Femur Fracture Management | Your Guide to Traction Splints

If you've ever treated a femur fracture in the field, you know the challenge well: a patient in excruciating pain, rapid swelling, muscle spasms, and the very real risk of major bleeding into the thigh.

The femur is the largest bone in the body, surrounded by powerful muscles that contract when fractured. Patients instinctively grab their thighs, trying to splint and "auto-traction" their own legs to combat the relentless pain and spasms.

Thankfully in Australia, most of our ambulance services carry a traction splint. But not all traction splints are created equal, and understanding which splint works best in your environment helps you make informed decisions for your loadout. 

What is a Traction Splint? 

A traction splint is a medical device designed to stabilise a fractured femur while applying controlled tension to the leg. By providing external support and gentle stretching force, traction splints serve two critical functions: mechanical stabilisation of the fracture and therapeutic relief from muscle contraction.

How Traction Splints Work

When a femur fractures, surrounding muscles contract, creating a pain-spasm cycle. The more pain, the more spasm. The more spasm, the more pain. Meanwhile, broken bone ends can damage surrounding tissue and vessels, and blood pools rapidly in the thigh.

Traction splints help by:

• Stabilising the fracture site
• Stretching contracted musculature
• Reducing muscle spasm
• Minimising pain 
• Facilitate clot formation
• Reducing haemorrhage into the thigh

Types of Traction Splints

Traction splints have evolved significantly since their introduction in the 1800s. Understanding the different types helps explain why modern designs like the Slishman represent such a huge advancement.

Traditional Bipole Designs

Thomas Splint (1800s)
The original traction splint - steel construction with a ring that sits against the hip, extending well past the foot. Multiple midleg straps create a cradle for the injured limb. Heavy, bulky, and difficult to apply in the field, but it established the fundamental concept of femoral traction.

Hare Traction Splint
An evolution of the Thomas with improved padding on the proximal crossbar and some length adjustment capability. Uses a ratchet mechanism distal to the foot for traction delivery. Requires separate paediatric and adult sizes.

Donway Traction Splint
Combines features of the Hare and Sager with pneumatic traction delivery. Uses a pressure gauge to infer traction force. Popular in the UK, Australia, and New Zealand.

Unipole Designs

Sager Traction Splint
The first major innovation - removed the painful proximal crossbar and introduced quantifiable dynamic traction with a tension gauge. This design taught the medical community that 4.5-7kg of traction is typically sufficient (more is often excessive). Also offers bilateral traction capability.

Compact Lateral Monopole Designs

Kendrick Traction Device (KTD)
A major design leap that demonstrated femoral traction could come from a compact package. Uses tent-pole-style folding aluminium construction with adjustable length defined by groin strap placement. The first true "one size fits all" splint, eliminating the need for separate paediatric versions.

CT-6 and CT-7
Evolution of the KTD manufactured by Faretec using carbon fibre instead of aluminium. Midleg straps attach to the lateral monopole (reducing confusion and loss). The CT-6 uses a pulley system offering more mechanical advantage; the CT-7 uses an ACME screw mechanism to limit extension past the foot.

Slishman Traction Splint (STS)
The latest evolution in the lateral monopole category and a game-changing traction splint. The revolutionary change is proximal traction delivery from the hip rather than distal traction from the ankle. This eliminates extension past the foot entirely.

Why We Stock The Slishman

Every traditional traction splint - from the Thomas to the Sager to the Kendrick - shared a fundamental limitation: they delivered traction distally, requiring splint extension beyond the patient's foot.

This created real operational problems: it's near impossible to navigate confined spaces, constant "door strikes" during transport, caregivers forced to position at the foot, and multiple other contraindications depending on design.

These weren't just inconveniences. They were barriers that complicated patient care when speed and efficiency mattered most.

We stock equipment that solves real problems for first responders operating in challenging environments. The Slishman Traction Splint represents genuine innovation - not just incremental improvement, but fundamental redesign that makes treating femur fractures faster, easier, and more effective.

This innovative design solved multiple problems:

1. No Extension Past the Foot. The splint ends at the patient's foot, making transport in confined spaces actually manageable. Whether you're loading into a helicopter, navigating a litter through tight terrain, or extricating from a vehicle, the Slishman doesn't catch on doors, equipment, or surrounding structures.

