Significant Rate of Misuse of the Hare Traction Splint for Children with Femoral Shaft Fractures

A Descriptive Analysis of Traction Splint Utilization and IV Analgesia by Emergency Medical Services

“…The data revealed that the TS was only utilized in 30.0% of the instances it was indicated. This finding is similar to a pediatric study in which 28.0% of the cases utilized a TS 9 . It was unexpected to see such a tremendous propensity away from splinting with the TS in penetrating trauma, with only a single TS use in the penetrating trauma group and an odds ratio of TS utilization of 20.81 comparing blunt to penetrating trauma.…”

“…When the data were analyzed excluding penetrating trauma patients, the difference was no longer statistically significant with deformity seen in 92.0% of TS patients and 86.0% of non-TS patients, with a P value of .2971 (Table 3; Figure 1). Pedestrian, n (%) 13 (10) 2 (4) 11 (9) .232…”

“…This finding is similar to a pediatric study in which 28.0% of the cases utilized a TS. 9 It was unexpected to see such a tremendous propensity away from splinting with the TS in penetrating trauma, with only a single TS use in the penetrating trauma group and an odds ratio of TS utilization of 20.81 comparing blunt to penetrating trauma. This finding is particularly interesting in the historical context of the TS used to treat ballistic injuries on the battlefield.…”

“…8 In a pediatric study including over 100 TS applications, 66.0% were improperly positioned. 9 Despite the evidence that questions the utility of a TS, there have also been positive prehospital studies showing greater reduction in pain compared to simple splints and even a reduced requirement for blood transfusions. 10,11 From the pediatric literature, it appears that the TS is underutilized by EMS, with 72.0% of patients with femur fractures arriving at the emergency department without a TS placed.…”

“…In one cohort of 40 cases, 38.0% were found to have injuries that would complicate or contraindicate the placement of a TS 8 . In a pediatric study including over 100 TS applications, 66.0% were improperly positioned 9 . Despite the evidence that questions the utility of a TS, there have also been positive prehospital studies showing greater reduction in pain compared to simple splints and even a reduced requirement for blood transfusions 10 …”