Either way, the patient is going to get antibiotics in an attempt to reduce the chance of allowing an infection to take hold. If the Fx has the bone still sticking out of the skin, traction splinting can be done, but you want to make sure that you document what you found before you apply traction. It is nice to know that info hasn't changed much since then. Much of the info in the article was "new" stuff about 12-15 years ago. Being that most of those Fx's will be repaired surgically anyway, there won't be much clinical benefit to prehospital traction splinting of mid-shaft femur Fx, except for perhaps blood flow improvement, if it's compromised. In my experience, and in the experience of an Orthopedic Surgeon that I have had a chance to work with, mid-shaft femur fractures do benefit from traction splinting precisely because of the improvement in patient comfort. The reason is that since the quads and hamstrings will contract, and this can cause the broken bits of the femur to grind against other bony fragments or dig into the musculature - both cause pain.Īs the article that JP posted suggests, there is little benefit to using a traction splint in a hip (femoral neck) fracture. Also, if you do apply traction, you're going to have to apply a considerable force. Traction is applied by pulling the ankle distally while the proximal end braces the pelvis to prevent it from moving, thereby enabling distraction of the femoral fracture fragments.Ĭlick to expand.If the Fx has the bone still sticking out of the skin, traction splinting can be done, but you want to make sure that you document what you found before you apply traction. The device is attached to the ankle at one end and secured against the pelvis at the other. Hare or Thomas traction splints are most commonly used.
Compound femur break skin#
Skin traction splints can be used for both closed and open fractures of the femoral shaft. (See "Hip fractures in adults", section on 'Initial management'.) A systematic review of studies of traction for proximal femur (ie, hip) fractures found no clear benefit comparable studies have yet to be performed in midshaft femur fractures.
Those who support the use of traction claim that it reduces patient discomfort, improves fracture alignment, and may resolve problems with arterial flow. Nevertheless, many orthopedic surgeons advocate immobilizing well-aligned fractures, with or without neurovascular injury, in a skin traction device. Little clinical evidence exists to support the use of traction in the preoperative management of midshaft femur fractures.
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