Traction Splints

A traction splint is used to prevent further vascular injury from isolated, mid-shaft femur fractures. A traction splint can be placed bilateral if needed. Contraindicated if there are fractures in the pelvis, knee, or lower leg.

An isolated midshaft femur fracture is considered life threatening due to the potential blood loss from a severed femoral artery. A traction splint reduces the risk of injury to the vasculature that lies alongside the femur bone and with better alignment of the bone pieces, it may decrease pain as well. The splint should be applied as soon as possible on stable patients and as a priority while transporting the critical patient. Traction splints can take several minutes and focus to apply, and with a critical patient, i.e., patient with other obvious life threats, traction splint application is recommended during transport. 

To place a traction splint:

1. 1. Confirm isolation of injury by completing the trauma assessment. Compare the injured side to the uninjured side if applicable.
   2. Direct your partner to stabilize the leg and/or instruct the patient not to move.
   3. Assess Circulation Motor and Sensation “CMS” in affected leg.
   4. Measure splint to unaffected leg if applicable
   5. Place provided ankle hitch around the ankle of the affected side.
      1. Makeshift ankle hitches are appropriate if commercial device is unavailable.
   6. Place the proximal end of the splint, known as the ischial strap, against the bony prominence of the pelvis and secure the strap tightly, as indicated by the manufacturer.
   7. Attach ankle strap to the distal end of the splinting device.
   8. Pull traction until either.
      1. 10% of patients body weight (in lbs.) of traction is applied.
      2. Marked relief of pain
   9. Secure additional straps in between the ischial strap and ankle strap ensuring the splint is secured above and below the approximate injury site
   10. Secure both legs together with middle straps, if possible, unless the patient cannot tolerate this, if so, then let the uninjured leg be in a position of comfort for the patient.
   11. Reassess CMS
   12. Reassess traction placement every 5 minutes including asking for the patient’s pain level.
   13. Tension may decline as the patient’s muscles fatigue and lengthen. You may need to pull tension to re-establish therapeutic traction.