Supracondylar fracture of the distal end of the femur
Patient Factors & Considerations
Assess distal neurovascular observations:
Pulse, Colour / Warmth / Movement / Sensation (CWMS)
Do not apply leg straps over knee as this will cause misalignment and pain.
Procedure is under the control of the person applying manual traction.
All relevant infection control methods to be utilised.
Explain the procedure to the patient.
Consider appropriate analgesia.
Expose the injured leg completely, examine leg, check for pedal pulses, motor and sensory function.
Apply manual inline traction.
Measure splint to the correct length by placing flat next to the patient’s uninjured leg.
Extend so that the patient’s heel is approximately 10cm above the heel stand bracket.
Dress open fractures and wounds.
Wrap the ankle harness around the patient’s ankle with additional padding and apply the velcro strapping.
Ensure traction is maintained by second person, adjust the ankle harness so the foot is central and the end of the traction strap is aligned with the malleoli.
Apply the splint under the injured leg up to the ischial fold.
Fasten the ischial strap.
Pull the traction release ring to loosen the ratchet strap, bring the S hook over the top of the splint and attach it to the D ring.
Turn the traction knob to replace manual traction. Ensure ankle harness is directly under the ankle and allow the ankle to rest on harness.
Reposition and fasten the leg straps ensuring they do not cover any section of the injury.
Transfer the patient onto the stretcher for transportation.
Ensure the splint is elevated by the heel stand.
Shortening the splint
Re-apply manual traction to the leg by holding on to the extension straps at the back of the ankle while using the other hand to release the traction ratchet.
Second officer is to loosen both locking collars in the anticlockwise direction simultaneously.
The person in control of the traction is to operate the ratchet by shortening the ratchet strap to about 75mm before the S hook, the telescopic tubes will shorten inward. Beware of obstacles in the way of the heel stand.
Re-tighten the locking collars simultaneously and check traction.