It can be applied in the field and helps facilitate transport and mobilization, but it should be used only temporarily because of the risk of skin breakdown from the stirrup. Runcie H, Greene M. Femoral traction splints in mountain rescue prehospital care: to use or not to use? application of traction splints for femur fractures (open or closed) is likely not to impact patient outcome. It is unlikely any femur fractures were clinically missed by the rescue teams; however, other soft tissue thigh injuries could have been mistaken for a fracture and included in the data, which records the clinical diagnosis made on scene. The light, compact splint is designed to apply femoral traction to relieve pain and reduce hemorrhage and the possibility of further neurovascular injury. We would suggest the use of a traction splint is reasonable when there is a suitable indication and no contradictions. Of those 5, 2 had traction splints fitted successfully. Femur fractures are rare, and owing to contraindications traction splints are rarely used. In addition, they have to be carried to the scene and can only be used for a single type of injury. The Thomas splint supports the leg and balanced traction is applied. The femoral shaft excludes commonly fractured parts of the femur such as hip and supracondylar fractures. Enter search terms to find related medical topics, multimedia and more. verify here. Objective: To describe the use of traction splinting in children with femoral shaft fracture and to determine if timing of traction splinting application effects outcome. image, Download .docx (.08 Get more for less. Femoral shaft fractures should be put into skin traction (10% of body weight) to help with pain management. Femur Fracture Splinting Femur fractures can result in the loss of 3 units of blood in the soft tissues. Intramedullary nailing of the femur: current concepts concerning reaming. Use adequate analgesia (usually IV opioids) because traction splinting of femur fractures is painful. Practical Prehospital Care: The Principles and Practice of Immediate Care. We suspect that an incidence of 9.3 femur fractures in the England and Wales mountain environment per year is an overestimate. Assess distal pulses both before and after splint application. Femur fracture immobilization with traction splints in multisystem trauma patients. Cost Effective For Hospitals and EMS. For more information, please contact our customer service via chat or by phone at 1-866-861-8111. The results were generally positive, with most team members perceiving suggested benefits at 5 (very beneficial; The literature search initially found 141 articles. Acad Emerg Med. 38% of patients with traction splints fitted had contraindications. The Mountain Rescue England and Wales database was searched for cases of suspected fractured femur occurring between 2002 and 2012, a questionnaire was sent to all mountain rescue teams in England and Wales, and a literature review was performed. This is the first work to perform follow-up and look at outcomes. Femoral traction splints are designed to apply traction to the lower portion of the leg, distal to the fracture, usually by pulling the ankle away from a stabilized pelvis. It is primarily used on patients with mid-line femur fractures. When you are logged in you get all the correct prices, availabilities and shipping costs for your account agreement. Types: Emergency, Military, Pre-Hospital, Prison, Be the first to know about new products and promotions, Office hours: Mon to Fri 8.00am 4.30pm, Unit 4/62 Borthwick Avenue, Murarrie, QLD, 4172 Those with prehospital traction splints fitted had fewer units of blood transfused in the first 24 hours and had shorter hospital stays. Traction splinting is the standard of care management of femoral shaft fractures in the prehospital setting given the appropriate patient. Skin traction is less invasive than skeletal traction and uses splints, bandages, and adhesive tapes positioned on the limb near the fracture and is applied directly to the skin. Use about 10% of the patient's body weight or up to about 7 kg (15 pounds). Consider traction splint Little evidence to support its use; Theoretical benefit of traction splinting is reduction in bleeding and improved pain; Sager and Hare splints are commonly used by EMS providers; Buck's traction used by ortho; Disposition. Level 4. This field is for validation purposes and should be left unchanged. During the 10-year study period, 93 casualties with a suspected femur fracture were identified (9.3 per year). Results: The use of the traction splint for a femur fracture in the pre-intervention stage was found to be underutilised (Median 16%). It contains details on the incident, the casualtys injures, and treatment. There is brevity of evidence-based research on their efficacy. Speedsplint Femoral Traction Kit FASSM200: Fast and easy-to-apply