture, take note of the blood com­ing from the wound. If it’s dark and slow mov­ing, firm pres­sure with a gauze or a clean rag should be all you need. Just affix it to the wound with a piece of your shirt and apply a splint. If the blood is bright red and com­ing out in spurts, you might need a tourniquet—sometimes thought of as the nuclear option. Use a piece of shirt, or if noth­ing else is avail­able, rope, and place it rough­ly two inch­es above the wound toward the cen­ter of the body. The wider the mate­r­i­al, the better.

Tie the tourni­quet tight­ly to reduce blood flow com­ing out of the wound. You can place a sol­id branch or stick above the mate­r­i­al and wrap the ends around it to cre­ate a dial if need­ed. This way you can turn it more tight­ly than you might be able to with your hands.

With the tourni­quet in place and splint set, it’s time to get mov­ing. Head toward the near­est exit from the trail and make your way back to civ­i­liza­tion as quick­ly as pos­si­ble. If you’re unable to move, or you’re with a friend who is immo­bi­lized by his wound, hope­ful­ly, you have a means of con­nect­ing some­one in the out­side world to call for help.

Look out for signs of shock and have the wound treat­ed by a pro­fes­sion­al as soon as pos­si­ble to pre­vent infection.