Traction Splint

Everything there is to know about a traction splint  

A femur is one of the largest and strongest bones of the body. This bone majorly carries the whole weight of the body, and it needs massive force to get fractured. In such cases, emergency medical services can be provided by restraining the femur, halting the movement, and further damage. A traction splint utilizes straps that wrap over the pelvic region while restraining the hip and supporting the leg and hip with a metallic rod by depicting normal bone functionality. The device performs traction for limb realignment with reducing pain, vascular as well as motor complications. The use of splints is a recommendation for fractures of the midshaft part in the femur to provide comfort with the appropriate alignment of the fracture. If the fracture occurred remotely in the midshaft of the femur, then its application is suggested. However, it does not apply to all sorts of fractures. We cannot provide relief by traction as support is needed from the strap site to apply traction for fractures that occur in the foot or ankle portion. 


History of a traction splint


An orthopedic surgeon of Great Britain Hugh Owen Thomas invented the traction splint for the first time in 1875. His father was a Welsh bonesetter, and this background helped him in this invention.

These traction splints were offered to the French army in the period of the Franco-Prussian War by Thomas. This device remained unused and unknown until World War I. Robert Jones promoted the device in 1915, and he said that it could decrease more than 70 percent of the military death ratio that occurred from femur fractures.

Glen Hare modified the model of traction splint to a better version around the 1960s, and it received its name after him as Hare Traction Splint. 

Other modifications were done in the latest model by incorporating length adjustment and enhanced quality. This model received the name FernoTrac Traction Splint. Then, came a compact and lighter version provided by Richard Kendrick around the 1980s as the Kendrick Traction Device. Along with this development, some other models came, which are known as Sager and Faretec CT-6. 


Indications to use a traction splint

If a fracture was found in the femur, especially its midshaft region, then there are increased chances that this device can heal the damage and manage the situation effectively. If the fracture location is in some other area, there might be no or minimal improvement in the condition. 

The reason behind their failure to cure other areas is that the maneuver needs support at the site of the strap for application of traction, which is sometimes not available in other areas.

Verdict based on clinical aspects can be apparent through pain, deformity, and swelling besides immobility of the affected region. Mostly the cause of fractures in femur happens due to the application of high pressure or force, leading to the suffering of the hip, pelvic area, groin, buttock, and perineum. 

More than 35 percent of femur fractures are related to the knee injury that occurs ipsilaterally. If they discover any sort of mal-perfusion around the extremities, then blood supply evaluation must be performed. In that case, these tools are advantageous as being capable of enhancing the flow of circulation. If the condition is more worsened when the injury leads to the causation of vascular damages, then these instruments are not useful; instead, surgical treatment becomes needed as an emergency measure. 

The traction splint is known for its ability to treat even without the application of traction. It seizes all the movements and lets the affected area grow after alignment, which aids the healing process even without medications.

There is also an application of this item in several posture correction strategies to aid treatment. Their digital version mostly testifies to such usage. They are useful as posture corrector through skeletal traction in patients of burns and rheumatoid arthritis.


Complications of using a traction splint


Apart from benefits obtained from it, some disadvantages also exist, which indicates some warnings for the user. One reported problem of using a traction splint is from its ankle hitch, which a closing part. The drawback arrives at the risk of Ischaemia when the application of traction continues for an extended period and is applied forcefully. In the process, there is a need for the injured person's transportation, which becomes painful for the patient, so to have less pain during transport, the splint can relate to the stretcher through the suspension bars. 

In New York City, some researchers performed a study over these objects and their causation of harms to the patients. Their research examined two boys with injuries, both having peroneal nerve palsies developed after traction performed through these gadgets. 

The research shows that in one individual provision of inappropriate force during traction has led to the consequences of exaggeration in effect, which may result in damages of the extremities. 

Sometimes while applying force, there is a chance that nerves may overlap or try to cross around the hard-bony region of the knee. This condition usually occurs with the Peroneal nerve, or fibular nerve crosses over the knee and becomes vulnerable to injury near the knee. When there is an injury to the knee, it is more severe as it can adversely harm the functioning of the knee.

In this study, the second suspect encountered pain in the lower thigh, accompanied by swelling. Upon examination, there was numbness of foot with negative X-ray reports. The surgeon discovered knee sprain, which reached severity. But soon after the removal of these devices, both individuals showed recovery, and the nerve palsy cleared.


General specifications

There are two versions of this emergency product one is the Paediatric version while the other is for Adults. Both kinds are different in dimensions of the length and are adjustable, too, with a requirement of two operators.  

For the pediatric population  

  • length ranges between 31-46 inches  
  • weight 3lbs 
  • height ranges from 2- 8 inches 
  • width is 8 inches 

For adults  

  • Length: Between 35- 54 inches  
  • Weight: 5 lbs. 
  • Elevation: 3 - 9 inches  
  • Width: 9 inches 

Components  

This emergency product consists of two components: A splint and an ankle wrap.  

Splint contains: 

  • Four leg Strap  
  • A Rachet strap 
  • A release ring for traction release 
  • A knob for traction 
  • A thigh pad with hip restrainer
  • S-hook and lock collar 
  • Heel stand release ring and a heel stand. 

Ankle strap consists of:  

  • Fastening strap 
  • Traction strap and  
  • D-ring. 

How a traction splint works 

This emergency product application needs the involvement of two people. The first person stabilizes the injury by placing his or her hands above and below the injury. Meanwhile, the other person removes the clothing from the injured site. The second individual also assesses the motor function as well as circulation. Assessing the motor function can be done by determining the sensation around the ankle by pressing the area around the hard bone around the ankle. In contrast, assessing circulation is done by pulse examination around the inner part of the ankle. 

The same person should place the ankle hitch, wrapping a strap around the whole leg within which the foot goes in.  

The person stabilizing the injury must raise the leg and adjust the length according to the leg length. Then they should secure the ischial strap. It must be tight enough but have space for sliding two fingers between the leg and the strap. 

Splint contains a Mechanical traction device that is attached to ankle hitch and provides traction to the affected part. Then they reassess the motor function and blood circulation of the leg. After that, they should place the injured individual over the backboard for rest and additional stabilization. The process is uncommon, so the application is not very well known.  

If Complete Immobilization is provided along with this procedure, the placement may become less painful and reduce bleeding and prevent illness. The process is only for professional applications. No layperson can practice the procedure, because, in case of inappropriate pressure, it may lead to severe injury or even death. 


Market Leaders 


The available brands for this equipment include, 

  • FERNOTRAC mechanical Model 444 for adults. 
  • Oscar Bos carol developed several versions. 
  • EGO Zlin ES-TD Model.
  • EMS ET-320 Model for limbs.
  • Med Plant 1332 Model 
  • ROTAX Medical Solution R-SI-TS-01, R-SI-TS-02 Emergency traction splint for legs in the pediatric population. 
  • Fare Tec Inc. QD-4 Hare Traction model for lower limbs.

Conclusion 

A traction splint is a useful tool for emergency conditions used in the realignment of fracture, especially of the femur. This tool is also advantageous as it possesses capabilities to upsurge the arteries' blood flow and provide comfort by reducing pain besides tremor relief. 

It also decreases the incidence of further damages and fracture of the bone. The traction splint is now available in a smaller modified version meant for the immobilization of small fractures.  

One thing to keep in mind while utilizing this device is that if the person is not stable, then these instruments cannot be useful. Such conditions are not for wasting a single moment and trying to have a recovery with these items. In such conditions, you need to ease transportation alongside recurrent re-evaluation of neurovascular function, especially in the extremity, when the splint placement is over the limb.  

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