Improvised arm break treatment in medieval ages

[pizzazzical]

Hello! I have multiple questions on this one scenario, I hope that's all right :)

Setting: I am writing a piece set in the "dark ages" around the time of Geoffrey of Monmouth and Arthurian legends. In the fandom canon knowledge and treatment of diseases and injuries is more advanced than it actually was at the time. For example there is knowledge of

Comments

[azalaea]

I broke my right humerus when I was 9, from a fall, in the late 80s. There was actually not much even modern medicine could do. You can’t, apparently, put a plaster cast on someone’s upper arm. At any rate, they didn’t. All that happened was I got up, my mum drove me to hospital, several hours passed before the break was confirmed, and then I wore a cloth sling for a couple of months - nothing to hold the bone in place at all. I think, from the fact that my other arm seems a bit more flexible (and I seem to remember x-rays showing the edges weren’t quite perfectly lined up), that it may have healed very slightly wonkily, but you can't tell.

If the break had been more seriously displaced I suppose they would have done something to set it, which your characters might not do particularly well as Sollersuk says. But once done, it would presumably be back to just keeping it in a sling and hoping for the best.

If it's a closed fracture, as I see you're leaning toward, and he's not losing blood, there would be no particular need to treat him at the scene at all (at least not for the arm.) No need for the other character to start tearing up valuable clothing. He can just walk home and be looked after as available there. If his friend’s got some suitable piece of cloth she could make a simple sling to keep it from swinging about too much on the way, but even that could wait. I think one tends to cradle it against one’s body in a sling-like position anyway.

Also, I remember that it really didn't hurt all that much. I was weepy and distraught for the first couple of minutes, but even then more from the shock of the fall itself than from the actual pain, (also from the fact that I KNEW as I was falling, with crystal clarity, that I was going to break it - certainty that diminished after it actually happened). I calmed down fairly quickly and then it was just sort of vaguely achey and I felt simply annoyed about the whole thing. I think this may have been somewhat unusual and of course I was lucky in having a nice clean snap, but I don’t think it would ever have been agony unless the break had been much fancier with bone edges cutting into things (in which case you’ve got all those nasty problems with internal blood loss and infection).

Another thing: why does he pass out for 3-4 hours? That's a long time. Do you mean from a blow to the head from falling, or from the pain of breaking his arm? I would think the latter would be unlikely, (and would not last for hours if it did happen), and the former would have to be a quite serious head injury to keep him under for such a long period, in which case he's got problems beyond undertaking a short walk with a broken arm.

[pizzazzical]

Thanks so much for all this information :) It was really clear and detailed, thank you lots!!! I understand that it might set a little wonkily etc., and that he would probably lose a little flexibility in his arm. Would it, however, impair his speed, reflexes etc. enough to be detrimental in armed combat later, do you think? (I'm leaning towards yes but as shown I know little to none about these things :x)

About the fainting thing, at first I was going to have him suffer a compound fracture where he was losing blood and the pain was perhaps a lot more than a closed fracture, which is why he fainted (though even in that situation 3-4 hours seems like pushing it xD). He didn't sustain any injury apart from his arm.

Anyways thanks again for all your help that was really useful :) I'm glad you recovered well!

[azalaea]

You're very welcome!

In my case it took about 2 weeks longer to heal than it was supposed to, 8 rather than 6, I think precisely because there was no plaster or anything keeping it from jiggling about. And I was nine and was not that careful with it - almost deliberately careLESS because I resented it so much, though I still remember being devastated and hating the doctor when I thought I was only a fortnight away from being able to take the sling off and they told me it would be another month.

I don't know what difference serious wonkiness would make - if I have any it's very slight. You can't see anything. As I say I suppose if there had ever been any sign there was going to be a real problem, they would have done something about it - but my experience does show that it CAN heal fine without anything much being done. Aside from a vague and possibly untrustworthy memory of an x-ray, the only thing that makes me even suspect it's not quite right is - well, you know this yoga position? Bending my left arm up behind my back, I can do it easily, but with my right arm? Can't get it up my back at all. Hands stuck about a foot apart. But there may be no connection to the break whatsoever. Typing it suddenly made me think it was silly even to think so - but googling does reveal people complaining of loss of range of movement. And sometimes I think it aches, when it's cold. But then I get other odd pains in my bones.

In any case, I don't think it would make much difference to my ability with a sword, if I had any! I suppose my arm must have been weaker and skinnier when the sling came off, but I didn't notice much difference, (I was weedy already) I'm pretty sure it must have recovered quickly.

Your fellow would probably notice lost strength more as he'd be relying on it more and have more to lose. But in the long run, and assuming a comparable break to begin with, I think he'd be for all practical purposes the same as ever. But if you wanted a more obvious long-term problem or a more difficult healing process, you could have the break be a "spiral fracture" or badly displaced, or located differently, or generally nastier in some other way.

I just did some searching and found this book, which says "fortunately, in the upper arm, malalignment rarely creates any functional loss. The flexibility of the shoulder allows most angular or rotational malalignment to be compensated." But if you haven't already I recommend searching "fractured humerus recovery", "fractured humerus flexibility," etc.

Maybe more details about the pain would be helpful to you? I remember it as a a sort of cold feeling inside the arm. Not severe, as I said, but deep somehow. I let myself be half convinced it wasn't really broken because it didn't hurt that much and because that's what the grown-ups, including the doctor who examined me to begin with, seemed to think. But on some level I knew it was - despite the relative lack of pain all my instincts were telling me this was something more serious than I'd had before.

[pizzazzical]

Wow thanks for all the information :O Also I'm glad that it probably won't really affect his swordsmanship (although even if it did he'd probably just ignore it and train 3 times as hard). So loss of range of movement, ok, he can probably live with that lol :P It needn't be a bad break (it just had to look bad, so I could use horrible imagery! But that's not the important part, I needed factual accuracy more xD)

Anyway thanks 100 times for the detail! That was so useful and helpful and gah xD Have a nice day!