Page 30 - Orthopedic Casts and Splints2

Performance Steps
c. Inspect both legs for any skin conditions(e.g. cuts, abrasions, laceration, or rashes).
NOTE: Inform nurse if skin conditions are present before continuing.
d. Pad medial/lateral malleolus(ankle) of the injured leg.
NOTE. Webril or felt may be used. Padding is used to reduce any chafing that may occur while the
patient's leg is in balanced suspension traction .

9. Check patient's capillary refill.
a. Squeeze patient's toes and nail beds will turn white .
b. Release patient's toes and nail beds will return pink .
CAUTION: If capillary refill is delayed for more than 2 seconds inform physician and follow physician's
order

10. Secure (1) cross clamp to the center of each vertically placed double clamp bar at the foot of the
bed.

11. Secure single plain bar to cross clamps at foot of bed.
a. Place one end of the plain bar in the clamp bar holder, adjust the bar and lock clamp.
CAUTION: The ridges of the bar and clamps must be in alignment to prevent the traction frame from
coming apart and putting the patient at risk.
b. Place opposite end of plain bar into clamp bar holder and lock clamp.

12. Secure (2) single clamp bars horizontally to the plain bar at the foot of bed.
13. Secure (2) pulley attachments to the single clamp bars at the foot of bed.

14. Secure 18 inch single clamp bar to long plain bar proximal to the injured hip.
15. Secure pulley to 18 inch single clamp bar above the hip.

16. Secure 18 inch single clamp bar distal to the injured foot .
17. Secure pulley to the 18 inch single clamp bar above the phalanges( toes).

18. Secure 5 or 9 inch single clamp bar to the lower crossbar at the foot of the bed aligned with the
injured leg's 2 and 3rd phalanges.

19. Secure pulley to single clamp bar at foot of bed.
20. Prepare Thomas Leg Splint with Pearson attachment.
a. Place Thomas Leg Splint to the side of the uninjured leg to determine splint length needed.
NOTE: All measurements are taken on the uninjured side.

NOTE: The Thomas Leg Splint is available in small, medium, and large.
NOTE: There should be at least a 6 inch distance between the patient's foot and the edge of the
Thomas Leg splint.
b. Secure the Pearson attachment under the Traction Leg Splint aligned with the bend of the
patient's knee and lock in place.
CAUTION: The alignment of the Pearson attachment reduces pressure on the fracture site.
c. Tie one end of the traction cord to the proximal strap clamp on the lateral side of the Thomas
Leg Splint.
d. Loop the traction cord around the strap clamp on the opposite side of the Thomas Leg Splint
and secure with a double knot.
e. Tie one end of the traction cord to the strap clamp at the distal end of the Pearson
attachment.
NOTE: It is the technician's preference to start medial or lateral.
f. Wrap the traction cord around the strap clamp at the distal end of the Thomas Leg Splint.
g. Measure the traction cord length at 12- 18 inches.

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