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 . Radiolucent design enables X-Rays and Catscans to be taken without . Level 1 evidence is a systematic review of randomized, controlled trials and level 5 is expert opinion. However, in prehospital care, treatment is determined by clinical findings and thus this represents real-world practice. Femoral shaft fractures should be put into skin traction (10% of body weight) to help with pain management. 4. if . Accessed October 2014. Traction splints provide a counter-pull to reduce the size of the thigh and realign the fractured femur. First, a traction splint stretches out the powerful muscles of the thigh (and the surrounding fascia), which compresses blood vessels embedded in the muscles and holds the bone ends in place. Diseases of the Hip, Knee and Ankle Joints With Their Deformities: Treated by a New and Efficient Method. This study shows that all teams own one and usually carry it out to casualties when a femur fracture is suspected. The Donway Traction Splint. It is possible to insert these instruments into the femoral and bifurcated shafts of the femur and tibia. 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 In the end, I'm not saying that traction splinting isn't without benefits. The Thomas splint causing urethral injury. night-time surgery. Traction splinting is the standard of care management of femoral shaft fractures in the prehospital setting given the appropriate patient. However, the database is a record of events whereas the questionnaire responses are estimates and perceived ideas. Commercially available femoral traction splint kit (eg, Hare, Sager, Ferno-tracTM, KendrickTM), Drugs for analgesia/sedation (eg, fentanyl, morphine, propofol). Copyright 2022 Midmed Medical Suppliers. Femoral Traction Splint. 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 . Level 4. There are several different types of commercially made traction splints available. No follow-up or review of outcome. Use for phrases Some of these include: The development of a deep vein thrombosis 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. They require training and may not fit into the package of stretcher, casualty bag, and vacuum mattress. Advise femoral traction splint or simple vacuum mattress/box splint. SPEEDSPLINT FEMORAL TRACTION KIT (F200) X-ray penetrable One size fits all Includes 2 self-adhesive foam groin pads Velcro traction straps Compact design allows for efficient use of limited storage space SPEEDSPLINT ADJUSTABLE LEG SPLINT (L300A) X-ray penetrable Adjusts to fit all heights Flat design allows easy storage This helps reduce blood loss, alleviate pain and minimize further injury. o [ pediatric abdominal pain ] This was a commonly used traction apparatus. Devices supposed to only be used for Femur fx. associated with bone or joint disease. For more information, please contact our customer service via chat or by phone at 1-866-861-8111. Fixed ring: the shorter side goes medially; Split ring: the shorter side goes medially, and the buckle should be over the outer thigh . All rights reserved. This is the first work to perform follow-up and look at outcomes. During the 10-year study period, 93 casualties with a suspected femur fracture were identified (9.3 per year). 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 . 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. 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. The CT-6 helps relieve patient pain and prevents further damage to surrounding muscle and tissue while reducing the risk of death caused from severed arteries. There are many commercial brands available which vary slightly in their design and instructions and thus require individual familiarity for correct use. Hare Traction Splint (Bipolar Traction Splint) Use adequate analgesia (usually IV opioids) because traction splinting of femur fractures is painful. Use to remove results with certain terms Femur fracture; External Links This could be a stretcher, a rod, or a piece of wood. Thomas splint: Thomas splint with a Pearson knee piece attached to the splint. [10] If the patient is not stable, do not waste time trying to apply traction splint at the scene. They come made for left and right legs . This is the location linked to your SPI customer account. Femoral traction splints are used to stabilize femur fractures prior to definitive care (eg, operative fixation). To determine the incidence of femur fractures in mountain rescue in England and Wales. The splint is x-ray penetrable and adjusts to fit most heights. 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. 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. If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. 38% of patients with traction splints fitted had contraindications. This database was searched using the search criteria fractured femur for cases between April 2002 and April 2012. Cost Effective For Hospitals and EMS. Midmed is committed to embracing diversity and eliminating all forms of discrimination. Please confirm that you are a health care professional. Femoral traction splints are used to temporarily stabilize and possibly reduce femoral shaft fractures. To investigate the attitudes of rescuers toward the use of femoral traction splints. A generalized look at splinting. Transient peroneal nerve palsies from injuries placed in traction splints. Severity and pattern of injury in survivors of alpine fall accidents. CT-EMS Traction Splint with Blue Carrying Bag, Civilian Version, Pediatric/Adult, Orange Straps By: FARETEC, INC. Those with prehospital traction splints fitted had fewer units of blood transfused in the first 24 hours and had shorter hospital stays. The Hare traction splint applies a distraction force through an ankle stirrup and can provide effective immobilization for femoral shaft fractures (Fig. Jones