Open Tib/Fib Splint

[BobBarker]

Off dury going dirtbike riding and we encounter a 15yo male who fell off his dirtbike. Only complaint is right lower leg pain. Got consent from him and mom to help and cut the pant leg to discover a open tib fib fracture. 911 was called but they were going to be 15-20min so we controlled the bleeding and made sure he had no ither injuries. We were gonna splint it but realized it was going to be difficult so we just put an icepack over the controlled bleeeing and kept him calm. Does anyone have any resources or a video on splinting open tib fib fractures? We couldn’t exactly splint it on both sides of the leg because the bone was sticking out. I’m glad I carry a small mymedic kit with me, I recommend it!

 

[Akulahawk]

You fashion a splint setup that allows you to splint the leg in the position found unless keeping it in that position is a worse option because there's no circulation because of positioning. If the bone ends retract under the skin, you make sure that you observed an open fracture with protrusion of bone from the skin. That's what you do while waiting for on-duty people to arrive. Otherwise, I'd say you did just fine as long as the leg didn't move during the hand-off of care and no further injury occurred because of it, splinting is not a huge concern for you to do that early on. It very well otherwise could help pain control measures later by at least keeping things stable.

 

[BobBarker]

You fashion a splint setup that allows you to splint the leg in the position found unless keeping it in that position is a worse option because there's no circulation because of positioning. If the bone ends retract under the skin, you make sure that you observed an open fracture with protrusion of bone from the skin. That's what you do while waiting for on-duty people to arrive. Otherwise, I'd say you did just fine as long as the leg didn't move during the hand-off of care and no further injury occurred because of it, splinting is not a huge concern for you to do that early on. It very well otherwise could help pain control measures later by at least keeping things stable.

Thanks! CMS was intact, equal bilateral pulses juat painful and controlled bleeding with gauze. I was just a bit worried because the guys that responded first were EMR’s and ALS with pain meds was 45+min out and no way to get him out without meds. I’ve Always heard split in position found unless extremity is pulseless but there was not much literature in school on splinting an open fracture.

 

[Summit]

Prefer vacuum. Two full length Sam splints work great. But also you can improvise with any decent wrap, padding (great option is a hydration bladder and some clothes) ,and some sticks. Just make sure to immobilize the ankle super well. Knee immobilization save for extrication team.