Thomas Splint, Calcaneus Fracture, and Compartment Syndrome of the Foot

Watson, Anthony D.; Kelikian, Armen S.

doi:10.1097/00005373-199801000-00031

Cited by 10 publications

(9 citation statements)

References 11 publications

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“…Frequently, these patients have suffered severe foot trauma, including crush injuries, calcaneal fractures, Lisfranc fracture-dislocations, and lower leg trauma. 3,4,7,8,11,17,18,19,20,23,[25][26][27][28][29][30][31][32]34,35,38,41 Elevated tissue pressure is the only truly accurate means of making a diagnosis as compartment syndrome usually occurs in the presence of concomitant injuries that often confuse subjective clinical findings. Multi-stick catheterization may itself present a challenge, as there are nine compartments in the foot, each of which carries the potential for development of compartment syndrome.…”

Section: Discussionmentioning

confidence: 99%

Review: Acute Compartment Syndrome of the Foot

2003

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Foot compartment syndrome is a serious potential complication of foot crush injury, fractures, surgery, and vascular injury. The purpose of this article is to summarize and review the existing literature on this entity. Long-term sequelae of foot compartment syndrome (FCS) include contractures, deformity, weakness, paralysis, and sensory neuropathy. These complications are poorly tolerated, and often necessitate multiple procedures for rehabilitation. Therefore, the threshold for considering compartment syndrome and performing fasciotomy must be low to minimize such outcomes. The existence of nine foot compartments and frequent presence of complicating injuries necessitate multi-stick needle catheterization for direct measurement of compartment pressures. Fasciotomy is indicated when compartment pressure exceeds 30 mmHg, or if compartment pressure is greater than 10-30 mmHg below diastolic pressure. The approaches for compartment decompression generally include two dorsal incisions for access to forefoot compartments, and one medial incision for decompression of the calcaneal, medial, superficial, and lateral compartments.

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Section: Discussionmentioning

confidence: 99%

Review: Acute Compartment Syndrome of the Foot

2003

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“…Other contraindicating injuries include pelvic or knee ligamentous injury, patella fracture or dislocation and tibia or fibula fracture (22). Contraindicated injuries were found to be present in two case studies that resulted in peroneal nerve damage and a third who developed compartment syndrome (20,21). Only one study reported there was no inappropriate or incorrect application of traction splints (23).…”

Section: Inappropriate Applicationmentioning

confidence: 99%

“…While vascular complications weren't further defined, compartment syndrome was reported separately in three papers. Of the three papers, with a total population of 786 patients (280 with traction splints, 406 without traction splints), four patients (1.43%) with traction splints developed compartment syndrome and five without traction splints (1.23%) (21,26,27). In the one study comparing traction splints and static splints, no significant difference was found (p=0.8) (26).…”

Section: Vascular Complicationsmentioning

confidence: 99%

Are you Pulling My Leg? Does the Use of Traction Splints in the Pre-Hospital Management of Patients with Femur Fractures Reduce the Complications Compared to Traditional Splinting?

Syme¹

2020

Australasian Journal of Paramedicine

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IntroductionFemoral shaft fractures are a serious but infrequently seen injury in the pre-hospital environment. Management of these fractures includes immobilisation, analgesia, fluid administration and appropriate conveyance. Despite traction splints being widely used since World War I, there has been no systematic review published to date. In order to support evidence-based practice this systematic review will attempt to determine if the use of traction splints in the pre-hospital management of patients with femoral shaft fractures reduces the complications compared to traditional splinting. MethodsA systematic review using the MEDLINE database (1946 to 27 August 2019) using a combination of keywords and medical subject headings. The reference lists of all relevant papers were reviewed to identify further papers. The title and abstracts of all records retrieved by the search strategy were reviewed by one independent author to identify potentially relevant papers. All potentially relevant papers were read in full text. ResultsA total of 42 papers were identified from the search strategy; 10 met the inclusion criteria and informed the results of this paper. Five key themes were identified: inappropriate application; on-scene times; effect on pain; vascular complications; and nerve complications.ConclusionTraction splints are frequently applied incorrectly but no statistical increase in on-scene times was found. A statistically significant decrease in the need for blood transfusions was demonstrated with the application of a traction splint.

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“…The prehospital use of the TS has come into question, in part due to several case reports showing iatrogenic effects of the TS, including compartment syndrome of the foot requiring fasciotomy and transient fibular nerve palsies. 5,6 The utility of the prehospital TS has come into question, also in part due to a low incidence, 0.35% of patients having a mid-thigh injury in a single, low-volume, urban EMS system. 7 Additional concern has been raised with regards to the proper application of the TS.…”

Section: Conflicts Of Interest: Nonementioning

confidence: 99%

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

Nackenson

Báez

Meizoso

2017

Prehosp. Disaster med.

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Although signs of femur fracture are recognized in the majority of cases of midshaft femur fracture, only 30% of patients were immobilized using a TS. Statistically significant differences were found in the utilization of a TS and IV analgesia administration in the setting of blunt trauma when compared to penetrating trauma. Nackenson J , Baez AA , Meizoso JP . A descriptive analysis of traction splint utilization and IV analgesia by Emergency Medical Services.Prehosp Disaster Med. 2017;32(6):631-635.

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Thomas Splint, Calcaneus Fracture, and Compartment Syndrome of the Foot

Cited by 10 publications

References 11 publications

Review: Acute Compartment Syndrome of the Foot

Review: Acute Compartment Syndrome of the Foot

Are you Pulling My Leg? Does the Use of Traction Splints in the Pre-Hospital Management of Patients with Femur Fractures Reduce the Complications Compared to Traditional Splinting?

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

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