traction splint contraindications open fracture
With this type of apparatus, heavy traction can be applied to the skull Like many whove seen the statistics on prehospital pain treatment, I was stunned at the results of an Ohio study that showed only a small number of the patients had their pain addressed by EMS. Femoral Traction Splinting BLS PROCEDURE BP-08. The Pass the pin through both bones to avoid the The use of traction splints to treat complete . 5 controversy exists regarding whether a traction Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. Attach a single, Make a supporting or master pad that is 1, Use heavy traction with care and close observation to avoid. The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. In a non-displaced fracture, no gross deformity can be seen, whereas, with a displaced fracture, a deformity can be seen. is impossible to anesthetize the area between the two bones. The patient will present withpain or swelling in the thigh, hip and/or knee pain, andunable to weight bear. Guidelines by local protocol or instructions by a Medical Consultant should be followed. Painful, swollen, deformed, isolated mid-thigh injury with no other leg injury - contraindications would be anything other than those conditions. Gardner W. The principle of spring-loaded points for cervical traction. Photo courtesy Ed Dickinson, The splint should cover the joint above and below the fracture site. Such insertions do not conform to our, Yoga, Physical Therapy Reduce Back Pain & Improve Sleep, This site uses cookies to deliver our services.By using our site, you acknowledge that you have read and understand our, Dr. Shivani Nayar,B.Sc (Physiotherapy), PG in Hospital Management, Spinal Cord Injury - First Aid and Emergency Treatment Guide, Back Pain - Backache - Workplace - Prevention - Exercises, How to Reduce School Bag Weight - Simple Tips, Pott's Disease and all inflammatory diseases of the vertebrae, Cardiac or circulatory disease and severe respiratory problems, Post-operative patients within 3 months of back surgery, Vertebral fracture within 6 months of initial injury. It can often be difficult to differentiate a sprain from a fracture in the field. The knee is a complicated synovial joint. We use cookies to improve your experience on our site and to show you relevant advertising. Suspend the distal end of the splint from a single rope to an Our teaching regarding compound femur fractures is to use the traction splint without applied traction to stabilize the long bone fracture if possible . A sprain is caused by the twisting or pulling of a joint beyond its normal range of motion, causing soft tissue injury to the underlying tendons, muscles and ligaments. In my mind, this is a bit too simplistic. Bilateral femur fractures have higher rates of pulmonary complications and increased mortality rates, compared to unilateral fractures. Her ankle had started to bruise and was markedly swollen. Photo Ed Dickinson. The Prometheus Traction Splint (PTS) was created with valuable input from end-users and has built in features that are an advancement on the traction splints . Aplain film radiographis the only routine imaging that is often needed (Fig. Epiphyseal (Salter) Fracture: A fracture involving the growth plate that has separated the bone edges. emergency department, conscious sedation should be utilized. Treatment can be nonoperative or operative depending on location of fracture, fracture morphology, and association with other ipsilateral injuries. Femoral fractures should besurgically fixedwithin 24-48 hours, although sooner if an open fracture. Ensure the patient hasadequate pain relief,often requiring opioid analgesia +/-regional blockade(such as a fascia iliaca block). Other injuries: A dislocation to a joint is the displacement of bones from their rightful place. When a person injures an extremity, they frequently attempt to protect it from further injury by holding it against their body. EMS, like many other facets of health care, is now moving toward evidence-based practice. Application of traction splints to the femur can be a bit tricky, mostly because of the various indications and contraindications. Contraindications for Spinal Traction. This can cause further tissue or vessel damage and increased hemorrhaging. Kendrick's Other Devices for Extrication include the K.O.D.E 1, K.O.D.E. Patients presenting following amajor traumashould be investigated and managed as per the ATLS protocol. Garfin SR, Botte MJ, Enteno RS, et al. Photo Ed Dickinson. that as soon as the drilling stops, the pain will cease. Dr. Shivani Nayar. For a femur, what are the indications and contraindications for traction splint? 