1. Have an Emergency Plan in Place

I’m a parent who takes my young daughter backpacking in the wilderness, often far away from civilization and miles away from the nearest help.

While these experiences are wonderful for teaching resilience and survival skills, there’s still the risk of something going wrong.

Along with snake bites, bear attacks, and heavy bleeding, broken bone injuries are common in the wilderness.

Knowing how to treat a broken bone is a vital first aid skill you should know before going into the wilderness.

Here are the steps to take to make sure you are prepared. I’ve included pictures of how to use improvised splints for each type of broken bone.

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Whenever you go into the wilderness, always plan for the worst.

Don’t think you need to be this cautious? 

Consider that day hikers are actually more likely to need rescuing than multi-day hikers.  The reason is many day hikers don’t bring basic survival gear because it’s just going to be a “short trip.”

Then something goes wrong – injury, getting lost, bad weather… — and they find themselves without adequate supplies and no one to help them.

You should:

Bleeding takes precedent over a broken bone.  Take these steps:

For open fractures – when the broken bone is sticking out of the skin – take these steps:

If the bone is sticking out of the skin, a limb is visibly deformed, or you can hear or feel grating around the injured area (sign that the ends of the bone are rubbing together), then you know the bone is broken.

Likewise, if the limb is too painful for the victim to move or use, then the bone is probably broken.

However, some injuries – like sprains or torn muscles – are hard to distinguish from fractures.  In wilderness situations where you can’t check injuries with an X-ray, you should assume the bone is fractured and treat is as such

Important: Move the victim as little as possible during first aid.

Movement can jostle the broken bone and result in further damage, including pinched nerves or severed blood vessels. When possible, use scissors or a knife to remove clothing around the injury site.  If you are unable to remove clothing without jostling the broken bone, then it is better to leave clothing in place than risk further damage.

Injuries that cause fractures in the wilderness can also cause severe internal bleeding.  The fracture itself might cause internal bleeding if broken bone severed a blood vessel.  The pieces of broken bone can also damage nerves.

Before you treat the fracture, you’ll need to check for any signs of internal bleeding or nerve damage.

This is done with a CSM check: Circulation, Sensation, Movement.

Any sign of internal bleeding or nerve damage is urgent: The victim needs help within hours and should be evacuated immediately. If you have an emergency beacon, now is the time to use it!

Traction is a process which involves applying gentle pressure to the fracture to put it back in proper position.  It is not the same as setting a bone.   Setting a bone is about lining up the broken bone so it heals properly.

By contrast, the goal of traction is to improve circulation.  Traction also helps relieve pain and makes it easier to splint the fracture.

When to Apply Traction:

 Do Not Use Traction If:

 How to Apply Traction:

In the case of open fractures where the bone is sticking out of a wound, traction will cause the bone ends to slowly go back under the skin.  Once the bone is in place, you can dress the wound.

*Also remove any jewelry, such as bracelets, around the injury site. Severe swelling can occur and jewelry can get stuck on limbs cut off circulation.

After applying traction, you’ll need to perform the CSM check again.  If the victim does not have normal circulation or sensation below the fracture, try to determine why.

Are there any clothes which are cutting off circulation?

If so, remove them.

Is the bone still not set in the proper anatomical position?

Attempt traction again.

If you don’t have a splint in your first aid kit, you can easily improvise a splint out of materials around you.

There are three components of an improvised splint: The actual splint, fastener, and padding.  Gather all of these supplies before you start splinting the broken bone.

Here are some examples of materials you can use for an improvised splint:

Don’t underestimate how important padding is!

Tissue around broken bones will swell up a lot.  If there is not enough padding, the splint will cut off circulation and can cause severe damage, not to mention a lot of pain.  It’s actually more important for the splint to be padded than rigid.

You can wrap the padding around the splint.  Or you can put the padding between the splint and the limb.  It’s a matter of what materials you have to work with and personal choice.

A splint works like a temporary exoskeleton.  Its job is to hold the broken bone in position and immobilize it so further damage doesn’t occur.

