lower limns splinting, Thomas splint.pptx

Emergency splinting of long bone fractures , femur and tibia, with Thomas splint. history, indications , measurements, correct choice and benefits of Thomas splint in long bone fractures.

1. Thomas splint Introduction

2. Fig 1

3. Thomas splint Originally described by Hugh Owen Thomas Used for support and immobilization during transport Initially used for treatment of inflammatory knee conditions Adopted in early 1919s by military to splint battlefield injuries Lower limb Fxs Mortality decreased from 80% to 15.6%

4. Indication Femoral shaft fractures during transportation With no wounds on buttocks or thighs (why?)

5. Contraindications Injury to the knee Injury to the around the hip Injury to the pelvis Ankle injuries Partial amputation , avulsion fx with bone separation Distal limb is only connected by marginal tissue

6. Parts Proximal padded metallic ring Inner and outer side bar Ring to inner side bar set at 120degrees W piece joining the inner and outer bar distally Outer bar protrudes 2 inches below thr ring to give way for GT

7. Fig 2.1

8. Fig 2.2

9. Choosing Correct size Obliquely measure the circumference below the gluteal fold and ischial tuberosity Taken as internal circumference of the ring Add 2 inches in case of oedema (maintain 1 finger between the inner ring) Measure distance from crotch to heel , add 6- 9 inches Taken length of inner side bar (2.5” off the heel)

10. Complications Pressure sores Proximally , relieved by increasing the traction Distally , relieved by adequate padding and good nursing care