R. Correspondence: Treatment of Fractures of the Thigh. Please enter a term before submitting your search. to splint an isolated mid-shaft femoral fracture What does an isolated mid-shaft femoral fx mean? Little detail on femoral fractures. bunglegoose 1 yr. ago 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. Can you use traction splint open femur fracture? A microadjustment system allows for precise traction application and adjustment. This study was designed to investigate the strength of literature supporting the use of femoral traction splints and the attitudes of rescuers who use them. There are no published trials demonstrating that a traction splint reduces bleeding and other complications of a femur fracture. there are no other injuries to hip and legs; the fx is in the middle of the femur It has been made more rigid and indestructible with thicker carbon tubes. Log in to see the inventory. Fax: 519-622-1142, document.write(new Date().getFullYear()); | McArthur Medical Sales Inc. Traction splints are widely used for immobilisation of fractures of the lower limb. Enter search terms to find related medical topics, multimedia and more. This field is for validation purposes and should be left unchanged. In the hospital, weighted traction splints may be placed on the patient. Sign in to see your prices and availability that match your account. A Descriptive analysis of traction splint utilization and IV analgesia by emergency medical services. We present a case of skin complication following traction splint for spiral fracture of femur. During the First World War, Dr Jones introduced femoral traction splints into military practice. Children that sustain femur fractures prior to walking age should be screened for non-accidental . Ipsilateral fracture(s) of the ankle, foot, and/or lower leg. Femoral traction splints are used to temporarily stabilize and possibly reduce femoral shaft fractures. Disclaimers: The authors have no financial ties to disclose. Assess distal pulses both before and after splint application. Ideally this should be a femoral nerve block; Measure the . There are six basic methods of skeletal traction of the femoral fractures: 1. In my mind, this is a bit too simplistic. The Thomas splinta necessary tool in the management of battlefield injuries. Following the intervention period, however, traction splint use increased significantly (Median 50%). Prehospital midthigh trauma and traction splint use: recommendations for treatment protocols. For femur fractures, using a splint that applies consistent traction has several benefits. Traction splints are used infrequently; 13% of the suspected femur fractures were treated with traction. Of those 5, 2 had traction splints fitted successfully. It has been tested under the harshest conditions around the world by an array of first responders and medics. BMJ. Runcie H, Greene M. Femoral traction splints in mountain rescue prehospital care: to use or not to use? Check for distal neurovascular status (eg, capillary refill, distal sensation, toe flexion and extension). Recognise the complications associated with the use of femoral traction splints. 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. True incidence could only be established by recording casualty details and correlating with the results of radiological investigation. It has a smaller footprint and no longer extends beyond the patients foot. Lie the patient supine with the injured lower extremity supported. 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. To splint the bone, a hard object is tied to the edge of the leg. Observation study of 5 cases, no follow-up. 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. These were looked at to assess whether they helped disprove the hypothesis that traction splints reduce morbidity and mortality of femur fractures. 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. Simpler methods of immobilization may prove safer and equally efficacious. 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? To investigate attitudes toward traction splints, a questionnaire was designed (. Learn more about the Merck Manuals and our commitment to Global Medical Knowledge. 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. The Oxford Centre for Evidence-Based Medicine describes the quality of evidence in levels from 1 to 5. CT7 Femoral Traction Splint SKU: F.1126629 After 2 years of development, the next-generation CT-7 is finally available. Wilderness Environ Med 2015;26:305-11. allows elbow motion while maintaining alignment of a humeral fracture. Your delivery address has an impact on prices and inventories. 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 treatment of a femoral fracture; overbody or lateral skeletal traction. Of 4513 paramedic calls over a year, 5 had suspected femur fracture. The light, compact splint is designed to apply femoral traction to relieve pain and reduce hemorrhage and the possibility of further neurovascular injury. We found very little evidence supporting the use of prehospital traction splints in the literature. Use the contralateral, uninjured leg as a landmark if the injured leg is shortened. When you are logged in you get all the correct prices, availabilities and shipping costs for your account agreement. Office: 519-622-4030 These injuries were identified by the mountain rescue team members and included all clinically suspected femur fractures. An example is Buck traction, which is sometimes recommended for patients with hip injuries. Application of traction splints to the femur can be a bit tricky, mostly because of the various indications and contraindications. 