Traction Splints help.

[ThatEMTGuy]

When using a traction splint, for a leg fracture, and the bone is protruding outward, do we still use manual traction and traction it with the splint by pulling?

 

[MonkeyArrow]

I'm not sure what you mean by:

manual traction and traction it with the splint by pulling?

But traction splints are contraindicated for open fractures where bone is poking through/visible through the skin, amongst other things. Tractions splints are also contraindicated with pelvic fractures, patellar fractures, and with any sort of tib/fib fractures, although the last one is up for debate.

 

[Jim37F]

But traction splints are contraindicated for open fractures where bone is poking through/visible through the skin, amongst other things.

Depends on your local protocols. My county skills sheet for both the Sager Unipolar traction splint (the style my department uses) and the Hare Bipolar traction splint say that "Traction splints may be used on open femur or closed fractures, especially if there is neurovascular compromise, uncontrollable bleeding and severe pain due to muscle spasm."

 

[Akulahawk]

Use of traction splints with open femur (only) fractures is a relative contraindication. They'll consider the entire wound "contaminated" and the patient will end up getting broad spectrum antibiotics and they'll have to do some work on that wound anyway, so applying the splint, pulling traction and potentially allowing the broken femur bits to slip back under the skin is kind of a moot point.

 

[NomeProvider]

But traction splints are contraindicated for open fractures where bone is poking through/visible through the skin, amongst other things.

This must be a local protocol thing; this is not what I was taught nor what my protocols dictate (Rural Alaska). From my class, with two providers one is providing manual traction as soon as the initial assessment is complete and any other life threats are dealt with first; ideally this is mitigating pain while the second provider sets up and applies the traction splint.

 

[Jeff Bazz]

Not that I have any field experience, but we're taught in class to use a traction splint only for a "closed long bone [femur] fracture with no other complaints on the leg or pelvis."

 

[NomadicMedic]

Mid shaft femur fracture, either open or closed, would get a traction splint.

Given that ALL OPEN FRACTURES are contaminated and subject to infection and will need to undergo wash-out and / or debridement by an orthopedic surgeon, we believe that application of a traction splint ... to either open or closed fractures benefits the patient.

...In urban situations with short transport times, application of traction splints for femur fractures (open or closed) is likely not to impact patient outcome.

https://www.itrauma.org/wp-content/...ctionSplintswithOpenFemurFracture_Nov2011.pdf (citations are included)