There are three main types of fracture, and two states of fracture. These are Simple, Comminuted and Greenstick types of fractures, and then open and closed states of fracture. This section will concentrate on more complicated fractures, which are consequently harder to deal with.

Fractures may be associated with an open wound, and complicated by damage to other structures. An open wound fracture, or a compound fracture, means that immediately you have a greater risk of infection, both in treating the injury, and subsequently. When the hide remains closed over a break, there is often substantial swelling and bruising.

Often a broken bone is obvious, but occasionally they occur distal to the point of impact. Not only this, but they can be further complicated by being a fracture with multiple bone fragments (comminuted), or a greenstick, in which the bone in a young dragon splits. In the former case it may be necessary to remove some of the bone fragments. However, if this is not possible, there appears to be an internal mechanism that accomplishes this, though recovery is substantially longer. The dragon may also complain of 'grinding' at the point of injury, and this may never be corrected. Rest therefore, particularly immediately after injury is fundamental to healing this type of injury. Greenstick fractures, whilst traumatic for the weyr as the young dragon is likely to broadcast loud and clear what pain it is in, aren't problematical from a healer standpoint. They heal quicker than most fractures, and have few, if any, complications.

Once you have correctly diagnosed the injury, the fractured bone should be straightened and returned to its normal configuration. You may have to request the aid of other dragons in order to accomplish this. The injury should then be stitched if applicable, splinted securely, elevated if possible, and an attempt made to prevent motion of the bone wherever possible.

Assess the situation: If the dragon is in pain, then ask a Gold to 'dampen' the pain and still the movement. Involve the rider. Ask the rider for details of the injury, and keep them with you (don't get them too drunk, you need to ask them questions!). Take control of the situation, but never forget to ask a rider first for permission to approach their lifemate - big dragon, in pain, equals a dangerous combination.

Determination: Is the injury bent at an impossible, or distorted, angle? Is there any swelling? Is mobility restricted? Was a cracking noise heard? Is it tender over the area? Is that pain 'sickening'? Ask as many questions as you can think of as soon as possible, while both dragon and rider are still conscious because both are likely to be distressed. If the answers are: Yes, it's bent at an impossible, or distorted, angle; mobility is restricted; there was a cracking noise; the area is tender; and there is swelling; then you are dealing with a fracture and not a sprain nor a dislocation. Next determine whether the injury is open or closed, if it is a comminuted, or greenstick fracture. If comminuted and open, multiple fragments will be seen, if comminuted and closed, you should be able to feel them under gently probing fingers. Additionally a comminuted fracture isn't usually bent at such a severe angle as a simple bone fracture, although there is a higher possibility of it breaking through the hide. A greenstick will almost always occur in any dragon under 18 months of age, and will appear as more of a bend in the limb, rather than an awkward angle. If uncertain, treat as a simple fracture.

Treatment:

1. Immobilize immediately. Support if possible, but get weight off area. Remember, dragons are huge! You may need to enlist the help of other dragons, and or use a ladder/table to properly treat this injury.
2. Wash your hands in redwort, water, and then coat then in oil. These will help prevent infections, and protect them from the numbing effects of
numbweed. If instruments are needed, presoak these in redwort.
3. Numb the wound and then make thorough assessments. It is likely that for most broken bones (wings and toes) numbweed will be enough to deaden the pain, but for larger bones (leg bones, etc), the numbweed will not penetrate the hide deep enough to work. However, if you are dealing with an open wound, cleanse first with redwort to disinfect the area, and then apply a liberal coat of numbweed.
4. Pull steadily in a line with the bone, keeping it as straight as possible. You will have to have assistance from a larger dragon.
5. If the hide is open, stitch the wound closed. Stitches for injuries are unlike stitching clothes. Each stitch is separate from the next, each one basically a separate knot from the other. Stitches are made by pushing a needle through one edge of the hide, then through the other. A loop is then made with the thread of the second entry, and the first part of the thread pulled through this, pulling it closed, and closing the wound. A dragon will need a lot of stitches. This can take a long time. Remember to recoat your hands with oil so that they do not become numb. Stitching should be performed so as not to pucker the hide but still provides a barrier to infection (ie. not too tight and not too loose).
6. Splint with tree trunks, branches or other materials that have been prepared before hand. Supplies of these are kept in every dragon infirmary.
7. Move the dragon to the infirmary or a ground weyr. Other dragons can be used to help with supporting the injured one. Make sure that they have plenty of water to prevent dehydration.
8. Soaking in the lake/ocean will help further with swelling reduction, but support will be needed to and from the lake/ocean. The wound will need to heal somewhat before this is done if the fracture was an open one. Once the bone has begun to knit (approximately half the recovery time), then gentle exercise may begin to bring muscle strength back. It is recommended that these start in the water.

Recovery: This will vary, depending on the age of the dragon and the severity of the break. Figure on two months for a minor break (wingbone) and six months for a major break (leg bone). Some dragons will be permanently disabled after fractures, and might not be able to launch from the ground, fly in a straight line or fly an entire Threadfall.

© 2000 Eliwys
Last updated August 2000

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