2022 - TeachMe Orthopedics. It may initially cause the injury to throb a bit because it causes blood vessels to constrict, but it decreases the swelling of an injury and the pressure that swollen tissue exerts on the injury. rotation of the extremity by a light counterweight attached to the side The halo ring, skull pins, and positioning pins should be autoclaved or gas sterilized. with abscess does occur, then drain it by extending the stab wound. Tell the Revisions: 7. While the leg is supported in traction, place the ring on the limb. Assuming theres no pathological defects, always compare the injured extremity to the uninjured one to reveal signs of injury. Traction splinting, such as a Kendrick traction splint, are used in suspected or isolated fractures of the mid-shaft femur, acting to hold the femur in correct position against action of the large thigh muscle mass. Traction can overcome muscle spasm Proper splinting increases arterial blood flow, decreases pain and spasm, and lowers the risk of further injury from bone fragments. All traction can be applied by the traction splint. Procedural Protocols. All bony prominences should be padded before placing a splint over them to prevent pressure points and keep skin healthy. B. increase the risk of infection. 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. She simply wasnt being well cared for. If this is the case, you must make sure he has an open airway, is breathing (with or without intervention) and he has a pulse. Methods: This was a descriptive, prospective study utilizing a data collection tool to identify patients with multisystem trauma for which a TS was in place for FFI. The bed must have a firm mattress or a bed board. "Once the traction splint has been positioned under the leg, and the ankle hitch is applied, manual traction can be released." . If you do not agree to the foregoing terms and conditions, you should not enter this site. Measure splint to the correct length by placing flat next to the patient's uninjured leg. Check the ABC's: Airway, breathing and circulation. What sedentary excercises should I do sitting in the office? They may be, in essence, an EMS relic we may want to part with. 9-3) (1). Dec 11, 2022. 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. hand weight. St. Louis, Mo., 2007. Typically, patients can accurately localize (musculoskeletal) somatic pain. Apply a traction splint on a patient who has sustained an isolated mid-shaft femur fracture. Objective: To evaluate the frequency of concomitant injuries that can complicate and/or contraindicate the use of traction splints (TSs) for femur fracture immobilization (FFI) in a population of multisystem trauma patients. Humeral shaft fractures are common fractures of the diaphysis of the humerus, which may be associated with radial nerve injury. Unfortunately, there are lots of contraindications. A good mnemonic to use in remembering some simple, but often overlooked, pain management techniques is RICE (rest, ice, compress [splint] and elevate). His surgical wounds appear well-healed with a small sinus tract over the open fracture site. Apply longitudinal traction on the ankle to straighten and lengthen the shortened leg to the length of the contralateral leg. Supracondylar fractures of the humerus. Placing a blanket between the patient and a splint or backboard provides some padding, as do towels in voids between the patient and the immobilization device. Jerre R, Dosh A, Karlsson F, et al. scalp is cleaned and draped; local shaving is sufficient but is not As previously mentioned, this sometimes results in an extra joint, but other times the deformity is subtle. Retrieved on Dec 11, 2022 from https://www.medindia.net/patients/lifestyleandwellness/traction-for-lumbar-pain-contraindications.htm. An improvement was also noted in staff perception and understanding of the management of femur fractures. This is especially true when placing splints or other spinal immobilization devices on elderly or very young patients. Indications Suspected femur fracture Contraindications The injury is within 1-2 of the knee or ankle The knee is injured The hip is injured The pelvis is injured In the field, open femur fractures are contraindications to traction splint application Significant injuries to the knee The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". NOTE: The information included below is designed to be used as a guide for an " Ischial" type traction splint. Capillary refill times that increase over time reflect a decreasing perfusion, while decreasing capillary refill times indicate increased distal perfusion. > Pollak A: Emergency Care & Transport of the Sick & Injured, 7th edition. Splinting techniques are used to treat musculoskeletal system abnormalities. I understand the importance of realigning deformed extremities, but my understanding on the exacts of some situations elude me - obviously baring that almost every situation will be different. The significance of open fractures is they have a high risk for infection in the bone, called osteomyelitis. Common in children. The proximal fragment is invariably pulled into flexion and external rotation (by iliopsoas and gluteus medius & minimus, respectively), which can further tent the skin. Theres also an increasing trend toward refocusing on the basics, including the application of splints and pain management. Patient assessmentThe first thing you should do when assessing and managing a potential fracture is ensure the blood supply to the extremity is not impaired. Therefore, if you apply unnecessary traction to this joint, you can further tear tendons