Tip: Before applying the splint on the broken bone, practice doing it on the uninjured side.  This way you will can figure out how to position the splint properly without jostling the injury and causing pain and further damage.

Below are instructions on how to apply a splint to various bones.

With broken forearms, the arm should be splinted with the elbow bent. This position makes it easier to keep the arm from moving around, especially if the victim needs to walk over tough terrain in order to get to help.

For splinting to be successful, the broken bone needs to be immobilized. In the case of upper arm injuries, this means immobilizing the elbow and shoulder joints.

The best way to do this is to use a sling and swathe.  With this method, you can actually skip the splint; the victim’s body is used as the rigid object to hold the fracture in place.

If you are certain the humerus (upper arm) is broken, you can also use this splinting method:

Splinting a broken lower leg is pretty straight forward.  The key thing to remember is you want to keep the ankle in a bent position.

A SAM splint works particularly well for this: you fold the SAM splint over the foot so it holds the foot upright as you secure the splint.  If you don’t have a SAM splint, you can tie the ankle in position.

Broken elbows and knees should be splinted in the position they were found.  Do not try to straighten the joint to apply a splint.   The following instructions are for splinting broken elbows but the same instructions also apply to broken knees.

*It is also possible to do this splint with two boards: one under the arm and another above.  The splints get tied together using figure eight loops.  The extra splint provides more support, but it is fairly difficult to tie in place.

You can see a video of how it is done here.

The thighbone (femur) is the largest bone in the body.  It is connected to very large, strong muscles.  If the femur breaks, these muscles will contract and pull on the femur, causing the broken bone parts to overlap.

Even if you are able to straighten the bone using traction, it may still start to overlap again. To keep the femur straight, you need to apply a traction splint.

*You can see a good example of an improvised traction splint here.

Broken hand bones usually don’t seem very serious at first.  Then a few hours pass and swelling sets in.  If the hand wasn’t properly splinted, it can become very uncomfortable.

The swelling will make it nearly impossible to splint the broken hand after the fact.

This link shows an image of an improvised hand splint made with a hydration bladder.

Broken ankles are common injuries in the wilderness.  Ideally, you use a “wire ladder splint” to treat a broken ankle. This is a metal splint which can be bent into an L shape.  The shape keeps the ankle in a flexed position.

You could make your own ladder splint by bending backpack frames into an L shape.   In the image below, cardboard is used to make an improvised ankle splint.

The following instructions are for if you don’t have anything which can be used as a ladder splint.  In this situation, you use a “stirrup splint” instead.

If the hip bone is broken, the victim will be in severe pain and unable to walk at all. They won’t be able to move their legs upwards and probably not able to sit up.

These injuries are very difficult to treat and it’s even more challenging to move the victim.  Emergency rescue will be needed.

*Note it can be difficult to tell the difference between a broken and a dislocated hip.  If you suspect the hip is dislocated, do not attempt to return the leg to its normal position.  Instead, use bulky materials like a sleeping bag to support the leg in its normal position.

Under normal situations, a person with a broken bone would be instructed not to move.  However, in wilderness situations, the victim might need to walk to get help.

Prevent pressure on the injury by improvising a crutch for broken legs and ankles.  Broken arms should be immobilized with a sling.

Keep checking on the victim.  You’ll want to:

Here is where things get very tricky with broken bones in wilderness situations, especially if you don’t have a way to call for help.  How do you get the victim to help?  What if you are alone?

Depending on the circumstances, you might want to:

Injuries in the wilderness do happen – don’t think you are immune!

That’s why it is so important to think about these scenarios before they happen and come up with a plan.  Hopefully you will never have to enact your plan, but at least you will be ready if necessary.

Disclaimer: All content and media on the primalsurvivor.net is created and published for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Use of the information on this site is AT YOUR OWN RISK, intended solely for self-help, in times of emergency, when medical help is not available, and does not create a doctor-patient relationship. Always get professional help if available.

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Wow, Thank-you for sharing this information. I have learned a lot more about how to treat broken bones in the wilderness.

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