2. Proximal Traction Delivery. Using a pull cord at the patient's hip rather than a mechanism at the ankle means fast application, easy adjustment, ad allows the patient to adjust their own traction for comfort.

3. True One-Size-Fits-All. Single telescoping lateral monopole adjusts to fit any patient - paediatric to adult. No need to carry multiple sizes or guess which one you'll need. 

4. Splint First, Traction Second. The Slishman's rigid aluminium construction provides excellent stabilisation even before traction is applied. 

5. No Contraindications. Because it's designed as a splint first that just happens to offer traction, the Slishman can be used in scenarios where traditional traction splints are contraindicated:

• Suspected proximal femur fractures
• Suspected knee fractures
• Concurrent pelvic fractures
• Concurrent foot injuries
• Open fractures (with care not to pull debris into the wound)

The Three Slishman Models

STS Original
Single midleg strap, thumb screws to lock telescoping poles in position, pull cord traction system at the hip.

STS-C
Spring button locking mechanism (faster deployment than thumb screws), Slishman Pressure Wrap instead of midleg strap (encircles feet for rotational stability, eliminates need to lift injured limb during application), V-cleat lock for traction cord.

STS-Gen2
Similar to STS-C with updated materials and design refinements based on field feedback.

All three models share the core innovation: proximal traction delivery, no extension past the foot, and rapid application in under one minute.

Application in Under One Minute

Summary

Traction splints have evolved significantly since the 1800s, but every design until the Slishman shared the same limitation: they extended past the patient's foot, complicating transport and limiting where they could be used effectively.

The Slishman's innovation - moving traction delivery from the ankle to the hip - solved this problem. No extension past the foot, rapid application, patient-adjustable traction, and no contraindications. That's why is one of our most trusted bits of kit year on year.

Stay safe,

Team TacMed.

Note: Always follow current ANZCOR guidelines and seek immediate emergency medical care in any trauma situation. The information in this blog supplements but does not replace proper first aid training.

FAQs

When should I use the Slishman Traction Splint?
Any suspected mid-shaft femur fracture. If a patient says "I think I broke my leg" and the mechanism suggests femur involvement, apply the splint. The Slishman has no absolute contraindications, so you can use it even with suspected proximal femur fractures, pelvic fractures, or concurrent lower limb injuries.

How much traction should I apply?
Typically 4.5-7 kg is sufficient. Apply traction until the patient reports relief - they'll tell you when it feels right. More isn't better; excessive traction can cause additional pain.

Which Slishman model should I choose?
Contact our customer service team for help choosing the right model for your environment and capability. Email info@tacmedaustralia.com.au or call 1300 862 633.

Can patients really adjust their own traction?
Yes. Because traction is delivered from the hip via a pull cord, patients can reach down and adjust tension themselves throughout transport. This is a major advantage during extended evacuations.

How long does application take?
Under one minute once you're familiar with the device. 

Will it fit in my response kit?
The STS-C packs down to 30cm x 8cm x 8cm and weighs 415g. It fits easily in flight kits, rescue packs, and vehicle trauma bags where space is limited.

Can I leave it on through X-ray?
Yes. The Slishman is relatively radiolucent and can stay on through the emergency department, radiology, and all the way to the operating theatre or floor bed.

References:

Slishman, S. & Rescue Essentials. (2025, September 15). Traction Splint Comparison | Types and Uses in Femoral Traction. Rescue Essentials Blog. Retrieved from https://rescue-essentials.com/rescue-essentials-blog/traction-splint-comparison-types-and-uses-in-femoral-traction/

Studer NM, Grubb SM, Horn GT, Danielson PD. Evaluation of commercially available traction splints for battlefield use. J Spec Oper Med. 2014 Summer;14(2):46-55. doi: 10.55460/074X-GZAQ. PMID: 24952040. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24952040/

Rescue Essentials. Femoral Traction: Evolution, Engineering, and Systems. Rescue Essentials. Retrieved from https://rescue-essentials.com/femoral-traction-evolution-engineering-and-systems/

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