and ligaments that are already injured. As I left her side, she thanked me for being gentle. James Bartlett: Sudbury, Mass., 2005. Traction is a medical term the refers to the process of slightly. Control decreases pain, minimizes soft tissue trauma, and prevents disruption of clots . There are several contraindications to the use of traction splints: -The patient has an open fracture -The patient has a suspected spinal injury -The patient has a suspected pelvic fracture -The patient has a suspected hip fracture -The patient has a suspected femur fracture -The patient has a suspected knee fracture - Verbalize: Traction splint not intended to realign fracture; used to reduce muscle spasm. Traction to the lumbar spine is contraindicated in various conditions. If the pin is placed too far Also, check for adequate sensational capillary refill distal to the effected area by blanching the nail bed (usually fewer than three seconds). Once you've finished editing, click 'Submit for Review', and your changes will be reviewed by our team before publishing on the site. In the presence of neurovascular compromise, the fracture can be manipulated to allow for restoration of pulses distal to the fracture. We use traction splints on open femur fractures, wash out with 2L of saline first. - Obviously something we would never do. Lock the ankle attachment. Make the changes yourself here! Morphine, Dilaudid, fentanyl and Toradol are options for pain management in many states. In my mind, this is a bit too simplistic. Description. Preliminary research shows that using a pelvic sling in an unstable pelvic fracture in the prehospital environment is indicated and can help prevent further injury when transferring the patient during extrication and transport. Patients who survive the initial trauma associated with the injurytypicallyheal well. A comparative study of Dunlops traction versus percutaneus pinning. 6 weeks. Finally, along with splinting, ice, elevation and positioning, the touch of another human being has been shown to reduce the anxiety level of patients in pain and should be used in conjunction with your reassuring words. 4(3):205-208, 2000. I applied an ice pack to her ankle, reapplied the splint and put her chart in the to-be-seen rack for the physician. Dress any open wounds on the leg before applying the traction splint. Splinting can still be used in pelvic trauma/fracture though II. However, its important to remember that absorption rates may vary depending on the patient, injury and co-morbid factors. parallel In most cases, an obviousdeformitywill be apparent from the end of the bed. The bone is supplied by penetrating branches of the profunda femoris artery, therefore large volumes of blood (up to 1500ml) can extravasate if fractured. are recommended (Fig. A couple of months ago, while walking through an emergency department (ED), I saw an EMS crew rolling a young woman in a wheelchair toward the triage desk, and I noticed how uncomfortable she was. This cookie is set by GDPR Cookie Consent plugin. When should you not use a traction splint? Because fractures are painfulPain management is something that many EMS agencies are working to improve, particularly when dealing with fractures. As they passed by, I saw that her ankle was dangling near the ground, unsupported by the wheelchair pedal. 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Contraindications for traction splinting include hip or pelvic fractures, supracondylar fractures, fractures of ankle or foot, or partial amputation. 24 hours whereas others require it for a number of weeks ie. Please use one of the following formats to cite this article in your essay, paper or report: Dr. Shivani Nayar. These cookies will be stored in your browser only with your consent. Thus, with the relatively low usage of the traction splint, it may be time to revisit guidelines that require traction splints on every ambulance and rescue vehicle. However, keep in mind that, during proper splinting, bone ends frequently do re-enter the subcutaneous area on their own as the bone segments are realigned. These are usually in . Apply manual inline traction. Medindia. It is during this war that the Thomas traction splint created its lasting legacy, reportedly reducing mortality from military femoral fractures from 80% to 15.6% by 1918 (13). Pharmacological analgesics are also effective at reducing pain and are a key tool in the ALS toolbox. An incomplete linear break in a bone. To find out more, read our privacy policy. A poorly immobilized fracture can sometimes cause more damage than no splint at all. Contraindications for the use of traction splint: Injury is close to the knee Injury to the knee Injury to the hip Injury to the pelvis Partial amputation or avulsion with bone separation, distal limb is connected only by marginal tissue. Splinting: How to use a Sager Traction Splint.https://sites.google.com/site/emtbasicskillsvideo/ Radiolucent design enables X-Rays and Catscans to be taken without . Seen a lot in children with fractures and other injuries, this is called guarding and serves as a form of self-splinting. Open fractureswill need to be managed appropriately (discussedhere), including antibiotic prophylaxis, tetanus and medical photography. There is brevity of evidence-based research on their efficacy. Early mobilisation following surgical intervention greatly reduces complications. - The same as in getting someone with a femur fracture (with indications) secured into a traction splint and then just loosening up the straps and cranks? 