You’re hiking down a particularly steep talus field in a remote mountainous area. You take a step forward and suddenly the ground gives out beneath you. A jettison of loose rock spirals out from under your feet and you fall and begin sliding down the slope. In an instance your descent is halted and your foot slams into a boulder as another rock careens from above and makes impact with your ankle. You hear a pop and sharp jolts of pain and pressure shoot through your leg. In a moment of shock you try and get up but can’t. Your ankle is broken.
A broken or fractured bone is one of the worst scenarios that can occur out in the wilderness. These injuries are not just very painful, but can completely immobilize you–potentially leading to a variety of other life threatening complications. In the event of a broken, fractured, or even sprained limb, you will need to address the affected area immediately by immobilizing the limb, setting it, and splinting the break. Unfortunately, in a survival situation you may not possess the means to efficiently treat a fracture or break and it is likely that you will have to improvise a way to set and splint the break to get yourself back to civilization.
Depending on the nature of the break, you may have to address open wounds as well. Here the distinction between fractures–compound (open) and closed– becomes important. If you are confronted with a compound fracture, you will need to set the break and then clean the wound. One of the most important things to understand about setting a fracture or break is that only minimal adjustments should be made at the site of injury, and very carefully. There is a serious risk of severing or compressing a nerve or blood vessel and causing internal bleeding. While some first aid emphasizes splinting fractures in the position in which they are found, in a back country survival situation, you need to return the bone to its natural position.
The most conventional and effective way of setting the broken limb or fracture is to use traction to return the limb to it’s natural position. This is done by grabbing an area of the body above the injured area and slowly applying traction by grabbing below the broken limb and gradually adjusting it until it meets the other end of the limb. This should always be done very carefully and slowly to avoid causing excessive pain. When done correctly this practice can help alleviate some pain since you will be returning the fractured or broken bone to its anatomical position. The key is to keep the affected area stable and the bone in place and immediately apply a splint.
Chances are you don’t have a medical grade splint on hand out in the wilderness. This means that you will need to improvise one out of materials you can find. The first thing to do, however, is evaluate the circulation and movement of the injured site and reposition the limb as necessary. You may need to loosen tight clothing or otherwise reduce constriction if you lack sensation in the affected area. When it comes time to create the splint, you will want to utilize any materials near to you. A splint can be made out of nearly any material strong enough to support a limb
Tent poles, ski poles, backpack frames, paddles, sleeping pads, climbing rope, straps, webbing, belts, sturdy sticks, and even snowshoes, wood, scrap metal, or your own clothing can be used as splints. You will need to assess how dire your situation is and what you have at your disposal to adequately splint the break. If you have gear with you chances are you can re-purpose something to make a pretty good splint. If not, look for a nearby sturdy object and set the splint in the inline position with the break.
You will next need to immobilize the limb above and below the break and may need to use some traction to set the limb into the correct anatomical position. Use caution and make sure that when you set the splint it is snug but not constricting. The strongest splint will be one that is applied to two or more sides of the break. This will help keep the limb immobilized from multiple directions and the allow the break to properly set and begin to heal.
If possible, use some padding on the area of the splint that comes into direct contact with the break. Something compacted or compressed works best to hold the splint in place while offering some comfort. After setting and splinting the break you will likely experience swelling during the first 24 hours. This may cause the splint to tighten, so you will need to monitor it and adjust as necessary. It should be neither too loose nor too tight. Constantly be aware of your circulation, sensation, and range of movement for signs of circulation loss like numbness, swelling and discoloration.
If you are stranded and injured you will eventually need to perform a self rescue and get to help. Circumstances and terrain vary, but if you’ve sustained a fracture or broken bone in your lower body you will need crutches to get yourself into a position where you can be rescued. Similar to the splint dilemma, you will likely not have a pair of crutches on hand but should be able to improvise some out of scavenged materials or personal gear. If you have poles–ideally ski or hiking poles–you can use these as aiders to maneuver yourself. Otherwise, look for sturdy tree branches–preferably ones that are forked at the top.
The branches should be about 4 feet long to allow you to comfortably and efficiently walk. Whether you are using poles or branches, you will need to wrap the tops with clothing or some kind of padding for comfort. Use what you have available, though if you can spare nothing you may be able to use some large leaves as padding. Branches that are forked at a broader angle will also be more comfortable as crutches. Gently weight them at first and proceed slowly. Depending on the nature of the break and location, you may not have to totally weight them and can instead use them for balance to negotiate rocky or steep terrain. Move carefully and monitor the injury as you move – resting frequently and staying hydrated.
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