1914; Dec 19:1086-1087. This allows femur traction to still be applied and leaves the lower leg accessible for other splinting or bandaging. No information on search criteria and inclusion/exclusion of studies. Femur fractures are rare and traction splints used infrequently in mountain rescue in England and Wales. There are some precautions to be taken before using traction splints. Responses were received from 26 of the 51 teams, a total of 164 individuals. Image source Further research is required to compare traction splints with simple splints and to evaluate their contribution in relieving pain, hemorrhage, other complications, and outcome for patients with a fractured femur. The basic concept is to overcome deforming forces around the fracture. doc files. All rights reserved. A microadjustment system . However, in keeping with the International Commission for Alpine Rescue (ICAR) guidelines. Here in NY State, whatever type or brand traction splint, CONTRA-Indicated to use for fx leg if possible tib-fib involvement. The traction splint is used to secure the leg in a better, near-reduced position. Update your shipping location to get accurate prices and availabilities, You must configure your product to be able to add it to your cart. We advocate the use of a femoral traction splints but recognize that other splints may also be appropriate in this environment. Prehospital midthigh trauma and traction splint use: a retrospective review of a trauma registry (SAEM Abstract). The broken femur bone is dangerously close to the femoral artery and can easily sever it. Stabilize the device against the pelvis and the ankle as directed by the product instructions, including the proper sequence of these steps. Traction splints may not be as effective on proximal femur fractures. We use cookies to help provide and enhance our service and tailor content. We suspect that an incidence of 9.3 femur fractures in the England and Wales mountain environment per year is an overestimate. Image, Download Hi-res No trials demonstrate that traction splints reduce morbidity or mortality, but a number describe complications resulting from their use. 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. The estimated incidence of femur fractures within mountain rescue is based on clinical suspicion of a fracture. 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. The first femoral traction splint was designed in 1875 by Hugh Owen Thomas for the treatment of chronic joint problems, in particular tuberculosis of the knee. From the 1980s onward, femoral nailing became the definitive treatment and traction splints were only used before surgery. docx files, Download .doc (.06 fracture comminution. Emergency traction splints are used to reduce and immobilize long bone fractures of the femur. When people suffer a severe femur fracture, such as that in an auto accident, there are major complications which might develop. PO Box 508, MORNINGSIDE, QLD 4170. This site complies with the HONcode standard for trustworthy health information: The following video has been prepared by the ECI and demonstrates the correct use of the Donway Femur Traction Splint. The splint can go with the patient to X-Ray or even surgery and be thrown out after. 2015 Wilderness Medical Society. Thomas splint, calcaneus fracture, and compartment syndrome of the foot: a case report. Hearns. Oxford Handbook of Expedition and Wilderness Medicine. The results were generally positive, with most team members perceiving suggested benefits at 5 (very beneficial; The literature search initially found 141 articles. This is likely to be a result of the teaching they receive and the practice advised in current guidelines, rather than from personal experience. Rescue Essentials offers the STS Slishman Traction Splint, a fully adjustable traction splint for patients with suspected femoral fractures. The reasons for the discrepancy between this perception and the database are not known. verify here. It is primarily used on patients with mid-line femur fractures. 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. 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). 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. To obtain the exact incidence within mountain rescue, the mountain rescue database would need to include the definitive diagnosis made after hospital assessment and radiological investigation. The Scottish mountain rescue casualty study. The most common traction splints you'll see in the field are the Hare (bipolar) and the Sager (unipolar). However, this group had lower ISSs, and we cannot attribute these outcomes to the use of a femoral traction splint. Protocols will vary, but national standard is NO traction on an open fracture. Conclusions based on only 4 case studies. 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. 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. The Thomas splint supports the leg and balanced traction is applied. The CT-7 femoral traction splint has been simplified by removing straps, velcro and all loose ends. Review of literature based on case studies. Traction splints are useful in the treatment of closed and open . There are many commercial brands available which vary slightly in their design and instructions and thus require individual familiarity for correct use. No details of follow-up, complications, and outcomes. Traction can overcome muscle spasm. Literature review of mainly case series studies. 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. Want to receive your item sooner? ABSTRAL, Actiq, Duragesic, Fentora, IONSYS, Lazanda, Onsolis, Sublimaze, SUBSYS, ARYMO ER, Astramorph PF, Avinza, DepoDur, Duramorph PF, Infumorph, Kadian, MITIGO, MORPHABOND, MS Contin, MSIR, Opium Tincture, Oramorph SR, RMS, Roxanol, Roxanol-T. Femur fracture immobilization with traction splints in multisystem trauma patients. Ensure adequate traction by frequently assessing pain relief and length of extremity compared to uninjured side. That Is the Question, http://www.cebm.net/category/ebm-resources/tools/, View Large The incidence of these fractures in mountain rescue in England and Wales has not been previously reported. *Some items in this product are in promotion. Closed treatment with traction, splinting, and casting may be temporary treatment or definitive treatment . In addition, they have to be carried to the scene and can only be used for a single type of injury. 