The Traction Splint for Femur Fractures: A Lesson from World War I

The femur is the thigh bone, the largest bone in the body and if it is fractured or broken, not only will great discomfort be experienced if the person is conscious, but there is also the high probability of losing a significant amount of blood. This is one of the most important facts about femur fractures that few people realize. Although they might have heard of the need to splint fractures, they might not be familiar with what's called the traction splint which is often used in cases of femur fractures if there are no contraindications.

There were a few soldiers in my emergency medical technician (EMT) training classes which sparked some discussion about how the skills of a military medic are sometimes considered inferior to those of a civilian one and how some doctors particularly don't have much respect for their skill. These certainly were not the attitudes of my instructors. I remember one of them mentioning how amazed she was when she found out that a military medic learns how to start an IV in the dark--for obvious safety reasons. However, lessons from the military don't stop there as I found out when learning about the traction splint for patient care when dealing with femur fractures.

Femur Fractures on the Battlefield in World War I

As I mentioned, significant blood loss can occur with femur fractures or broken thigh bones which, like all bones, are living tissues containing blood vessels; a person can bleed as much as 2 pints (1,000 cc). Complicating things are the muscle spasms that cause jagged bone ends to move over each other, further injuring blood vessels in the process. Closed (no open wound) femur fractures claimed approximately 80% of the lives of soldiers who suffered them until two brilliant surgeons invented the traction splint. This medical contribution is now used by civilian medics.

The traction splint applies a continuous pull throughout the length of the entire leg to keep the femur fracture as stable as possible. The action of the pull also diminishes the damage and discomfort caused by the spasms of the muscle groups in the thigh. Splinting femur fractures with this new method reduces additional bleeding and damage of the nerves and blood vessels. Those surgeons, with the invention of their traction splint, succeeded in dropping the date rate from femur fractures in soldiers from 80% down to 20%.

Today, a traction splint is available in two varieties: unipolar and bipolar. A single metal rod is used to stabilize the leg in the unipolar variety whereas the leg is kept immobile between two rods with the bipolar version. The Hare traction splint is probably the most popular among bipolar varieties while you might hear of the Kendrick or Sager when speaking of the unipolar version. A traction splint generally has to have been applied for several minutes before the patient begins to get relief from the spasms and discomfort, but it's good to know that unless he has other life-threatening injuries, his chances of survival are greatly increased.

Source:

My EMT training classes (lecture/hands-on training/text)
text: Emergency Care (11th edition) by Daniel Limmer, Michael F. O'Keefe, Medical Editor: Edward T. Dickinson MD, FACEP