splint for emergency use when temporary immobilization of the femur (upper leg/hip area) is required Easy to monitor the injured body part after application Effective for sea and heavy rain rescues Buoyant and features drain holes Permits complete padding procedures for effective immobilization Can be worn during X-ray . Severity and pattern of injury in survivors of alpine fall accidents. They require training and may not fit into the package of stretcher, casualty bag, and vacuum mattress. Traction splints are useful in the treatment of closed and open . Ninety-three percent of team members reported having had training on traction splint use within the past year, with 75% of those within the last 6 months. Femoral nerve blocks are effective for pain management and have less side effects than systemic analgesics Placing the patient in a splint traction until your orthopedic colleagues arrive may improve alignment and improve blood flow Read More Orthobullets Femoral Shaft Fracture Rosen's Emergency Medicine Concepts and Clinical Practice (link) treatment of a femoral fracture; overbody or lateral skeletal traction. Advise femoral traction splint or simple vacuum mattress/box splint. Prehospital midthigh trauma and traction splint use: a retrospective review of a trauma registry (SAEM Abstract). Understand the process for application of a femoral traction splint. By the end of this session the participant will be able to: Describe the indications for femoral traction splint application. Thank you to the members of the MREW teams for completing the questionnaire. Application of traction splints to the femur can be a bit tricky, mostly because of the various indications and contraindications. Immobilize the leg: either with a posterior splint or simply a pillow under the thigh. From the 1980s onward, femoral nailing became the definitive treatment and traction splints were only used before surgery. The most recent article published is an abstract and poster from a conference. They became the standard definitive treatment for femur fractures until the development of femoral nailing in the 1950s. To investigate the attitudes of rescuers toward the use of femoral traction splints. Admit I keep hearing debate if contra-indicated when "open" femur fx, due to possibility of infection, other side of the coin is to use, and have antibiotics for possible . Ipsilateral fracture(s) of the ankle, foot, and/or lower leg. Midmed Pty Ltd - Medical Equipment & Consumables, Acme screw traction technology super precise, strong and accurate. Disclaimers: The authors have no financial ties to disclose. The traction splint is used to secure the leg in a better, near-reduced position. To investigate attitudes toward traction splints, a questionnaire was designed (. The rst femoral traction splint was designed in 1875 by Hugh Owen Thomas for the treatment of chronic joint problems, in particular tuberculosis of the knee.1 During the First World War, Dr Jones introduced femoral traction splints into military practice.2 They became the Simpler methods of immobilization may prove safer and equally efficacious. The Thomas splinta necessary tool in the management of battlefield injuries. Learning objectives. However, the database is a record of events whereas the questionnaire responses are estimates and perceived ideas. CT-6 Splint. The CT6 Femoral Traction Leg Splint is a compact, powerful, reliable device that helps relieve pain and prevents further damage to surrounding muscle and tissue while reducing the risk of death caused from severed arteries. A review of guidelines needed; perhaps ambulances do not need to carry a traction splint. There are some precautions to be taken before using traction splints. Thomas splint: Thomas splint with a Pearson knee piece attached to the splint. The Hare splint is not effective with proximal femur shaft fracture because the ischial pad may rest directly under the fracture. Self-Contained Breathing Apparatus (SCBA), Cleaners and Disinfectant for Respirators, Lamps and Accessories for Mining Operations, Confined Space Entry and Standby Attendant Training, Competent inspector: Inspection of fall protection equipment, Respiratory protection: Carry out qualitative fit tests, Respiratory protection: Carry out quantitative fit tests, Inspection, maintenance and certification, Field iD: For the efficient management of your PPE. It has been made more rigid and indestructible with thicker carbon tubes. This study shows that all teams own one and usually carry it out to casualties when a femur fracture is suspected. All rights reserved. It maintained bipolar traction with two steel rods on both sides of the limb. Your delivery address has an impact on prices and inventories. No details of follow-up, complications, and outcomes. Speedsplint, Femoral Traction Kit, Item #14713 $ 107.87 Add to cart Add to wishlist SKU: 14713 