When using a Sager traction splint you should apply traction that is approximately?

Femoral traction splints are used to temporarily stabilize and possibly reduce femoral shaft fractures.

Femoral traction splints are designed to apply traction to the lower portion of the leg, distal to the fracture, usually by pulling the ankle away from a stabilized pelvis. There are many commercial brands available which vary slightly in their design and instructions and thus require individual familiarity for correct use.

Traction splints may also reduce and/or decrease pain and bleeding due to femur fractures, particularly those that are shortened.

• Femoral shaft fracture

Femoral traction splints are used to stabilize femur fractures prior to definitive care (eg, operative fixation).

• Pelvic fracture

• Ipsilateral fracture(s) of the ankle, foot, and/or lower leg

• Ipsilateral knee injury

Although traction is beneficial to femur fractures, it can be harmful to fractures or ligament injury distal to the femur fracture.

• Vascular or nerve traction injuries

• Commercially available femoral traction splint kit (eg, Hare®, Sager®, Ferno-tracTM, KendrickTM)

• Drugs for analgesia/sedation (eg, fentanyl, morphine, propofol)

• Traction splints may not be as effective on proximal femur fractures.

The femoral shaft excludes commonly fractured parts of the femur such as hip and supracondylar fractures.

• Lie the patient supine with the injured lower extremity supported.

• Follow the instructions and recommendations for the specific product being used.

• Ensure that the stretcher or table is long enough to support the distal end of the device (eg, 20 cm [8 inches] beyond the ipsilateral foot). Use the contralateral, uninjured leg as a landmark if the injured leg is shortened.

• Give the patient adequate analgesia.

• Stabilize the device against the pelvis and the ankle as directed by the product instructions, including the proper sequence of these steps.

• Lock the ankle attachment.

• Position any leg support straps as directed (eg, 2 above the knee and 2 below).

• Apply longitudinal traction on the ankle to straighten and lengthen the shortened leg to the length of the contralateral leg. Use about 10% of the patient's body weight or up to about 7 kg (15 pounds).

• Lock the device in place as directed.

• Check for distal neurovascular status (eg, capillary refill, distal sensation, toe flexion and extension).

• Remove the traction splint as soon as possible when definitive care is available.

• Assess distal pulses both before and after splint application.

• Ensure adequate traction is applied by using the traction scale if available on the specific device.

• Ensure adequate traction by frequently assessing pain relief and length of extremity compared to uninjured side.

• Use adequate analgesia (usually IV opioids) because traction splinting of femur fractures is painful.

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Indications and Contraindications,

Sager Facts, Cleaning Instructions

Indications and contraindications for the use of traction splints on femoral fractures.

A fracture of the Pelvis occurring with a fracture of the Femur is generally a contraindication for the use of a traction splint of any type. A Sager® Emergency Traction Splint is not contraindicated when MAST Trousers are used to immobilize the fractured Pelvis. In this situation, Sager® Splints may be applied over MAST Trousers if treatment of the fractured Femur is indicated or desired. Sager’s traction is quantifiable and gentle and will not disrupt or move Pelvic bones immobilized by MAST Trousers. Supracondylar fractures of the distal end of the Femur are contraindicated because traction can cause anterior rotation of the distal bone fragment – forcing the sharp fractured bone end down into the Popliteal Artery and Nerve. These fractures should be splinted as found. Compound fractures of the Femur with bone fragments sticking through the skin may be a contraindication. Guidelines by local protocol or instructions by a Medical Consultant should be followed. Fractures of the Ankle and Foot are also contraindicated. Pressure from the ankle harness and from traction is not therapeutic. The indications and contraindications listed above are only intended as a basic reference tool. Please defer to federal, state, and/or local protocol for definitive analysis and guidelines. Warning: All Operators should receive full and proper initial and refresher instruction sessions from a qualified person on detailed use of this equipment and regarding the particular situations in which it should be used.

How much traction should I apply?

Apply the amount of traction recommended by your medical consultant, or that required by protocol. For adults, the American Academy of Orthopedic Surgeons recommends gentle traction to a maximum of 7kg (15 pounds) per fractured femur (14kg (30 pounds) for a bilateral fracture. A general rule of thumb is 10% of the patient’s body weight per fractured femur. For example; if a patient weighing 45kg (100 pounds) has a single fracture, the appropriate amount of traction would be 41⁄2kg (10 pounds). If that same person has a bilateral fracture, 9kg (20 pounds) would be estimated.

Articulating Base and Cushion

Sager Form III splints have an articulating base and cushion (the saddle) which bends laterally for seating and exacting conformance to the ischial tuberosity. With a Sager® Form III Splint, most perineal examinations and procedures can be performed with the splint in place – without compromising the comfort and safety of the patient. Sager® Splints have a well-padded shaft cushion which provides additional comfort and stability.

Comfort

How comfortable are Sager® Splints against male and female genitalia? The ischial perineal cushion of the splint rests against the ischial tuberosity and with natural genital mobility the male genitalia can be checked and moved to ensure it is not under any pressure. During actual accident situations the clothing should be opened, cut and/or removed during the general assessment procedures. In practice trials, loose clothing should be worn to enable genital mobility. (Note: the structures used and pressed on are the same as sitting on a bicycle seat).

Cleaning Instructions

Software Goods and Stainless Steel: Manu-Klenz1 (i.e. Sodium Dodecylbenzine Sulfonate and Coconut Diethylthanolamide). Effective manual washing of heavily soiled washable surfaces, medical instruments, counters, glass and plastic surfaces.
Directions: 1 ounce Manu-Klenz to 1 gallon water.
Stainless Steel: 70% Alcohol solution or above instructions.
Foam Rubber: Precise2 Hospital Foam Cleanser/Disinfectant.
1,2 Or other comparable product