First Aid Bone, Muscle, and Joint Injuries 5 — Questions and Answers
Question 1: A child reports wrist pain after falling on an outstretched hand (FOOSH). Why is it especially important to X-ray children after this injury?
- Children feel less pain than adults
- Growth plate (physeal) fractures can be missed clinically but have long-term consequences (Correct answer)
- Children's bones never fracture
- Wrist sprains are more common than fractures in children
Correct answer: Growth plate (physeal) fractures can be missed clinically but have long-term consequences
Children have open growth plates that are vulnerable to fractures which can disrupt normal bone growth if undetected and untreated.
Question 2: Which of the following best describes a strain?
- Tearing of a ligament connecting two bones
- Tearing or overstretching of a muscle or tendon (Correct answer)
- Complete break through a bone
- Separation of a joint surface
Correct answer: Tearing or overstretching of a muscle or tendon
A strain is an injury to a muscle or its connecting tendon, while a sprain involves ligaments.
Question 3: A victim with a suspected spinal fracture after a car accident also has an obvious femur fracture. What is the correct order of priorities?
- Splint the femur first, then address the spine
- Control life-threatening bleeding and maintain spinal precautions simultaneously (Correct answer)
- Move the patient to a safe area before any treatment
- Focus only on the femur since it is more visible
Correct answer: Control life-threatening bleeding and maintain spinal precautions simultaneously
Life-threatening hemorrhage from a femur fracture must be controlled while maintaining spinal precautions; both are immediate priorities.
Question 4: Crepitus at a fracture site is described as:
- A crackling or grating sensation when the bone ends move against each other (Correct answer)
- Excessive warmth over the fracture
- A popping sound from a dislocating joint
- Muscle spasms adjacent to the injury
Correct answer: A crackling or grating sensation when the bone ends move against each other
Crepitus is the grating or crackling felt or heard when broken bone ends rub together, and is a reliable sign of fracture.
Question 5: A patient has a suspected hip fracture after a fall. Their affected leg is typically positioned:
- Straight and internally rotated
- Shortened and externally rotated (Correct answer)
- Lengthened and flexed at the knee
- Abducted and elevated
Correct answer: Shortened and externally rotated
A hip fracture classically causes the leg to appear shortened and externally rotated due to muscle pull on the fracture fragments.
Question 6: When using a traction splint for a mid-shaft femur fracture, the purpose of traction is to:
- Reduce swelling by compressing the thigh
- Align bone ends, relieve muscle spasm, and reduce pain (Correct answer)
- Stop all blood flow to the leg
- Replace the need for any padding
Correct answer: Align bone ends, relieve muscle spasm, and reduce pain
Traction splints apply gentle longitudinal force to counteract thigh muscle spasm, help realign bone fragments, and significantly reduce pain.
Question 7: After a suspected ankle sprain, which activity should be AVOIDED in the first 48–72 hours?
- Resting the ankle
- Applying ice wrapped in a cloth
- Heat application and vigorous massage (Correct answer)
- Elevating the ankle above heart level
Correct answer: Heat application and vigorous massage
Heat and massage in the acute phase increase blood flow and worsen swelling; they should be avoided for the first 48–72 hours.
First Aid Bone, Muscle, and Joint Injuries 5
A child reports wrist pain after falling on an outstretched hand (FOOSH).
Why is it especially important to X-ray children after this injury?