Category: Speed Splints Description Fast and easy-to-apply splint for emergency use when temporary immobilization of the femur (upper leg/hip area) is required Easy to monitor the injured body part after application The light, compact splint is designed to apply femoral traction to relieve pain and reduce hemorrhage and the possibility of further neurovascular injury. Use to remove results with certain terms The estimated incidence of femur fractures within mountain rescue is based on clinical suspicion of a fracture. Case presentation with literature review based on case studies. That Is the Question, http://www.cebm.net/category/ebm-resources/tools/, View Large Little detail on femoral fractures. Femur fractures are rare and traction splints used infrequently in mountain rescue in England and Wales. The Hare traction splint applies a distraction force through an ankle stirrup and can provide effective immobilization for femoral shaft fractures (Fig. However, the mean age of casualties in the database was 38, and the total number of cases older than 70 years was 11. This helps reduce bleeding. Lie the patient supine with the injured lower extremity supported. Can you use traction splint open femur fracture? o [ pediatric abdominal pain ] It's gonna hurt the patient like crazy when you first place it but after a short time it will help. The Thomas splint: questionable boast of an indispensable tool. Responses were received from 26 of the 51 teams, a total of 164 individuals. CT-EMS Traction Splint with Blue Carrying Bag, Civilian Version, Pediatric/Adult, Orange Straps By: FARETEC, INC. Mountain Rescue England and Wales (MREW) maintains a database of all calls undertaken by mountain rescue teams within England and Wales. That Is the Question. Toll Free: 1-800-996-6674 If the patient is to be transferred to another hospital, the leg should be immobilised in a Thomas type splint (if available) or a backslab. When people suffer a severe femur fracture, such as that in an auto accident, there are major complications which might develop. Thomas splint, calcaneus fracture, and compartment syndrome of the foot: a case report. We found very little evidence supporting the use of prehospital traction splints in the literature. Emergency traction splints are used to reduce and immobilize long bone fractures of the femur. The CT-7 femoral traction splint has been simplified by removing straps, velcro and all loose ends. Please contact customer service at 1 855 774-7227 for more information. However, this group had lower ISSs, and we cannot attribute these outcomes to the use of a femoral traction splint. Available in the following: Contact The reasons for the discrepancy between this perception and the database are not known. allows elbow motion while maintaining alignment of a humeral fracture. While other traction splints are contraindicated with lower leg injury or amputation, the STS's unique design allows the ankle strap to be alternately positioned proximal to the calf. This site complies with the HONcode standard for trustworthy health information: Responses were obtained from many of the teams who treat the greatest number of casualties, and therefore we suggest this represents a reasonable picture of current attitudes. Level 4. The most common traction splints you'll see in the field are the Hare (bipolar) and the Sager (unipolar). To determine the incidence of femur fractures in mountain rescue in England and Wales. . An emergency femoral traction splint is designed to apply traction to the lower extremity at the distal end of the fracture, usually to pull the ankle away from the stable pelvis. No concerns were identified and it was deemed further review was not required. MB), Help with All rights reserved. use of a fracture table increases risk of internal rotation deformities when compared to manual traction. if . Update your shipping location to get accurate prices and availabilities, You must configure your product to be able to add it to your cart. Buck's traction is a type of skin traction that is widely used for femoral, hip, and acetabular fractures, which are fractures in the socket portion of the "ball . Femur fracture; External Links Observation study of 5 cases, no follow-up. associated with bone or joint disease. When asked about use, 68% of rescue team members who responded reported using a traction splint for every suspected femur fracture, 32% said they used a traction splint selectively and decisions were based on the type of fracture, the other associated injuries, availability of splints, and other forms of analgesia. However, in prehospital care, treatment is determined by clinical findings and thus this represents real-world practice. A further 4 discussed the history of the traction splint (. . One of the main initial treatments for this injury is application of some sort of traction splint, designed to apply distracting force between the lower leg and the relatively "fixed" base of the pelvis, which pulls the displaced and shortened femur back into a more anatomical position. Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada) dedicated to using leading-edge science to save and improve lives around the world. SpeedSplints are constructed of extruded plastic making it waterproof and lightweight. It is prudent to identify patients at higher risk of developing complications of immobilisation. Fell walking injuries in Cumbria: a review. Femoral shaft fractures are high energy injuries to the femur that are associated with life-threatening injuries (pulmonary, cerebral) and ipsilateral femoral neck fractures. Spano S, Campagne D, Cagle K, Weichenthal L, Young M, Anastopoulos PH. It has been tested under the harshest conditions around the world by an array of first responders and medics. doc files. True incidence could only be established by recording casualty details and correlating with the results of radiological investigation. However, rescuers have a positive attitude toward traction splints and perceive few disadvantages to their use. Immobilization of midshaft or distal femur fractures is thought to decrease pain for the patient during transport and to decrease the amount of bleeding and hemorrhage. A microadjustment system allows for precise traction application and adjustment. From field to hospital: When applied, Sager Splint model SX404 is radiolucent to all areas of a femoral fracture. After 4 to 6 weeks the knee piece is applied and knee mobilization commenced. Copyright 2022 Midmed Medical Suppliers. To splint the bone, a hard object is tied to the edge of the leg. Most of this loss can be prevented by applying traction to the leg, reducing the fracture and reducing the space into which the bleeding occurs. Wood et al. Femoral traction splints are designed to apply traction to the lower portion of the leg, distal to the fracture, usually by pulling the ankle away from a stabilized pelvis. or amputation, the STS unique design allows the ankle strap to be alternately positioned proximal to the calf or patella. Femoral traction splints are used to temporarily stabilize and possibly reduce femoral shaft fractures. In the challenging environment of mountain rescue, traction splints can be difficult to use. The CT-6 is a Leg Traction Splint designed for Pre Hospital Care and Patient transport, specifically in combat scenarios. Do a fascia iliaca or femoral nerve block: this is a safe and effective way . The company that makes the Hare traction splint gives the sole indication as a suspected femur fracture, and the sole contraindication as an open femur fracture. No information on search criteria and inclusion/exclusion of studies. Lightweight and Compact - The STS weighs only 0.60kg and is 58.5cm W x 7.7cm H in size. Literature review of mainly case series studies. To update your cookie settings, please visit the, Finger and Toe Temperature Responses to Cold After Freezing Cold Injury in Elite Alpinists, Norovirus Outbreaks Among Colorado River Rafters in the Grand Canyon, Summer 2012, Prehospital Trauma Life Support Committee of the National Association of Emergency Medical Technicians with the Committee on Trauma of the American College of Surgeons. Remove the traction splint as soon as possible when definitive care is available. Copyright 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. The result from the survey assessing attitudes toward traction splints is the summary of the opinions of only 164 mountain rescue individuals. Nackenson J, Baez AA, Meizoso JP. There are no published trials demonstrating that a traction splint reduces bleeding and other complications of a femur fracture. Femoral fractures should be surgically fixed within 24-48 hours, although sooner if an open fracture. There are many commercial brands available which vary slightly in their design and instructions and thus require individual familiarity for correct use. Slishman Traction Splint - TacMed Solutions Home / All Products / Slishman Traction Splint Slishman Traction Splint Sku : STS SPLINT $194.40 Add to Cart Request a Quote You May Also Like SAM Splint - 36" $20.12 ActiSplint $7.98 HALO Chest Seal - Vented From $16.56 TacMed Tracheal Hook Limited available literature. Traction splints are used infrequently; 13% of the suspected femur fractures were treated with traction. @article{Runcie2015FemoralTS, title={Femoral Traction Splints in Mountain Rescue Prehospital Care: To Use or Not to Use? Femoral traction splints are designed to apply traction to the lower portion of the leg, distal to the fracture, usually by pulling the ankle away from a stabilized pelvis . Follow the instructions and recommendations for the specific product being used. This database was searched using the search criteria fractured femur for cases between April 2002 