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. Fell walking injuries in Cumbria: a review. 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. Forty-four percent of rescuers also reported not having encountered a fractured femur in the past 5 years, so thinking back longer than that to recall what was actually done is difficult and likely to be unreliable. 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 19.19 ). 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 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. 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 a temporary form of immobilization, as prolonged use of traction splints can cause pressure sores. Limited available literature. 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. 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. image, Download .docx (.08 o [teenager OR adolescent ]. Femoral fractures should be surgically fixed within 24-48 hours, although sooner if an open fracture. 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. Whole leg, air splint, vacuum splint, cardboard or a suitable commercially available splint. Already have an account with us? Wood et al. . A case presentation with discussion of literature. Please contact customer service at 1 855 774-7227 for more information. However, the mean age of casualties in the database was 38, and the total number of cases older than 70 years was 11. 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. @article{Runcie2015FemoralTS, title={Femoral Traction Splints in Mountain Rescue Prehospital Care: To Use or Not to Use? . The femoral shaft excludes commonly fractured parts of the femur such as hip and supracondylar fractures. Traction splints are used to keep a bone in a nearly-reduced position in a fracture. Little evidence for use of femoral traction splints. 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. This study has relevance to all those in prehospital care and in particular to those who practice wilderness medicine. The traction mechanism is easy, fast and precise by utilizing an acme threaded polycarbonate rod system. Midmed welcomes all people, irrespective of ethnicity, lifestyle choice, faith, sexual orientation and gender identity. M.K. Intramedullary nailing of the femur: current concepts concerning reaming. 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. Flusso, Swing Valve Technology and PEEP Stabilization are trademarks used under license by McArthur Medical Sales Inc. US and International Patents Pending, Fast & easy to apply to upper and lower extremities, Compact design allows for efficient use of limited storage space, Adjustable for straight leg with a knee injury or lower leg injury, including foot and ankle. 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. Current literature evidence suggests that traction splints may be no more beneficial than simple splints in the treatment of femur fractures. 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? Femoral shaft fractures are high energy injuries to the femur that are associated with life-threatening injuries (pulmonary, cerebral) and ipsilateral femoral neck fractures. The number of femur fractures in mountain accidents has been identified in other literature. Results: The use of the traction splint for a femur fracture in the pre-intervention stage was found to be underutilised (Median 16%). The product you're trying to purchase is not available or has an unknown delivery time. By the end of this session the participant will be able to: Describe the indications for femoral traction splint application. Remove the traction splint as soon as possible when definitive care is available. SpeedSplints are constructed of extruded plastic making it waterproof and lightweight. Femur fractures are rare, and owing to contraindications traction splints are rarely used. There are many commercial brands available which vary slightly in their design and instructions and thus require individual familiarity for correct use. Spano S, Campagne D, Cagle K, Weichenthal L, Young M, Anastopoulos PH. Level 4. Steps 1 Check the ABC's: Airway, breathing and circulation. We would suggest the use of a traction splint is reasonable when there is a suitable indication and no contradictions. A femoral traction splint is a mechanical device that uses traction to align and provide stability to femoral fractures. The rescuers, of course, should not. 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. You will then receive an email that contains a secure link for resetting your password, If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password. There are many commercial brands available which vary slightly in their design and instructions and thus require individual familiarity for correct use. It is prudent to identify patients at higher risk of developing complications of immobilisation. Curious were the National standard guidelines are located? Most importantly, the Hare traction splint was more compact, easy, and effective for a femur fracture. , MD, University of California San Francisco - Fresno. It has been tested under the harshest conditions around the world by an array of first responders and medics. Prehosp Disaster Med 2017;32:631-5. Five articles discuss traction splint use, either from reviewing the literature or after discussing case reviews (Table). Available at: http://www.cebm.net/category/ebm-resources/tools/. Nackenson J, Baez AA, Meizoso JP. Estimates on femur fracture encounters and on use of traction splints. . We failed to identify evidence that supports the hypothesis that traction splints reduce morbidity or mortality. This study suggests a mountain rescue team in England and Wales will encounter a casualty with a femur fracture on average every 6 to 7 years. 