You have been called to the local horse stables to a 22 y/o who was kicked by a

Question

You have been called to the local horse stables to a 22 y/o who was kicked by a horse. After examination you notice that the patient is in significant pain, with obvious deformity to their right upper thigh. You suspect that the patient has a broken femur and determine the need to apply the femoral traction device.

Question:

a) Why are fractured femurs treated differently to any other limb fracture?

b) If this pt had bilateral fractured femurs, how would you size up the traction splint and how would you know when enough traction has been applied?

Explanation / Answer

a) As femurs (thigh bones) are the strongest and longest bones present in the human body and only a high impact collision such as car accidents(in this case, a horse kick) is required break them. When broken, it causes a visible deformity in the leg (shorter and deformed appearance of the leg when compared to the other normal leg)along with severe pain and hence, femur fractures are usually treated differently and with special care as many complications including haemorrhage can be associated. Femoral traction device is a kind of pulley that gives support to the broken bones and keep them aligned as best as possible to maintain the length or minimize the deformity of the injured leg and to reduce the pain.

b)In the case of bilateral femural fractures (both left and right), the ischial cap of the splint should align with the iliac crest of the femur and the ankle hitch end should be 15 cm beyond the bottom of te patient foot.

Traction should be applied till the patients' pain decines and he feels comfortable,

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