Prehospital Traction Splint Use in Midthigh Trauma Patients

Context: Traction splint (TS) use during emergency medical system transport has been theorized to relieve pain, limit continued injury from loose bone fragments, and decrease potential bleeding space in the injured thigh. Aims: This study aimed to evaluate the benefit of prehospital TS (PTS) application, using data from the trauma registry at a large Level 1 trauma center. Methods: A retrospective review of patients from the NTRACS (c) and Trauma One (c) registry at an American College of Surgeons-verified Level 1 trauma center was conducted. All patients treated between the years 2001 and 2011 who were assigned a diagnosis International Classification of Diseases-9 code of 821.01 (closed fracture of shaft and femur) and 821.11 (open fracture of shaft and femur) (femur fracture [FF]) were included. Statistical Analysis: All categorical variables between the first groups were compared using Pearson's Chi-square and Fisher's exact test analysis. Comparisons were made using unpaired t-tests and Mann-Whitney test or Kruskal-Wallis one-way ANOVA, followed by Dunn's post hoc pairwise comparisons. Results: Patients with a TS and those without indicated that the patients with no traction split (NTS) had sustained injuries beyond a FF ( 14.43 +/- 9.740 vs. 18.59 +/- 12.993, P < 0.001). The three groups of TS placement (PTS, hospital, and NTS) only used patients with Injury Severity Score < 9 (n = 218). Hospital length of stay (LOS) was found to be significant (P = 0.05) between the patients who received a hospital TS (3.10 +/- 1.709) and NTS (5.42 +/- 5.144). Conclusion: PTS can lower LOS and mortality. Further research is needed to confirm these findings.