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. The most recent article published is an abstract and poster from a conference. 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. 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. Its compact design allows for efficient use of limited storage space. The light, compact splint is designed to apply femoral traction to relieve pain and reduce hemorrhage and the possibility of further neurovascular injury. Of these 141 articles, we identified 17 plus 1 conference abstract relevant to the hypothesis. Thank you to the members of the MREW teams for completing the questionnaire. Mar 4, 2020. We did, however, manage to capture all areas of England and Wales covered by the MREW teams, as teams are collected into groups to cover different areas and we obtained responses from all groups. From field to hospital: When applied, Sager Splint model SX404 is radiolucent to all areas of a femoral fracture. Femur fractures are uncommon in mountain rescue, with an incidence of suspected femur fractures on scene at 9.3 a year. This allows femur traction to still be applied and leaves the lower leg accessible for other splinting or bandaging. 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 Femur fractures are rare within mountain rescue. That is the question. Remove the traction splint: this can often result in worsening injury. Do a fascia iliaca or femoral nerve block: this is a safe and effective way . It contains details on the incident, the casualtys injures, and treatment. The trusted provider of medical information since 1899, Medically Reviewed Apr 2021 | Modified Sep 2022. Ellerton et al, as part of the International Commission for Mountain Emergency Medicine. There is brevity of evidence-based research on their efficacy. That Is the Question. 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. Femoral neck fractures can be occult: if patient has significant pain or cannot ambulate, do advanced imaging. Immobilization and splinting in mountain rescue. February 14, 2014. After 2 years of development, the next-generation CT-7 is finally available. The result from the survey assessing attitudes toward traction splints is the summary of the opinions of only 164 mountain rescue individuals. 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) It is primarily used on patients with mid-line femur fractures. Disposable, No Cross-Contamination, Single-Patient Use. Level 4. Use OR to account for alternate terms 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. Traction splints may be no more effective than other methods of splinting in prehospital care. 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. The CT-7 femoral traction splint has been simplified by removing straps, velcro and all loose ends. It's gonna hurt the patient like crazy when you first place it but after a short time it will help. 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. Nevertheless clinical suspicion of a fracture in the prehospital setting demands treatment for the suspected injury. An improvement was also noted in staff perception and understanding of the management of femur fractures. In this survey 44% of team members reported that they had not encountered a femur fracture or used a traction splint in the past 5 years. We apologize for any inconvenience caused. Mountain rescue team members report few difficulties in use despite their limited practical experience. View our range of top-quality products at discounted prices. It has been designed for pre hospital and patient transport. This correlates with the questionnaire, in which 44% of team members had not encountered any femur fractures in the past 5 years. The Fare-Tec CT-6 splint. The unit features three telescoping aluminum poles with two cam locks, a neoprene ankle hitch, an adjustable . Femur Fracture Splinting Femur fractures can result in the loss of 3 units of blood in the soft tissues. International Commission for Mountain Emergency Medicine. It is a common standard of care practice to immobilize open and closed fractures of the femur based on current PHTLS and ITLS guidelines. Published by Elsevier Inc. All rights reserved. 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. Ensure adequate traction is applied by using the traction scale if available on the specific device. or amputation, the STS unique design allows the ankle strap to be alternately positioned proximal to the calf or patella. 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. treatment. Get more for less. Responses came from all regions of the United Kingdom covered by the MREW teams. 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. 2014;21(suppl 1):S75S76. Methods: A retrospective descriptive study conducted over a five and a half year period (1 January 1996 to 1 July 2001) on children presenting with femoral shaft fracture to a Paediatric trauma centre. 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. application of traction splints for femur fractures (open or closed) is likely not to impact patient outcome. There are 2 types of Thomas splint frame. However, rescuers have a positive attitude toward traction splints and perceive few disadvantages to their use. Traction splinting should be used along with other pain control techniques to make the patient feel comfortable. use of a fracture table increases risk of internal rotation deformities when compared to manual traction. 