Tips for treating broken bones and other skeletal injuries during a disaster or emergency when you have no access to medical help.

“Is My Ankle Sprained or Broken?” Answers to Readers’ FAQs

by James Hubbard, MD, MPH What happens if you twist your ankle so badly that you don’t know whether it’s sprained or broken? I get that question a lot on my post about clues to a possible fracture. “I twisted my ankle in basketball. Is it broken?” “It’s really swelled up. It hurts a lot. Is it broken or sprained?” My answer? I don’t know. I can’t tell without a physical exam. And even then, my diagnosis would need to be confirmed with an X-ray because lots of times, breaks and sprains have the same symptoms. So, as you might imagine, in a survival situation without an X-ray, diagnosis and treatment will get tricky even for medical professionals. […]

By | May 11th, 2016|Bones|21 Comments

What’s So Bad About Moving a Broken Bone?

by James Hubbard, MD, MPH If you’ve only ever seen a dried-up old bone on a skeleton, you’ve gotten the wrong idea about bones. Bones are very dynamic, and that fact impacts how we treat broken ones. Last week, I wrote that it’s important to immobilize most fractures. Splint them, and don’t walk on them. (Make a cane or crutches if you have to travel for safety or to get help.) But learning why this immobilization is so important will help you remember to do it. […]

By | June 29th, 2015|Bones|3 Comments

When You Don’t Want to Set a Broken Bone (Read: Most of the Time)

by James Hubbard, MD, MPH It’s getting hot out there, so let’s cool off a little: It’s winter. You’re at your homestead, miles from the city. A severe ice storm has frozen your area. Large branches have crashed from the weight of the ice. The road is impassible, and there’s no phone service. You venture outside, just a bit, to survey the damage. Wouldn’t you know it; you slip backward. Your outstretched arm braces your fall. Immediate, intense pain. To your horror, your forearm is now crooked. You know you won’t be able to get professional help for at least another 24 hours. The pain is excruciating. So, should you have a family member try to put this displaced fracture back in place? […]

By | June 22nd, 2015|Bones|2 Comments

How to Set a Broken Bone or Treat a Dislocated Joint

The X-ray owner, Tim Snell, says this injury didn’t hurt as much as you’d think. “I can’t claim that the process of ‘popping it back in’ didn’t hurt though,” he wrote on Flickr, where he shared the X-ray. “What i thought would be a 5 second ‘click’ ended up taking 3 professionals over 10 minutes of tugging, twisting and pulling to get the little bugger back in place. it’s a good job i was pumped full of laughing gas.” (“Snap My Fingers,” shared via CC BY-ND 2.0.) by James Hubbard, MD, MPH Broken bones and dislocated joints are pretty common injuries, and I have several posts on how to treat them in an emergency. But many people have asked specifically how to “set” a bone, meaning, I presume, how to straighten a broken arm, leg, finger, or toe if it is crooked. The answer is most of the time, you should do nothing for a crooked bone or displaced joint other than splint it as-is until you can get to a doctor. Trying to move it around is likely to cause more damage. But there are some injuries when, indeed, you may want to take that chance and try to set (straighten) the bone or put the joint back into place. And, of course, there’s always a chance you’re in a situation where expert help is many days away. In those cases, the key to treatment is to apply traction—properly. […]

By | March 30th, 2015|Bones|26 Comments

5 Life-Threatening Injuries That Are Totally Survivable During a Disaster—if You Know How

by James Hubbard, MD, MPH I get a gnawing feeling in my stomach when I hear stories of people who died from an injury they might have survived if they’d just known a [...]

By | February 9th, 2015|Bones, Cuts, Other Wounds, Skin|8 Comments

Logrolling: How to Move an Accident Victim

U.S. soldiers practice rescuing during medical training at Fort Hood, Texas, in 2011. The soldiers are assigned to the 1st Brigade Combat Team, 1st Cavalry Division. by James Hubbard, MD, MPH You’re driving down a highway when the car in front of you swerves to avoid something. You swerve too—right off the road. You are able to stop on the grass, but the other car can’t. It flips and the driver is ejected. You find him lying on the ground, bleeding, groaning, but otherwise not responding. At this point, what’s the number-one thing you’ll avoid doing if possible, even though it might be tempting? Answer: moving him—unless you do it the right way. […]

By | September 8th, 2014|Bones|13 Comments

You Can’t Straighten Your Finger. Do You Know What’s Wrong?

In this picture, tendons are running on top of the fingers except for the little finger, which shows the bone and the ligaments (much smaller and on the sides of the joints). by James Hubbard, MD, MPH My mother used to love to tell the story about when I was an infant and I kept complaining that my heel was hurting. She looked and looked but couldn’t find anything wrong. Finally she figured out I was talking about my hip, not my heel. It’s important to know your anatomy when you’re dealing with an injury. I’m guessing you know the difference between your hip and your heel, but what about a ligament versus a tendon? If you understand what lies beneath the skin, not only will you have a better idea of what’s going on—and be able to communicate that to others—but you’ll also have a better idea of how to treat it. Also, if a computer or book—Living Ready Pocket Manual: First Aid :-)—is handy, you’ll be able to go right to the information needed. Here are some definitions from my Living Ready book: […]

By | January 27th, 2014|Bones|4 Comments

The Inside Scoop on RICE for Injuries

by James Hubbard, MD, MPH I love acronyms. They’re such great memory tricks. They saved me on many a test in medical school. And many of them I remember to this day. Needless to say, I use them when I can. RICE is one I use the most. […]

By | February 28th, 2013|Bones, Jargon|4 Comments

Knee Injury: Your Top-4 Questions, Answered

by James Hubbard, MD, MPH In this post, I’m going to address some of the more frequent questions that are being asked in the comment section of my post “8 Tips for How to Treat a Knee Injury and How to Know If It’s Bad.” The questions seem to center around the following: […]

By | February 25th, 2013|Bones, Reader Questions|159 Comments

6 Clues Your Ankle is Broken, Not Sprained

by James Hubbard, MD, MPH Sometimes it’s not that easy to tell a sprain from a broken ankle. Just this past year, a seventyish-year-old woman came limping into the clinic where I was working to have her ankle checked. Seemed she had twisted it a couple of weeks before and her husband was going to keep nagging her until she came in. The X-rays revealed a break. A pretty bad one at that. She couldn’t believe it. I don’t know if she was more upset that she was going to need a cast and crutches or she’d have to acknowledge that her husband was right. Many people come to the clinic convinced they have a break or just as sure it’s just a sprain. Often they end up being wrong. It’s not so easy for doctors to tell either. Fortunately we have the benefit of X-rays. But what if getting an X-ray is impossible? What can tip you off that it’s a sprain or a broken ankle? And why does it matter? […]

By | February 4th, 2013|Bones|1,342 Comments