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View Full Version : Makeshift treatment for a broken ankle



seun
11-20-2013, 02:32 PM
OK, all, here's the set up. A seventeen year old girl has broken her ankle. She and my other characters are miles from a hospital and on a mission to stop Mr Bad Guy from his evil plans. They have transport but it's more important they get to the bad guy before getting medical treatment. Another character has basic medical knowledge so what sort of makeshift treatment am I looking at for the broken ankle? It's not a compound fracture and they don't have medical supplies so it's looking very makeshift at this point.

ETA: Change of plan. Based on the replies, the break will now be a bad sprain. Thanks for the help, everyone.

Chris P
11-20-2013, 02:46 PM
The simplest fix would be a splint to either side of the ankle to prevent side to side motion, then wrap with a bandage or any cloth.

You should be able to find a free book online called "Where there is no doctor" by Hesperian Health Guides. It's a Peace Corps standard, and covers everything from mild burns to gunshot and stab wounds. I've even heard of people delivering babies by consulting it (although we're not supposed to!). It's a great resource for any writer, even those doing SFF since all the treatments are improvised from simple materials.

seun
11-20-2013, 03:20 PM
Thanks for the book tip, Chris. I will have a gander.

Trebor1415
11-20-2013, 10:06 PM
Heck, my old 1970's era Boy Scout manual shows how to make a splint for an ankle. It's pretty standard first aid, or was at least.

Just google it up and you'll find what you need.

Btw, you realize she's gonna slow them down, right? No way she'll keep up with the rest of the teenagers in a chase on a broken ankle and if they carry her, it will still slow them down.

StormChord
11-21-2013, 05:25 AM
A splint sounds good; also, thanks, Chris, I was actually looking for a book like that! :D

sheadakota
11-21-2013, 06:09 AM
a basic pillow wrapped around the ankle and taped makes a great temporary splint. bulky but it would work.

PorterStarrByrd
11-21-2013, 06:20 AM
If they are in a big hurry, no splint is going to make the injured functional. That being said, having determined it not to be compound, no treatment is needed. Sequester the injured and get on with the chase.

.. call 911 ..before or after continuing, depending upon what your story needs/ allows.

MDSchafer
11-21-2013, 06:52 AM
Duct tape and two paper back novels.

sheadakota
11-21-2013, 07:35 AM
The wonders of duct tape, will it never end.

infractuspennae
11-21-2013, 07:50 AM
OK, all, here's the set up. A seventeen year old girl has broken her ankle. She and my other characters are miles from a hospital and on a mission to stop Mr Bad Guy from his evil plans. They have transport but it's more important they get to the bad guy before getting medical treatment. Another character has basic medical knowledge so what sort of makeshift treatment am I looking at for the broken ankle? It's not a compound fracture and they don't have medical supplies so it's looking very makeshift at this point.

Are either of them wearing tennis shoes? Because if they are. You can take the laces, some strong sticks, and make a splint. Also wrap the heck out of it if possible. Try to find something that can be used as a crutch too so there is no weight on the ankle itself. A person can walk on a broken ankle as long as it is properly immobilized.

seun
11-21-2013, 01:38 PM
I like the idea of tape and two books. :D

The slowing the others down issue isn't a big one as they have transport, but they do need to stop in order to treat her ankle. I'm thinking a quick, temporary fix, get her in the car and get on with the chase. Ideally, she needs to be able to stand up by herself a few hours later but only for a short time. If need be, I can have her leaning against something while upright if that helps.

Matthew Hughes
11-21-2013, 02:33 PM
I'm sitting here with a double-broken ankle -- lateral and medial malleolus -- and it's been eight weeks since the break, and two since I had the cast off.

I started out with a temporary, incomplete cast that was put on in the emergency department at a Cyprus hospital. They told me to come back in a few days when the orthopedics outpatients clinic would be open. I hopped around on a cane for those few days, then found myself facing an angry orthopedics specialist who told me I was damn lucky that I had not displaced the fractures -- that would have meant an operation to pin the bones back in place.