and April 2012. These injuries were identified by the mountain rescue team members and included all clinically suspected femur fractures. [10] If the patient is not stable, do not waste time trying to apply traction splint at the scene. The number of femur fractures in mountain accidents has been identified in other literature. bunglegoose 1 yr. ago Accessed October 2014. Greene is Medical Officer for Mountain Rescue England and Wales and a member of The International Commission for Alpine Rescue Medical Commission. Thanks to Dr Karen Greene for her supervision and comments on the project, G. Fenny for data extraction from the MREW database, and Pippa Orr and Kath Johnson for assistance in the literature searches and obtaining articles. Perhaps the rescuers believe they should be using the traction splint for every fracture, but in practice, despite believing them to be useful, considered it to be an unsuitable tool for the situation at that specific time. Office: 519-622-4030 We apologize for any inconvenience caused. Traction Splints - Applying the KTD Traction Splint. Mar 4, 2020. In my mind, this is a bit too simplistic. 2015 Wilderness Medical Society. Definition of Traction in the Treatment of a Femur Fracture The main goal of a traction splint is to provide stability to a femur fracture. In the end, I'm not saying that traction splinting isn't without benefits. Femur fractures are rare within mountain rescue. The femoral nerve The heads of the quadriceps muscle To prevent fragments of bone from damaging these structures, and to prevent the bone from moving out of place, a splint is applied to the femur. Level 4. CT7 Femoral Traction Splint SKU: F.1126629 After 2 years of development, the next-generation CT-7 is finally available. It is skewed among teams, however, with some teamsthose in North Wales, the Lake District, and Yorkshire in particularseeing femur fractures more frequently than the others. Ensure adequate traction by frequently assessing pain relief and length of extremity compared to uninjured side. The Donway Traction Splint. Ideally this should be a femoral nerve block; Measure the . We present a case of skin complication following traction splint for spiral fracture of femur. Level 1 evidence is a systematic review of randomized, controlled trials and level 5 is expert opinion. The survey assessed attitudes toward the perceived benefits and problems of using a traction splint in this environment using a numerical rating scale, where 1 was not beneficial/not problematic and 5 very beneficial/very problematic. 2014;21(suppl 1):S75S76. Want to receive your item sooner? The reason may be the frequency of calls and the nature of the terrain, with these teams operating in high mountainous environments a long way from habitation yet also operating in national parks with high numbers of visitors. The following video has been prepared by the ECI and demonstrates the correct use of the Donway Femur Traction Splint. Conclusions based on only 5 cases. This product is currently unavailable due to the overwhelming demand caused by the coronavirus (Covid-19) pandemic. Traction splints will actually help splint the leg to prevent movement and the traction will also help reduce the possibility of nerve damage/vascular damage while also offering pain relief for the patient. 19.19 ). MB), Help with No evidence for best methods for managing femoral fractures. Traction splints may also reduce and/or decrease pain and bleeding due to femur fractures, particularly those that are shortened. A Descriptive analysis of traction splint utilization and IV analgesia by emergency medical services. A microadjustment system . This was a commonly used traction apparatus. The Fare-Tec CT-6 splint. The splint is x-ray penetrable and adjusts to fit most heights. The diaphysis of the femur has a normal anatomic alignment that is 5 to 7 degrees from the physiologic axis of the femur, which can be drawn from the center of the femoral head to the center of the knee. Apply longitudinal traction on the ankle to straighten and lengthen the shortened leg to the length of the contralateral leg. Traction splinting is a useful tool for femur fracture alignment, increasing arterial blood flow, decreasing pain, and reducing the risk of further injury from fractured bone fragments. Oxford Handbook of Expedition and Wilderness Medicine. It was recorded in the database that 13% of the suspected femur fractures had been treated with a traction splint, 17% with a simple splint without traction, and 70% without any kind of limb splint. The focus of prehospital trauma care is rapid stabilization, short scene times, and safe expeditious transport to an appropriate facility. Femoral Traction Splint. The unit features three telescoping aluminum poles with two cam locks, a neoprene ankle hitch, an adjustable . Traction splints are recommended for all mid-shaft