The application of a Thomas splint when managing a femoral fracture has the potential to be a painful experience for the patient. If movement of the injured limb can be reduced during the application then the patient will likely suffer less pain. In this report, we describe a method that enables the clinician to remove any slack in the tensioning system and apply the traction in a single movement. No additional equipment is required beyond the standard splint and skin traction apparatus. A pulley system is created using the cord, the splint and two overhand knots, minimising movement at the injury site whilst permitting sufficient traction to be applied. Once applied, it can be easily re-tensioned as the thigh musculature relaxes. We believe this method to be simple, more adaptable and quicker to apply than the current standard.
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