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                              TYPES OF FRACTURE
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  Fractures fall into two categories, closed or open and both can be very
  complicated.


  Closed Fracture
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  This is a fracture where the skin surface around the damaged bone is 
  not broken.


  Open Fracture
  -------------

  When a wound leads from the surface of the skin to the fracture or 
  a broken bone penetrates the surface of the skin, the fracture is said
  to be "open".

  Open fractures are serious not only because they can result in severe 
  external blood loss but also because germs can gain access to the soft 
  tissues and the broken bone. Such infections can be extremely dangerous
  and are very difficult to cure.


  Complicated Fracture
  --------------------

  Closed or open fractures are said to be "complicated" when there is an
  associated injury. For example, if an important structure, blood vessel,
  nerve or organ is damaged by the broken bone.


  General Treatment
  -----------------

  Casualties with fractures should not be moved unless it is absolutely
  necessary. Make the casualty as comfortable as possible, steady the
  part by hand or with padding and await the arrival of skilled help. 
  
  If you must move the casualty, do so with extreme care to gently avoid
  further injury and increased pain. General rules for treatment of any
  fracture are as follows.

  1:  Difficulty in breathing, severe bleeding and unconsciousness MUST
      be dealt with BEFORE the fracture.

  2:  Treat all fractures, if possible, in the position in which the
      casualty is found, unless there is imminent danger to the casualty's
      life or the casualty is exposed to bad weather.

 IF...Time will allow, temporarily immobilise and support the fractured
      limb before moving the casualty to safety.

  3:  Steady and support the injured limb by hand.

  4:  If removal to the hospital is imminent, gently support the injured 
      part by hand. Place the casualty in the most comfortable position
      and support with rolled up blankets or similar materials.

  5:  If transportation to the hospital will be delayed by more than 30
      minutes, but the journey will be short and smooth, immobilise the
      injured part by securing it to a sound part of the body with 
      padding and bandages.

  6:  Raise the injured part after immobilising it to minimise discomfort
      and swelling.

  7:  If the journey to the hospital will be long - in excess of 30
      minutes and/or rough, extra bandages and splints may be required.

  8:  To minimise shock - treat as in section ( Asphyxiation ).


 
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