Prehospital midthigh trauma and traction splint use: recommendations for treatment protocols

Am J Emerg Med. 2001 Mar;19(2):137-40. doi: 10.1053/ajem.2001.21302.


The present study was completed to establish an epidemiologic database defining the prehospital occurrence of midthigh trauma/suspected femoral shaft fractures, and the use of/need for traction splints (TS) in hope of developing recommendations for further treatment protocols. On review of 4,513 paramedic run reports for the 12-month period from January 1999 through December 1999, from a low-volume urban emergency medical services (EMS) system, 16 persons (0.35% total patients) presented with midthigh injuries. Data collected included patient chief complaint/injury, mechanism of injury, clinical findings, splint application, additional interventions, iatrogenic complications, patient age, and ambulance field time. Paramedics noted injuries suspicious for femoral shaft fractures in 5 patients (31.25% study patients, 0.11% total patients). TSs were applied successfully only twice (12.50% study patients, 0.04% total patients). Fourteen patients (87.50% study patients) were managed with long backboard immobilization, rigid splinting, and/or patient transportation in a position of comfort. No sequelae as a result of such care occurred. No inappropriate use, point estimate (PE) [(0)/(16) (0.00% to 20.60%)] or unmet need, PE [(0)/(4), 497) (0.00% to 0.08%)] of care was noted. The data presented in this study suggest that given similar EMS system characteristics, prehospital midthigh injuries/suspected femoral shaft fractures occur on an extremely rare basis, and treatment with long backboard immobilization, rigid splinting, and/or patient transportation in a position of comfort may constitute an acceptable course of care. Including TSs as essential ambulance equipment may be unnecessary.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulances*
  • Child
  • Clinical Protocols
  • Femoral Fractures / epidemiology
  • Femoral Fractures / etiology
  • Femoral Fractures / therapy*
  • Humans
  • Illinois / epidemiology
  • Leg Injuries / epidemiology
  • Leg Injuries / etiology
  • Leg Injuries / therapy
  • Middle Aged
  • Organizational Policy
  • Retrospective Studies
  • Splints / statistics & numerical data*
  • Thigh
  • Traction*
  • Utilization Review*