Splinting Angulated Fractures

Discussion in 'BLS Discussion' started by IvanD, Aug 23, 2011.

  1. IvanD

    IvanD New Member

    Hi all,

    I have a question regarding splinting of angulated fractures, I was taught as a WFR to apply traction and straighten it out but I know this is probably not the case on the street.

    How would one apply a splint to angulated fractures on the tibia/fibula or ulna/radius?

    Thanks!
  2. Linuss

    Linuss New Member

    Location:
    DFW
    Depends on a few things, such as if they have CMS compromise, and if your protocols allow you to try and set it in it's anatomical position.
  3. IvanD

    IvanD New Member

    Right, but say if there was no CSM compromise, limb circulation is fine but its all bent out of shape.

    I volunteer on the sidelines for school games and I was curious how I should splint that up before transporting them to the hospital.
  4. Linuss

    Linuss New Member

    Location:
    DFW
    If there's no compromise, chances are I'm not going to screw with it and will splint it as found.

    Just use the correct board, vacuum, air, or even a pillow /towels. I find pillows are great... wrapped tightly they often relieve a bit of pain in my experience.





    But I also give the patient a crap load of Fentanyl, so who knows.
  5. fast65

    fast65 Doogie Howser EMTP

    Location:
    Oregon
    If CMS isn't compromised then I would just try to splint it as is. However, in my protocols, if CMS is compromised then I've got one shot at reducing it to get CMS back, if not, then I just splint it in place.
  6. Chief Complaint

    Chief Complaint New Member

    Like Linuss said, i would check your protocols to be sure, but i would also prefer to splint the extremity in the position in which i found it. Pillow would likely work well here.
  7. IvanD

    IvanD New Member

    Does anyone have any visual aid on how to splint an angulated fracture though? I agree on splinting it as it is but I haven't seen anyone do this before so I'm unsure how to splint it in the position it was found.

    Would you secure the sites above and below the point of fracture?

    Sorry if this is a stupid question.
  8. ol' poke

    ol' poke New Member

    Had an MVA last spring where the end of driver's tibia was extending above her kneecap. Her leg was bent nearly 90 degees in a normal position. We splinted it as found, making sort of a triangle with the splint, attaching one end of the splint to the upper leg, and the other to the lower leg, with a towel roll in back of the knee. Padded the entire mess with towels and transported. Without pictures, that's about as visual as I can describe. Our protocols don't allow for (re)setting - we splint as found. Splinting can be a very creative excercise.
  9. phideux

    phideux Member

    Location:
    South Carolina
    EMS Training:
    EMT-Paramedic
    If the break is in or near a joint, splint it as it lays. If PMS is present and intact, splint it as it lays. If it is an open fracture, splint it as it lays. If PMS is compromised, we can manipulate to try and restore PMS. If it is a mid shaft Femur, traction splint.
    Like ol'poke said, sometimes you have to get creative.

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