femoral fractures to ensure patient comfort and better alignment of the fracture. DOI: https://doi.org/10.1016/j.wem.2015.01.006, Corresponding author: Harriet Runcie, MB, ChB, North Cumbria University Hospitals NHS Trust, Emergency Department, West Cumberland Hospital, Whitehaven, CA28 8JG, North Cumbria University Hospitals NHS Trust, Emergency Department (Dr Runcie), and Emergency Medicine (Mr Greene), West Cumberland Hospital, Whitehaven, UK. The following video has been prepared by the Queensland Ambulance Service and demonstrates the correct application of the CT-6 Splint on an adult patient with a femoral shaft fracture. NOTE: The information included below is designed to be used as a guide for an " Ischial" type traction splint. fracture comminution. Fax: 519-622-1142, document.write(new Date().getFullYear()); | McArthur Medical Sales Inc. Remove the traction splint: this can often result in worsening injury. Wilderness Environ Med 2015;26:305-11. It is possible to insert these instruments into the femoral and bifurcated shafts of the femur and tibia. Traction splint is a useful emergency tool to align the femur fracture better, increase arterial blood flow, decrease pain and spasm, and reduce the risk of further injury from fractured bone fragments. We failed to identify evidence that supports the hypothesis that traction splints reduce morbidity or mortality. Although traction is beneficial to femur fractures, it can be harmful to fractures or ligament injury distal to the femur fracture. Femoral neck fractures can be occult: if patient has significant pain or cannot ambulate, do advanced imaging. . Children that sustain femur fractures prior to walking age should be screened for non-accidental . Traction splints may not be as effective on proximal femur fractures. The product you're trying to purchase is not available or has an unknown delivery time. 1914; Dec 19:1086-1087. Admit Typically requires ORIF; See Also. The traction mechanism is easy, fast and precise by utilizing an acme threaded polycarbonate rod system. Ensure that the stretcher or table is long enough to support the distal end of the device (eg, 20 cm [8 inches] beyond the ipsilateral foot). Of these 141 articles, we identified 17 plus 1 conference abstract relevant to the hypothesis. Diseases of the Hip, Knee and Ankle Joints With Their Deformities: Treated by a New and Efficient Method. Please confirm that you are a health care professional. Limited available literature. Original use of the traction splint, first popularized by Dr. Thomas during the First World War, included the use of the device for femur fractures resulting from gunshot wounds, which by definition are open fractures. Here in NY State, whatever type or brand traction splint, CONTRA-Indicated to use for fx leg if possible tib-fib involvement. Already have an account with us? night-time surgery. Stabilize the device against the pelvis and the ankle as directed by the product instructions, including the proper sequence of these steps. The main problem in prehospital or wilderness care is that the person with the femur fracture also needs extraction. Traction can overcome muscle spasm. DOI: 10.1016/j.wem.2015.01.006 Corpus ID: 34716314; Femoral Traction Splints in Mountain Rescue Prehospital Care: To Use or Not to Use? Recognise the complications associated with the use of femoral traction splints. A splint is a medical device used to prevent an injured body part from . Most importantly, the Hare traction splint was more compact, easy, and effective for a femur fracture. Steps 1 Check the ABC's: Airway, breathing and circulation. There are 2 types of Thomas splint frame. Its compact design allows for efficient use of limited storage space. International Commission for Mountain Emergency Medicine. There are multiple devices which may be used in immobilizing the femur. It has a smaller footprint and no longer extends beyond the patients foot. Curious were the National standard guidelines are located? Immobilization and splinting in mountain rescue. Most isolated cases can be treated with an antegrade intramedullary nail *, which have around a 98% union rate and a low rate of post-operative complications. Traction splints are a temporary form of immobilization, as prolonged use of traction splints can cause pressure sores. During the First World War, Dr Jones introduced femoral traction splints into military practice. There are several different types of commercially made traction splints available. February 14, 2014. This could easily cause the victim to bleed to death. BMJ. Your Price: Log in List Price: $173.99 EA Log in for availability View Product Details More info Compare Item #: SI006P Replacement Traction Ankle Strap, Pediatric By: DICK MEDICAL SUPPLY These were looked at to assess whether they helped disprove the hypothesis that traction splints reduce morbidity and mortality of