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. > Sanders M: Paramedic Text, 3rd edition. Later that shift, I took over care for this patient. absolutely mandatory. Ensure to perform afull neurovascular examinationof the lower limbs to check for any vascular or peripheral nerve injury, as well as a thoroughsecondary surveyfor associated injuries. > Friese G, Lamay G: Emergency stabilization of unstable pelvic fractures. Emergency Medical Services. Generally speaking, unless you have a traction splint device of some sort, you aren't going to be easily able to pull traction on a broken femur. Dr. Shivani Nayar. It is primarily used on patients with mid-line femur fra. splint, brace, or traction for temporary stabilization. III. Pain management comes in many forms and isnt always pharmacological. His family was bonesetter from Welesh and this was inherited by Thomas. Open reduction internal fixation (ORIF) is a surgery to fix severely broken bones. Use of the PQRST acronym when classifying pain and/or tenderness will help to evaluate not only the injury, but how the patient perceives the pain (see Table 2, below). Volume 4: Trauma Emergencies. Step-by-step procedure for applying a halo ring. The physical therapist should take a proper medical history before prescribing traction for lumbar pain. Contraindications for traction splinting include hip or pelvic fractures, supracondylar fractures, fractures of ankle or foot, or partial amputation. However, prolonged utilization of traction splint can lead to pressure sores. Traction may also be contraindicated if you have: Osteoporosis Rheumatoid arthritis Infection Pregnancy Respiratory or circulatory problems Claustrophobia Cardiovascular disease Joint problems These should all be discussed with your healthcare provider if you are considering traction. I helped her move to a bed, shifted her ankle onto a big, soft pillow, loosened the splint and checked for pedal pulses. Upon recognizing the injury, Rescuer One should stabilize leg in. However, if you meet any type of resistance during repositioning, stop the attempt and splint the extremity in the position found. Skeletal traction through the olecranon may also be Accept Dr. Shivani Nayar. I suffer from Discogenic pain. The cookie is used to store the user consent for the cookies in the category "Analytics". Advertise with us | Medindia Copyright | Privacy Policy | Terms of Use. The white surface within this open fracture is the open joint surface of the disrupted bones. You also have the option to opt-out of these cookies. > Bledsoe B, Barnes D: An EMS relic? JEMS. patient ahead of time that this may be painful for a few seconds but A special, rarely used adaptation of upper extremity olecranon traction may be made by, The foot and ankle are maintained in a neutral. Supporting ligament and tendon injuries are a common complication. The traction splint has evolved to be plaster splint. All Rights Reserved. These cookies track visitors across websites and collect information to provide customized ads. Drill - A patient with a midshaft femur fracture. Traction splint (device) is used in compound (open) femur fractures, to help align the broken bone as well as reduce the level of pain. This wound can be caused by bone edges puncturing the skin from the inside out, or by the external force compressing or shearing the skin, causing the open wound to result from the outside. Preoperative skin traction was not useful for hip fractures. Like other skills, the more we splint, the better we get. satisfactorily with antibiotic therapy. Pelvic slings are now being used increasingly in the prehospital environment. Position the patient supine on a bed with the head extended beyond the edge. 2, as well as the Kendrick Traction Device KTD and are all designed by Rick Kendrick, a leader and innovator in Fire Rescue - EMS for over 30 years. A fracture in which the bone has broken completely and pierced the skin Why would you NOT want to use a traction splint with exposed bone ends? EMTs and paramedics have more pain management at their disposal than they often realize. This is referred to as crepitus. Finsen V, Borset M, Buvik GE, et al. Once these early assessment procedures are completed, examine the injury more thoroughly. Double traction splints stabilized the injuries. "Contraindications for Spinal Traction". 