Femur fractures can be successfully immobilized using a traction splint. A femur fracture is complicated due to the amount of bleeding that can occur from the broken bone. In addition, the thigh muscles will contract and pull the fractured ends so they overlap or pass each other. This increases the size of the thigh, which leads to more blood loss, pain and internal soft tissue injury.

Traction splints provide a counter-pull to reduce the size of the thigh and realign the fractured femur. This helps reduce blood loss, alleviate pain and minimize further injury. The most common traction splints you’ll see in the field are the Hare (bipolar) and the Sager (unipolar).

Hare Traction Splint (Bipolar Traction Splint)

The Hare is a bipolar traction splint, which means it uses two external poles to support the injured leg.

Indications

• Suspected femur fracture

Contraindications

• The injury is within 1-2″ of the knee or ankle
• The knee is injured
• The hip is injured
• The pelvis is injured
• There’s a partial amputation or avulsion with bone separation and the distal limb is connected by only marginal tissue

How to Apply

1. Assess distal PMS.
2. Stabilize the injured leg by applying manual traction.
3. Measure the splint on the uninjured leg and adjust the length accordingly.
4. Position the splint under the injured leg until the ischial pad rests against the bony prominence of the buttocks. Once the splint is in position, raise the heel stand.
5. Attach the ischial strap over the groin and thigh.
6. Secure the ankle strap with the patient’s foot in an upright position.
7. Attach the “S” hook to the “D” ring and apply mechanical traction; continue until it’s equal with the manual traction and the pain and muscle spasm are reduced.
8. Attach the leg support straps.
9. Recheck the ischial strap and ankle hitch to ensure both are securely fastened.
10. Reassess distal PMS.

For unresponsive patients, apply mechanical traction until the injured leg is the same length as the uninjured leg.

Sager Traction Splint (Unipolar Traction Splint)

The Sager is a unipolar traction splint, which means it uses one external pole to support the injured leg.

Indications

• Suspected femur fracture

Contraindications

• The injury is within 1-2″ of the knee or ankle
• The knee is injured
• The hip is injured
• The pelvis is injured
• There’s a partial amputation or avulsion with bone separation and the distal limb is connected by only marginal tissue

How to Apply

1. Assess distal PMS.
2. Position the splint on the inside of the injured leg and adjust the length so it extends approximately 4″ beyond the heel.
3. Attach the strap to the thigh.
4. Secure the ankle strap with the patient’s foot in an upright position and attach it to the splint.
5. Apply traction by extending the splint to 10% of the patient’s body weight.
6. Attach the leg support straps.
7. Recheck the ischial strap and ankle hitch to ensure both are securely fastened.
8. Reassess distal PMS.

Remember, you don't have to be certain the patient has a femur fracture. If the thigh is painful, swollen or deformed you should assume it's fractured and splint accordingly.