Traction splint

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A traction splint is used to treat severe bone fractures of the femur. The use of traction splints by prehospital care providers is designed to reduce the pain of trauma from such fractures and are a near-universal piece of ambulance equipment.

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[edit] Principles

Traction splints are most commonly used for mid-shaft fractures of the femur, or upper leg bone. Due to its being the strongest bone in the body, the muscles surrounding the bone are also strong. When the bone is broken, the surrounding muscles often spasm, pulling the bone ends past each other, causing immense pain, muscle, and nerve damage.

Traction splints are applied only when the fracture is isolated to the femur and there are no other associated traumatic injuries to the leg or pelvis.[1] Use of a traction splint while other fractures in the leg exist will cause the weaker fracture site to pull apart and not the targeted femur fracture.

[edit] Models

There are four basic types: the Thomas half-ring, the Hare, the Sager, and the KTD. The basic principle is that one end of the traction splint is positioned against the hip, and pushes upward against the pelvic bone. A strap around the foot and ankle is connected to the other end of the splint, and tightened to counteract the muscle tension and produce traction. Only then are additional straps added to aid immobilization of the limb.

The Thomas half-ring consists of a padded half-circle of steel which is strapped to the hip, hinged to a U-shaped rod that extends along both sides of the leg. An ankle strap may be fashioned from cloth, and tied or twisted to apply traction force.

The Hare traction splint is similar, to the Thomas. Its length is adjustable via telescoping rods, and it has built-in straps for the hip, and to support the leg at several points along its length. It also provides a more comfortable ankle strap and a small winch that makes it much easier to apply and adjust traction force.

The Sager splint consists of a metallic splint that is placed between the patient's legs. Some models may be placed on the side closest to the injury for bilateral femur fractures without pelvic trauma. Straps are then applied, first at the thigh and then at the ankle, to strap the injured leg to the pole and provide support. The pole is extended to supply the needed traction, and then both legs are wrapped with cravat-like straps.

The KTD (Kendrick Traction Device) eliminates the need for leg-raising and unnecessary rolling of the patient, and can be easily applied to both pediatric and adult applications. It consists of a round pole that can be located on the lateral aspect of the leg, with straps at the upper thigh and ankle for immediate placement, and three wider straps for immobilization. It is very light at 20 ounces. The KTD does not afford the rotational stability normally seen in long bone traction splints.

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