The worst place you could possibly break a bone  is out in the wilderness, but of course it does happen, and it happens quite often, in fact.
The main reason for this is simple: The wilderness is a place that hasn’t been sanitized and made perfectly safe for human habitation. There are no building codes to prevent someone from falling off a steep trail; no convenient handrails on trees, boulders or loose ground. In short, the wilderness is rife with potential hazards, and each year, hundreds of people find themselves with an injury sustained due to a little outdoor adventuring.
In theory, you can break any bone in your body up to and including your skull in the wilderness. In practice, most breaks tend to revolve around the lower arm (radius and ulna), the upper arm (humerus), the lower leg (tibia) and the upper leg (femur). Mainly, these bones are broken more frequently than others in the outdoors because of falls, although it’s common to see non-limb breaks as well.
Bone breaks are grouped into two major categories – open fractures and closed fractures. An open fracture is one in which the bone has broken such that it penetrates the skin; this is sometimes referred to as a compound fracture. A closed fracture  is one in which the bone is broken or cracked, yet does not penetrate the skin.
Both types of fractures will present a significant problem to the would-be outdoorsman, and both will result in a significant degree of immobilization. Basically, you need to take steps to stabilize the wound, and get the person back to a hospital posthaste. Here are some tips to effectively stabilizing broken bones :
- Manipulate the broken limb as little as possible. There is a danger with bone breaks of pinching a nerve, or worse yet, puncturing or severing a major blood vessel, which could result in internal bleeding, shock, and ultimately death. Keep the amount of movement on the broken limb to an absolute minimum.
- Set the break. In order to relieve pain and return the injured limb to its correct anatomical position, you’ll need to re-set the limb. In medical terms, this is called applying traction. Traction is pretty simple to understand. Let’s say a person has broken a bone in their lower arm, and the forearm is bent at an unnatural angle. In this case, you need to hold the upper arm in place, while using downward pressure (traction) to pull the lower arm back into shape. It sounds gruesome, but will usually result in the patient feeling a lot less pain.
- Immobilize and splint: Once the broken limb is set in an approximately correct position, you need to create a makeshift splint. The easiest way to do this is by using a couple of straight tree branches, about a half inch or so thick. Take these tree branches, and place one on each side of the break (if the break is an open fracture, keep all materials away from the wound). Tie these tree branches in place with paracord, handkerchiefs, bandannas or anything similar. Make sure the branches are firm, but not so tight that you’re cutting off circulation. What you’re doing here is creating a temporary exoskeleton to hold everything in place until the patient can be seen at a hospital.
- Watch for shock: After the limb is set and splinted, keep an eye on the patient for signs of shock, which includes a rapid, fluttering heartbeat and pale skin. Place the patient in a comfortable position with their weight off the broken limb, and make sure the patient is kept warm. Keep the patient hydrated!
- Get the patient to a hospital: It’s never a good idea to move a patient with a broken leg, but those with arm injuries often can move at a reduced pace. The key to successful healing of a broken limb is immediate, professional medical attention at a hospital. Sometimes, this is not always close by; consider a patient with a broken bone to be a medical emergency worthy of a radio or telephone call to a local search and rescue, police or fire department, all of whom can summon helicopters and professional first aid crew.
There is one piece of advice we’ve left out until now, and it may seem relatively obvious, but it bears stating: Avoid breaking a bone in the wilderness in the first place! What this means is adjusting your mindset in the wilderness and being extra careful. This means taking affirmative actions like watching where you put your hands, being extra careful of where you step, making sure the objects and ground you stand on can support your weight, and not taking stupid risks. A little planning, quality footwear, and a smart attitude will prevent bone breaks in the first place, which means you won’t have to treat them!