9-6). Contraindications There are few contraindications, primarily if the patient refuses a splint or other immobilization. Adult CPR/trauma manikin or live model, assistant, two (2) traction splints, long spine board, all . Morphine, fentanyl and Toradol can all be given IM if no IV is accessible. But having been a paramedic for 12 years and an ED nurse for four, I knew the injury wasnt the only cause of her pain. Control If I remember correctly, the femur injury only has to be stabilized before using the traction splint. [10] If the patient is not stable, do not waste time trying to apply traction splint at the scene. Proper use can decrease the pain and damage caused by the fracture. Osteology of the skull as it effects halo pin placement. The Thomas splint: questionable boast of an indispensable tool. The splint should be secured with the appropriate straps or fasteners and the extremity rechecked for CMTS after splinting and frequently throughout patient transfer to the hospital. Follow your local protocols when using traction splints because of the potential for making undetected soft tissue injuries worse. > Henry M, Stapleton E: EMT Prehospital Care, 3rd edition. Medindia, viewed Dec 11, 2022, https://www.medindia.net/patients/lifestyleandwellness/traction-for-lumbar-pain-contraindications.htm. Traction to the lumbar spine is contraindicated in various conditions. Soft tissue injuries, such as sprains or strains, are frequently splinted in the ED because a splint provides support and protection, and prevents the injury from being jostled excessively, causing further damage and pain. Position any leg support straps as directed (eg, 2 above the knee and 2 below). Faretec CT-EMS & CT-6 is a Leg Traction Splint designed for Pre Hospital Care and Patient transport. the pin, curette the pin tract, and replace the pin in the operating The limb is suspended in a cast, and there is no pressure on the calf muscles or peroneal nerve. Application of traction splints to the femur can be a bit tricky, mostly because of the various indications and contraindications. overhead pulley, with the weight attached to the rope at one end of the Absolute contraindications for traction splinting include: Fractures of ankle or foot and Partial amputation or avulsion with bone separation while only marginal tissue connects the distal limb. "Contraindications for Spinal Traction". We present a case of skin complication. IDF physicians in 2007 felt traction splints were "essential" for wartime extremity injuries. > Porter K, Lee C: Prehospital management of lower limb fractures. Emergency Medicine Journal. which the wire penetrates two bones, such as the tibia and fibula, it Routine urgent bloods, including a coagulation and Group and Save, should be sent. He has an open fracture to his right femur. *Referred pain is particularly common in the elderly population with femoral shaft fractures. Contraindications of splints compartment syndrome need for open reduction infected skin condition or. Diagnosis is made with orthogonal radiographs of the humerus. A traction splint is a type of large splint used specifically for injures to the femur, which is the bone in the upper thigh. 3-3. > Bledsoe B, Porter R, Cherry C: Paramedic Care: Principles & Practice. Sudden shifting of the unstable pelvic ring can cause a tear in large blood vessels, thus causing hypovolemia (hypotension and tachycardia) and death. two tibial cortices. This information is intended for medical education, and does not create any doctor-patient relationship, and should not be used as a substitute for professional diagnosis and treatment. Initiate cervical traction at 10 to 15 lb. Summary. > White LJ, Cooper JD, Chambers RM, et al: Prehospital use of analgesia for suspected extremity fractures. Prehospital Emergency Care. These cookies ensure basic functionalities and security features of the website, anonymously. The actual medical term for this concept is therapeutic touch. Also, simply talking with your patients and telling them you care is just as important as showing them the splinting process. I think you got a little confused, I am not saying you are to "release tension" on a traction splint - I was only equating that to pulling manual traction on an open long bone (not femur) fracture, and then letting go once the bone is realigned - obviously we are not holding traction on a long bone fracture all the way to the operating room. This cookie is set by GDPR Cookie Consent plugin. (accessed Dec 11, 2022). The only 3 acute pathologies are trauma, toxins and infection. Wrap the ankle harness around the patient's ankle with additional padding and apply the velcro strapping. Preoperative traction in patients with hip fractures. Medindia. The splint itself does a good job of managing pain, when properly applied. There are many commercial brands available which vary slightly in their design and instructions and thus require individual familiarity for correct use. for as long as required. The splint supposedly saved lives in open femur fractures from gunshot wounds, though there are no studies to demonstrate this.2. The first wide-spread prehospital usage of the Thomas splint was on the battlefields of World War I (1914-1918) to treat a large number of open femur fractures from ballistic injuries. You use 10% of the PT's weight for traction (max 15lbs), and a max of 5lbs for open fracture. So in the case of an open long bone fracture, lets say radius/ulna this time, we pull manual traction and the bones are realigned. Overview. 