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. Check out our substitute products! Case presentation with literature review based on case studies. Level 4. Traction splints may also reduce and/or decrease pain and bleeding due to femur fractures, particularly those that are shortened. There are multiple devices which may be used in immobilizing the femur. 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. Relevant articles were critically reviewed to identify the evidence base for the use of femoral traction splints. In the challenging environment of mountain rescue, traction splints can be difficult to use. A questionnaire was sent out to all MREW teams to assess attitudes toward traction splints. They became the standard definitive treatment for femur fractures until the development of femoral nailing in the 1950s. Admit Typically requires ORIF; See Also. Although traction is beneficial to femur fractures, it can be harmful to fractures or ligament injury distal to the femur fracture. 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. The use of the device minimizes pain, pulmonary complications, blood transfusions and neurovascular complications to the limb [ 1 ]. An adult unit is not adjustable for . No evidence for best methods for managing femoral fractures. Traction splints are recommended for all mid-shaft femoral fractures to ensure patient comfort and better alignment of the fracture. Greene is Medical Officer for Mountain Rescue England and Wales and a member of The International Commission for Alpine Rescue Medical Commission. This could easily cause the victim to bleed to death. The Thomas splint: questionable boast of an indispensable tool. The CT-6 is a Leg Traction Splint designed for Pre Hospital Care and Patient transport, specifically in combat scenarios. Lightweight and Compact - The STS weighs only 0.60kg and is 58.5cm W x 7.7cm H in size. This study has been discussed with the U.K. NHS Research Authority Research Ethics Committee. Traction Splints - Applying the KTD Traction Splint. A general rule of thumb is 10% of the patient's body weight per fractured femur. No concerns were identified and it was deemed further review was not required. Apply longitudinal traction on the ankle to straighten and lengthen the shortened leg to the length of the contralateral leg. 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. 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. After 4 to 6 weeks the knee piece is applied and knee mobilization commenced. Learning objectives. NOTE: The information included below is designed to be used as a guide for an " Ischial" type traction splint. Immobilize the leg: either with a posterior splint or simply a pillow under the thigh. Limited available literature. Pre-hospital providers often use commercial traction splints which have a rigid element with straps to attach to the patient and then apply traction using cords and tension devices. 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. A review of guidelines needed; perhaps ambulances do not need to carry a traction splint. Conclusions based on only 5 cases. CT-6 Splint. o [ abdominal pain pediatric ] MB), Help with This helps reduce bleeding. Mountain rescue teams have infrequent opportunities to use a femoral traction splint. 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. Oxford Centre for Evidence-Based Medicine. The focus of prehospital trauma care is rapid stabilization, short scene times, and safe expeditious transport to an appropriate facility. Available in the following: Contact Mountain Rescue England and Wales (MREW) maintains a database of all calls undertaken by mountain rescue teams within England and Wales. 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. In the context of mountain rescue and other situations of prehospital care, it is reasonable to ask whether other forms of splint may be as effective or superior to the femoral traction splint. All rights reserved. For adults, the American Academy of Orthopedic Surgeons recommends gentle traction to a maximum of 7kg (15 pounds) per fractured femur (14kg (30 pounds) for a bilateral fracture. 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. Acad Emerg Med. Position any leg support straps as directed (eg, 2 above the knee and 2 below). A splint is a medical device used to prevent an injured body part from . At the present time there are no studies on which to base practice. Unknown whether contraindications had an adverse effect. A further 4 discussed the history of the traction splint (. Practical Prehospital Care: The Principles and Practice of Immediate Care. 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. Two people are required for effective application of the traction. This product is currently unavailable due to the overwhelming demand caused by the coronavirus (Covid-19) pandemic. 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. Follow the instructions and recommendations for the specific product being used. 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 . MB), Help with This is the reason why it is vitally important to make a traction splint for a fractured femur as quickly as possible. Copyright 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. Midmed Pty Ltd - Medical Equipment & Consumables, Acme screw traction technology super precise, strong and accurate. Application of a traction splint, however, is a somewhat uncommon, and therefore potentially unfamiliar . There is no need to worry about lost expensive splints. Use about 10% of the patient's body weight or up to about 7 kg (15 pounds). The main problem in prehospital or wilderness care is that the person with the femur fracture also needs extraction. Understand the process for application of a femoral traction splint. 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. It maintained bipolar traction with two steel rods on both sides of the limb. Copyright 2022 SPI Health and Safety. 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