fig 6
Safe traction
Safe traction for field use should be traction in a known amount prescribed by protocol or a
medical consultant. It should also be traction that is dynamic in nature using a resilient member
that permits graded reduction of traction force as the muscle spasm decreases and leg
length increases. It should avoid the pitfalls of rope, weight and pulley traction — which is a
constant and unrelenting force that can result in over-extension of the bone elements. This
method is more conducive to a hospital environment where it can be monitored at length, under
the care and supervision of an Orthopedic or other Medical Consultant.
Static traction, as provided by drum and crank arrangements should also be avoided. The traction
is not quantifiable and, most importantly, can be completely lost if leg spasm stops and the
limb lengthens. This traction force exists only for a set length between points of traction and
countertraction. It also necessitates constant monitoring and resetting of traction — leading
to further distraction of bone elements, and/or needless increase in pain. In addition, uneven
forces in lifting and carrying, or simply moving a patient can double or triple the forces against
the injured limb. This drawback is commonly associated with most Ischial Pad splints that
promote the use of static traction arrangements.
Common femoral fractures versus splinting systems
In 1997, the projected potential of U.S. Femoral Fracture hospital admissions totaled 474,551
(USA ICD9 Projections, Internet). Of these, Proximal Third Fractures accounted for 84% or
399,484 of total hospital admissions, while Mid Shaft Fractures accounted for 9% or 41,012
of all admissions. Together, these two fracture types amounted to an estimated 93% of all
hospital admissions. The remaining 7% (34,055) of fracture types indicates traction not
needed or contraindicated.
Sager Emergency Traction Splints are indicated for treatment in all Proximal Third and Mid
Shaft Fractures. In other words in 1997 alone, Sager® Splints had the capability and potential
to treat 93% of all projected Femoral Fractures. Conversely, Ischial Pad splints are
contraindicated in the treatment of Proximal Third Fractures, and thus are only indicated for
treatment of Mid Shaft Fractures (roughly 9% of all Femoral Fractures).
A major concern relating to Proximal Third Femoral Fractures is the proximity of the Sciatic Nerve.
The Sciatic Nerve exits the Pelvis behind the Femoral Head and lies along the Postero-Medial edge
of the Shaft of the Femur. Improper traction splinting of Proximal Third Fractures may result in
unnecessary nerve injury. These concerns do not apply to Sager® Splints because of the unique
design of the Ischial Perineal Cushion.
Pelvis, Femur and the Sciatic Nerve
(Overhead Projection #3)
(PowerPoint #3)
Sager® Emergency Traction Splints and the Minto Fracture Kit 7