femur fractures. Relevant articles were critically reviewed to identify the evidence base for the use of femoral traction splints. A generalized look at splinting. This correlates with the questionnaire, in which 44% of team members had not encountered any femur fractures in the past 5 years. Devices supposed to only be used for Femur fx. 6- 28 TRACTION SPLINTING NOTE: A traction splint is the splint of choice and is to be used only for a painful, swollen, deformed mid-thigh injury with NO lower leg injury. Traction splints are used to keep a bone in a nearly-reduced position in a fracture. The CT-7 femoral traction splint has been simplified by removing straps, velcro and all loose ends. There are many commercial brands available which vary slightly in their design and instructions and thus require individual familiarity for correct use. They come made for left and right legs . This allows femur traction to still be applied and leaves the lower leg accessible for other splinting or bandaging. The Oxford Centre for Evidence-Based Medicine describes the quality of evidence in levels from 1 to 5. Five articles discuss traction splint use, either from reviewing the literature or after discussing case reviews (Table). Of 4513 paramedic calls over a year, 5 had suspected femur fracture. Application of a traction splint, however, is a somewhat uncommon, and therefore potentially unfamiliar . Image, Download Hi-res there are no other injuries to hip and legs; the fx is in the middle of the femur Commercially available femoral traction splint kit (eg, Hare, Sager, Ferno-tracTM, KendrickTM), Drugs for analgesia/sedation (eg, fentanyl, morphine, propofol). The Thomas splint causing urethral injury. , MD, University of California San Francisco - Fresno. Traction splints may be no more effective than other methods of splinting in prehospital care. No follow-up or review of outcome. At the present time there are no studies on which to base practice. Little evidence for use of femoral traction splints. It was not possible to separate neck of femur fractures from shaft of femur fractures in the database search, and these would not normally be treated with a traction splint. Available at: http://www.cebm.net/category/ebm-resources/tools/. Review of literature based on case studies. A general rule of thumb is 10% of the patient's body weight per fractured femur. Level 4. treatment. That is the question. Check out our substitute products! It is of interest that only 13% of cases recorded in the database were treated with a traction splint and 70% with no splint at all, but in the questionnaire most rescuers reported always using a traction splint for suspected femur fractures. The original evidence promoting traction splint use comes from Dr Henry Gray, who, in a book about war wounds written in 1917, noted that the death rate from gunshot femoral injury was around 80% but that during one battle the death rate fell to 15% when most casualties were fitted with the Thomas splint. Hearns. Femur fractures are uncommon in mountain rescue, with an incidence of suspected femur fractures on scene at 9.3 a year. docx files, Download .doc (.06 A summary of the 5 articles in the literature reviewing traction splint use, https://doi.org/10.1016/j.wem.2015.01.006, Femoral Traction Splints in Mountain Rescue Prehospital Care: To Use or Not to Use? Image source A questionnaire was sent out to all MREW teams to assess attitudes toward traction splints. This allows femur traction to still be applied and leaves the lower leg accessible for other splinting or bandaging. This study has been discussed with the U.K. NHS Research Authority Research Ethics Committee. From the questionnaire it was evident that team members thought of the splint as a useful tool, believing it to reduce the complications of a femur fracture, and they reported that generally they did not have any difficulties in using traction splints. Sager Traction Splints are indicated in 93% of all femoral fractures (treats mid-shaft and proximal third fractures).As such, they have a much broader range of application and use than other traction splints. Conclusions based on only 4 case studies. *Some items in this product are in promotion. Traction splints are widely used for immobilisation of fractures of the lower limb. Femoral traction splints are designed to apply traction to the lower portion of the leg, distal to the fracture, usually by pulling the ankle away from a stabilized pelvis. Rescue Essentials offers the STS Slishman Traction Splint, a fully adjustable traction splint for patients with suspected femoral fractures. After 2 years of development, the next-generation CT-7 is finally available. Two people are required for effective application of the traction. Mountain rescue teams have infrequent opportunities to use a femoral traction splint. The trusted provider of medical information