2. Once the material has been applied . But opting out of some of these cookies may affect your browsing experience. You must log in or register to reply here. Effective Date: 04-01-2022 Revised Date: 04-01-2023 Page 1 of 1 . This reduces movement and the subsequent pain it causes. "use strict";var wprRemoveCPCSS=function wprRemoveCPCSS(){var elem;document.querySelector('link[data-rocket-async="style"][rel="preload"]')?setTimeout(wprRemoveCPCSS,200):(elem=document.getElementById("rocket-critical-css"))&&"remove"in elem&&elem.remove()};window.addEventListener?window.addEventListener("load",wprRemoveCPCSS):window.attachEvent&&window.attachEvent("onload",wprRemoveCPCSS); Femoral Neck Fracture: Closed Reduction and Internal, Pathologic Fractures Associated with Tumors and Unique, Subtrochanteric Femur Fractures: Reconstruction Nailing, Ovid: 5-Minute Sports Medicine Consult, The, Rotator Cuff Tear: Arthroscopic Treatment, Anterior Glenohumeral Instability: Conservative Treatment,, This website uses cookies to improve your experience. Pelvic injuries are another contraindication of traction splint use, due to the pressure it places on the posterior wall of the pelvic ring. 9-11). I DID NOT have any fusion. Remember that the anatomy underneath this splint is very susceptible to injury. This type of infection usually requires large doses of antibiotics and, when left untreated, can be limb or life threatening. Any femur fracture that has broken the skin What is a compound fracture? Lock the device in place as directed. However, wouldn't that be pretty much the same thing? For safety reasons, place no weights over the patient. The cookie is used to store the user consent for the cookies in the category "Performance". Avoid placing adhesive straps over bony prominences, placing the patient in a shoulder spica cast, In the rare situation in which the fracture must be reduced. Henry BJ, Vrahas MS. Other classifications of fracture appear in Table 1 below. Pediatric patients lack adipose and muscle that supports the skeletal frame and prevents pressure points during periods of inactivity. If theres a noted loss of perfusion (cool, clammy, cyanotic skin tone) upon initial assessment, attempts to reestablish circulation should be made while loading and going.. Out of 1,073 people diagnosed with an extremity fracture, only 182 (17%) received ice, 268 (25%) had a splint placed and 18 (1.67%) received pharmacological treatment. So then no manual traction is being held, While we are at it, it was never explained to me if a traction splint. In most states and the NREMT it is contraindicated unless you have an air traction splint. Dress the pin site with sterile 4 4s on each side with Betadine Steps. In a case in The rest of the modern pathology requires years and decades to create an acute event; if possible to manage or reverse, it takes years. Also ask your patients if they can move the distal end of the appendage. These are simple ways to decrease their anxiety and consequently decrease their pain. During splinting, take care not to cause sharp bone ends to move unnecessarily and re-enter the wound. Dress open fractures and wounds. Traction splints should not be used for proximal or distal fractures of the femur, or where there are knee, lower leg, ankle or foot injuries, or in patients with pelvic fractures. Traction splints may apply pressure on the pelvis in order to achieve traction, potentially worsening an injury. bed. It was obviously fractured but haphazardly immobilized with a padded disposable cardboard splint. By visiting this site you agree to the foregoing terms and conditions. The editorial team reserves the right to review and moderate the comments posted on the site. Figure 2 An AP view of plain film radiograph, demonstrating a mid-shaft femoral fracture. Gentle longitudinal traction may be exerted while the splint is being applied, except when the injury site involves a joint, a dislocation, or an open fracture. Contraindications. IV. Is it hot, cold, clammy or dusky? With fractures, we can sometimes feel and hear the broken bones rub against each other. This gives added support to the splint and prevents movement of the joint and extremity, and shifting of bone ends. Most orthopedic specialists feel that the anatomical position occurs when the body naturally rests to alleviate stress, exertion and pain and argue that repositioning protects against further injury and makes the patient more comfortable. In these cases, the injury should be splinted in the position found, unless circulatory compromise exists, in which case the injury site should be straightened only enough to restore . We'll assume you're ok with this, but you can opt-out if you wish. 24. Elevating a splinted extremity can also decrease painful throbbing and swelling. The Winquist and Hansen Classification can be used to classify the degree of comminution to femoral shaft fractures: If the mechanism was high-energy, ensure you perform full ATLS management and formally assess for other injuries. Following the intervention period, however, traction splint use increased significantly (Median 50%).
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