Femoral shaft fractures and the prehospital use of traction splints

BACKGROUND: Traction splints are generally accepted as standard prehospital treatment of femoral shaft fractures. The effects of different splints are not suffi ciently studied and the use of traction splints is not evidence-based. The aim of study was to determine the incidence and epidemiology of femoral shaft fractures and the prehospital use of traction splints in these fractures and to determine the force of traction exerted by traction splints over time. MATERIAL AND METHODS: a) Retrospective study of all adult patients with femoral shaft fractures treated at a university hospital during a 5-year period. b) Study of traction force exerted by traction splints on ten healthy volunteers. RESULTS: Femoral shaft fractures were caused by low energy trauma in 77% of the cases. There were no signifi cant differences in age, gender, and mechanism of injury or on scene time between patients treated with tractions splints and patients not treated with traction splints. In the experimental study the initial force of traction decreased by 58% during the fi rst 30 min, with the fastest rate of decline within the fi rst fi ve minutes. CONCLUSIONS: Low energy trauma may today be the most common cause of femoral shaft fractures. Traction splints were in this study probably not used on all patients were this was indicated. The force of traction exerted by the traction splint decrease considerably after application. Future studies need to investigate the clinical signifi cance of this.