Injuries to the Lower Body

A broken bone in the lower body is a serious injury that requires hospital treatment. The pelvis is a large bone and is generally very difficult to break. Severe impact such as a fall from a height or a car accident are the most common cause in young, fit adults. In the elderly a broken pelvis (or hip) happens more often and can be caused by a relatively minor impact. In healthy adults it takes a major impact to break the thigh bone and there are likely to be other injuries.

Broken pelvis

The pelvis protects the urinary system and the biggest danger is that sharp bone ends may burst the bladder, creating the possibility of infection. Internal bleeding is another likelihood with a fractured hip, as the impact required to break the bone is likely to have caused other damage.

Signs and symptoms of a broken pelvis

• Bruising and swelling over the hip area
• Urge to urinate
• Blood-stained urine
• A sensation of falling apart: the pelvis is like a girdle and a break means that it may not be able to hold itself together
• Legs rotate outwards as the support at the pelvis gives

As the pelvis can also be broken at the back, it is easy to mistake a pelvic fracture for a spinal injury. If in doubt, treat for a broken spine.

First Aid Treatment

1. Call an ambulance immediately and reassure the casualty while you wait.
2. This is a very serious condition and it is best not to move the casualty because you could easily make things worse.
3. If the ambulance will be some time, tie the legs gently together at the ankles and knees using triangular or improvised bandages.
4. Treat the casualty for shock.

Fractures of the upper leg

The key risk with fractures of the femur (thigh bone) in the upper leg is shock. The thigh bone protects the main artery in the leg, the femoral artery, and if broken may pierce it, causing severe internal bleeding.

A person with a broken thigh bone will require transportation by ambulance. The general treatment is therefore nothing more than to hold the injured part still and treat the casualty for shock. Do not bandage the leg if help is on its way as this is likely to cause more pain and potentially cause further damage.

Support the leg above and below the site of the fracture if possible, placing padding around the broken leg to further help to reduce movement of the injured limb.

If you have been trained in the use of traction then you may apply this gently to the leg to help to reduce pain and circulatory damage.

The injured person may benefit from immobilising the broken leg by using the good leg as a splint, particularly if there is a wait before medical help arrives.

1. Apply broadfold triangular bandages under the ankles, knees and above and below the site of the fracture.
2. Place padding between the legs to help immobilise them.
3. Gently but firmly tie the bandages on the injured side.
4. Take care to check the circulation below the bandages to ensure that they do not become too tight as the leg swells.

Warning

• Do not give anything to eat or drink - the casualty may need a general anaesthetic in hospital.
• Do not move the casualty unless he is in danger or needs resuscitation.