So if your helpful character knows something about ankle fractures, he'll know that the injured joint has to be immobilized, and no weight at all can be put on it. That means an improvised splint, very tight -- duct tape and chopstick-sized supports would do it -- and if there are no crutches avalable, your injured character will have to be carried. No limping or cane-assisted hobbling.

I would splint her up and leave her somewhere safe while the rest go after the bad guy. She's not going to be much help, is she?

seun
11-21-2013, 05:51 PM
She's got an important part to play right at the end, so I need her involved. It's not far from where she breaks it to the car so someone can carry her. Strapping it up and planning on medical treatment later is the best I can offer her - not even any painkillers.

I really am horrible to my characters.

Matthew Hughes
11-21-2013, 06:04 PM
If it's any help, my experience is that a bad sprain is actually more painful than a break. You can walk on it, but it really, really hurts.

seun
11-21-2013, 07:11 PM
Hmm. Maybe she doesn't need to break it. I need her slowed down but if a sprain is enough to do so, then that could be an option. I'll have a think.

asroc
11-21-2013, 08:56 PM
I like the idea of tape and two books. :D


The pillow idea is much better. Fractured extremities swell and change their form. A splint, especially one that covers bony protuberances like a joint and that's supposed to stay on for a while, has to accommodate that, so it needs padding. A hard splint will eventually cut off circulation, so you really only want to use that if you expect to get treatment very quickly. What you can do is use padding and then use something rigid over that in the manner of a plaster cast, but check the leg frequently in any case.
As for wrapping, ideally you want something non-sticky with a bit of elasticity that can be removed quickly if necessary, like an ACE bandage. Duct tape can work, but is iffy because if has no give and is difficult to remove. If you do use it, don't put it on the skin. The wrapping also needs to be wide so as to not cut into the flesh, so no shoe laces, twine, yarn etc.

As for the other treatment, the oft-forgotten first aid acronym is RICE: Rest, Ice, Compression, Elevation. If she's in a car, have her keep the leg up and don't move it. Make sure the splint is snug, but not tight, and put an ice pack or a bag of frozen peas or whatever on the ankle.

Before you splint anything, check if the foot has sensation and a pulse. After you splint it, check if it still does.

Splint it in the position you found it, don't try to realign it. (There are situation where you can try to reduce a fracture in the field if you know what you're doing, but that's not a good idea with a joint.) Just because it's not a compound fracture doesn't mean it doesn't need further treatment. Closed fractures end up needing an orthopedic surgeon all the time and if she continues to use the leg (if she can; she probably won't be able to) her bones can move out of place even if they weren't before, so she's making it worse. If you don't want her disabled completely I wouldn't recommend a fracture.

seun
11-23-2013, 02:33 PM
The more I read the replies, the more I'm edging to turning the break into a bad sprain (although there's no harm in having the characters think it might be a break to start with). I can't leave the girl alone; she's got stuff to do nearer the end and needs to be focused and upright, not in too much pain to think.

Thanks for all the help, everyone. A sprain could be the way forward.

Mr Flibble
11-23-2013, 05:18 PM
Aren't you supposed to shoot them if they break their leg? :D

I'll second a sprain -- my daughter's on crutches atm after a nasty sprain, lots of swelling and copious tears. She couldn't put weight on it for a few days. Also less likely to have later complications (if you want later complications, I think a broken ankle would do better. ) and if you need her walking any time soon, a broken ankle isn't going to cut it.

seun
11-23-2013, 06:33 PM
Aren't you supposed to shoot them if they break their leg? :D

I'll second a sprain -- my daughter's on crutches atm after a nasty sprain, lots of swelling and copious tears. She couldn't put weight on it for a few days. Also less likely to have later complications (if you want later complications, I think a broken ankle would do better. ) and if you need her walking any time soon, a broken ankle isn't going to cut it.

Cheers for the info. A sprain it is.

debirlfan
11-24-2013, 07:30 AM
When I was young and stupid, I sprained my ankle jumping out of a perfectly good airplane. Instead of staying off of it like someone with some common sense would do, I walked around on it the rest of the day. (Note that I was wearing lace up boots at the time - I loosened them a little but kept them on.) It took a couple weeks to really heal - I'm sure it would have healed faster if I'd gotten off of it.