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Thomas Splint

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Edited by Grace Xiong, Harry Lightsey, Brendan Striano, Mike Gustin, Ophelie Lavoie-Gagne - 7/1/2021

Indications:

Femoral shaft fractures

Materials:

Correct laterality Thomas splint (make sure the "high" side is sitting lateral and not in the crotch!)
Tensoplast kit (contains tensoplast and ace wrap)
Hockey tape
5+ tongue depressors

splint-thomassplint_supplies

Preparation

Create a sturdy stick with your tongue depressors and hockey tape.

Telescope the end of the thomas splint so that it is longer.

splint-thomassplint_tonguetaped

Positioning:

Supine with an assistant available to help raise the leg for patient comfort.

Place splint:

Slide the Thomas splint under the leg so that it rests in the groin.

Remember that the "low" side should be in the crotch and the "high" side on the lateral side of the hip!

splint-thomassplint_placement

Tensoplast:

Unwrap the tensoplast and place on the patient. The white rope should be facing down and be at the patient heel.

splint-thomassplint_heel

Adhere the tensoplast directly to patient skin and overwrap with the provided ace wrap.

splint-thomassplint_tensoplast splint-thomassplint_wrapped

Tensioning

Pull the tensoplast taut over the end of the thomas splint and tie to secure.

splint-thomassplint_pulling

Insert the tongue depressors between the ropes and twist to lengthen the limb.

splint-thomassplint_depressorplacement

splint-thomassplint_twist

Secure the tongue depressors in place with hockey tape.

splint-thomassplint_initialtape

splint-thomassplint_finaltape

Potential complications:
Grabbing the wrong-sided splint can put the "high" side into the crotch - pay attention to which one you grab!

Be sure the move the scrotum, foley, and any other sensitive areas out of the way of the splint.

Tips for efficiency: Have all supplies ready at the start.