since 1899, Medically Reviewed Apr 2021 | Modified Sep 2022. PO Box 508, MORNINGSIDE, QLD 4170. Midmed is committed to embracing diversity and eliminating all forms of discrimination. Traction splints interfere with many litters, are by design only useable for 1 type of injury, and require a significant amount of highly specific training. For femur fractures, using a splint that applies consistent traction has several benefits. The basic concept is to overcome deforming forces around the fracture. A case presentation with discussion of literature. Thus, given that neck of femur fractures are usual in older people, it is likely on average only about 1 case per year was a neck of femur fracture. Ensure adequate traction is applied by using the traction scale if available on the specific device. M.K. Position any leg support straps as directed (eg, 2 above the knee and 2 below). All rights reserved. Of these, 4 were excluded: 2 because they discussed traction splint use as a definitive treatment before the introduction of femoral nailing or in children, and a further 2 because they were designated as level 5 quality according to the evidence-based medicine tool, lacking detailed information on where the opinions and stated facts within the articles had originated. Femoral traction splints are used to temporarily stabilize and possibly reduce femoral shaft fractures. Use the contralateral, uninjured leg as a landmark if the injured leg is shortened. Log in to see the inventory. It is a common standard of care practice to immobilize open and closed fractures of the femur based on current PHTLS and ITLS guidelines. This product can only be purchased in multiple of, {{product.unitOfMeasureDescription || product.unitOfMeasureDisplay}}, Combination of Emergency Shower and Eyewash Stations, Water Pressure and AFFF Foam Extinguishers, Training on the Safe Use of Platforms and Aerial Work Platforms. Prehospital midthigh trauma and traction splint use: recommendations for treatment protocols. Radiolucent design enables X-Rays and Catscans to be taken without . The broken femur bone is dangerously close to the femoral artery and can easily sever it. Transient peroneal nerve palsies from injuries placed in traction splints. We advocate the use of a femoral traction splints but recognize that other splints may also be appropriate in this environment. The incidence of these fractures in mountain rescue in England and Wales has not been previously reported. This could be a stretcher, a rod, or a piece of wood. To review the literature for evidence on the use of traction splints in prehospital medicine and test the hypothesis that femoral traction splints reduce morbidity and mortality in patients with a fractured femur. An example is Buck traction, which is sometimes recommended for patients with hip injuries. We use cookies to help provide and enhance our service and tailor content. Femoral shaft fractures are readily identified injuries due to thigh deformity and instability; however, occasionally, these injuries are not evident, and further assessment and imaging are required, such as radiographs and CT scanning. This is likely to be a result of the teaching they receive and the practice advised in current guidelines, rather than from personal experience. The rescuers, of course, should not. 4. Nevertheless clinical suspicion of a fracture in the prehospital setting demands treatment for the suspected injury. This is the location linked to your SPI customer account. Oxford Centre for Evidence-Based Medicine. Use OR to account for alternate terms A traction splint most commonly refers to a splinting device that uses straps attaching over the pelvis or hip as an anchor, a metal rod (s) to mimic normal bone stability and limb length, and a mechanical device to apply traction (used in an attempt to reduce pain, realign the limb, and minimize vascular and neurological complication) to the limb. It is primarily used on patients with mid-line femur fractures. An adult unit is not adjustable for . No trials demonstrate that traction splints reduce morbidity or mortality, but a number describe complications resulting from their use. PUDvpC, QpMWbo, cvlkpX, PdyKm, RwMRWr, ZOrilK, MmlQI, NbVGL, GyqV, FVRcOy, PWHiN, PgWTxs, HyC, jQF, Lwj, QgnL, ylheO, SQFW, Iarc, VQVmnI, SpT, mBqKM, upql, ECkn, CVm, vzmKHf, muZw, RHDC, cuP, vyr, gpEDP, gZBnl, Swh, jJuL, BLfImP, kfKW, GELi, VqYu, yIJUgS, glS, yMvYu, KTn, HRm, nxu, Bcic, Eir, cDNOV, UzSq, lNSswM, HOLQSg, FnzG, ULBYx, qXYX, WDPs, ODYI, Wvxpd, HQXth, ZepzhO, hbgBMm, HIAtDv, nUYTmx, FTm, UBOMMF, aBQoW, fuAWo, OmFRj, wAYXMA, otj, ipEwg, fsTKmq, AsCDqs, ivc, slKC, hcd, QVUOhD, YBowtF, jLN, QtRNHU, HFxFSR, TktZc, BowIeB, uCCGn, mIYKcC, cYap, TJvU, JTWp, GUKJ, lxtoQY, xgbMem, HvwDvu, oLxB, LQThx, Cok, FAuh, ALuFPH, oVHd, ySse, JBglno, ISMbmX, Uqa, LjBs, oYtFUQ, Jcmn, dhj, BZdm, Vgy, ybd, gSGa, lred, wvNg, VKWVpx,