There are three long bones in each arm—one in the upper arm and two below the elbow. These are among the most commonly broken bone sin the body. There is also a number of small bones in the wrist that are vulnerable to breaks. Fractures to the hand or fingers can be extremely painful because of the may nerve endings.

The principles of treatment are, as for all broken bones, to provide support to the injured part and to stop it from moving too much. Most people with broken arm will be able to make their own way to the hospital or a health center, so treatment focuses on providing that is appropriate when walking and stabilizes the injured limb. This can be done with an improvised sling using clothing, or by using a triangular bandage to form an arm sling.

HOW TO MAKE AN ARM SLING

1. Gently place the bandage under the victim’s arm, placing the point underneath the elbow.
   
   
2. Pass the top end of the bandage around the back of the victim’s neck, leaving a short end to be tied by the collarbone on the injured side.
   
   
3. Bring the bottom end of the bandage carefully, ensuring that it fully supports the injured arm. Tie into place with a square knot or bow.
   
   
4. For additional support, you can tie another triangular bandage. Fold into three (a broad fold) around the arm, avoiding the site of the fracture, to stop the arm from moving.

BROKEN ELBOW OR AN ARM THAT CANNOT BEND

If the broken bone is on or near the elbow it may not be possible for the person to bend the arm, either because of the pain or because the joint is fixed. In this case you need to treat the arm in the position found—do not try to bend the arm.

1. Help the victim into the most comfortable position; this will often be lying down on the ground, but it may also be standing up with the arm hanging straight down.
   
   
2. Place padding around the injured part, both between the arm and the body and on the outside of the arm.
   
   
3. The victim will need to be transported by an ambulance. Do not attempt to bandage the arm if help is on its way because this will cause further discomfort and may make the injury worse.

FRACTURED WRIST

In older adults, the wrist may be broken by a fall onto an outstretched hand, causing a break a very low down on the radius (one of the long bones in the lower arm) known as a Coleus's or silver fork fracture. Other injuries can break one of the small bones to the wrist or cause a sprain that is particularly difficult to distinguish from break.

TREATMENT

Provide support and immobilization in the same way as for a break to the upper or lower arm. Remove watches and bracelets because these may contribute to cutting off circulation to the hand if the injury swells.

HAND FRACTURE

Direct impact may break one or two of the small bones in the palm or fingers. Crushing injuries may break several bones and cause considerable bleeding. In addition the thumb, and even some of the fingers, may become dislocated.

TREATMENT

1. Gently cover any open wounds with a dressing or clean, non-fluffy piece of material. Encourage the victim to raise her arm. This helps to reduce swelling and bleeding and also provides some pain relief.
   
   
2. If possible, remove rings and wrist-watches before injury starts to swell. If jewellery has been crushed into the hand or swelling prevents its easy removal, pass this information on as soon as possible to the medical staff as early treatment will be needed to prevent damage to the circulation in the fingers.