Sager® Emergency Traction Splints and the Minto Fracture Kit
21
Step 1
Position
With the splint fully collapsed and the
calibrated Pulley Wheel facing up, position
the Sager®
S
300
between the patient’s
legs resting the Ischial Perineal Cushion
(the saddle) against the ischial tuberosity. In
the case of a unilateral fracture, the splint
should be placed in the perineum on the side
of the injury. In bilateral fractures –
excluding pelvic trauma – the side with the
greatest degree of injury should be the side
of placement. Apply the Abductor Bridle
(thigh strap) around the upper thigh of the
fractured limb. Tighten the strap snugly. Lift
the Spring Clip to extend the inner shaft
until the Pulley Wheel extends just beyond
the heel. Note that the splint will still
perform if an infant is so small that the
Wheel extends further.
Step 2
Set
Note the absence or presence of distal
pulses, check for sensation. Position the
Malleolar Harnesses (ankle harnesses)
beneath the heels and just above the ankles.
Fold down the number of Comfort Cushions
needed to engage all of the ankle above
the medial and lateral malleoli. Using the
attached Hook and Loop Straps, wrap the
ankle harnessaround the ankle to secure
snugly.
Note:
On very small children with
mobile ankles, it is often necessary to
apply tape over the ankle harness and to
the skin of the heels to prevent slippage of
the harnesses.
Pull the Control Tabs to
engage the ankle harness against the Pulley
Wheel. This will ensure that the Cable Rings
are pulled snugly against the soles of the
feet. Apply
Quantifiable Dynamic Traction™
.
With one hand holding the Outer Shaft,
gently extend the Inner Shaft of the splint
by pulling it out until the desired amount of
traction is recorded on the calibrated Pulley
Wheel. It is suggested to use 10% of the
patient’s body weight per fractured femur up
to 3
1
⁄
2
kg (7
1
⁄
2
pounds) for each leg. If bilateral
fractures are present, the maximum amount
would be 7kg (15 pounds), or as directed by
the pediatric traumatologist. At the hollow
of the knees, gently slide the large elastic Leg
Cravat through and upwards to the thigh,
repeating with the smaller Cravats to
minimize lower and mid-limb movement.
Note:
On small infants, one or both of
the smaller Cravats may be sufficient for
secure immobilization.
Step 3
Secure
Adjust the Abductor Bridle (thigh strap)
at the upper thigh making sure it is not too
tight, but snug and secure, then firmly
secure the elastic Leg Cravats. Apply the
Pedal Pinion (figure 8 strap) around the
feet to prevent distal rotation. Note the
absence or presence of distal pulses, check
for sensation. Patient is now ready for
transport. Warning: All operators should
receive full and proper initial/refresher
instruction sessions from a qualified person
on detailed use of this equipment and
regarding the particular situations in which
it should be used.
Training application sheet #5:
Sager® Model S300 – Infant Bilateral.
Size guidelines
The multi-patented Form III Series will fit patients ranging from a
four-year-old to an adult well over 2m (7 feet) in height. With the
Sager’s unique design the patient’s weight is not a problem in
application. For infants and children, the multi-patented Infant
Bilateral Emergency Traction Splint will fit patients ranging in
size from an infant to children six (6) years of age.
Childhood fractures are serious injuries
The greatest incidence of femoral fractures in children occur around
the age of three (3). Two-thirds of all femoral fractures and the
most frequent fractures occur in the middle shaft of the femur
1
.
In North America, fractures of the femoral shaft are common in
childhood and are serious injuries. Extensive soft tissue damage
occurs and blood loss of 500ml, or up to 20% of blood volume,
is common. Usually the distal fragments are laterally rotated
with variable amounts of overriding
2
.
Clinically, pain, deformity, swelling at the fracture site, shortening
of the limb and external rotation occurs. Application of traction
splinting aligns the fragments,
restores near normal tissue
pressure in the limb, reducing
further blood loss and tissue injury,
and decreasing pain. Early
traction may minimize blood
loss and reduce transfusions
and possible complications.
Reference:
1
Reisdorff, E. J., MD, FACEP, Roberts,
M.R., MD, FACEP, J.G. Wiegenstein, MD, Pediatric Emergency Medicine,
W. B. Saunders Company, 1993, pgs: 961-969
2
Rockwood, C.A. Jr., MD, Wilkins, K.E., MD, R.E. King, MD,
Fractures in Children, J.B. Lippincott Company, 1991, 1129-1132
Easy application
