# Thomas Splint Application

## Overview

This module describes how to apply a Thomas splint to immobilise a suspected fractured femur prior to diagnostic imaging, and to reduce pain, blood loss, and the risk of fat embolism and pulmonary complications.

## Indications

## Contraindications

## Patient information and consent

Always verify your patient’s identity and obtain informed consent before proceeding.

### How do I explain this procedure?

“I suspect you have broken your thigh bone. I’m going to straighten your leg and apply a special splint until I can get an X-ray of your leg to confirm the diagnosis. Having the splint on may seem uncomfortable, but because it reduces movement of the broken bone, it will actually reduce your pain and prevent the broken fragments from damaging surrounding tissue.”

### What can my patient expect?

“I’m going to wrap your leg in a bandage, place it in a metal splint, and apply traction to the end of the splint to slightly separate the ends of your broken thigh bone, preventing them from rubbing against each other. This is usually uncomfortable but you will feel much better once the splint is on.”

### What is my patient’s role?

“Let me know if it becomes too painful. Try not to move around too much while we put on the splint.”

## Preparation

An assistant is needed for this procedure.

### Documentation

### Equipment

## Site & Positioning

The patient should be supine. The affected leg will usually tend to be shortened and externally rotated. Applying a Thomas splint will help to internally rotate the affected leg to a neutral position.

## Procedure

Follow medical asepsis without gloves.

## Troubleshooting

The patient is complaining of pain in the gluteal area.

This may be more uncomfortable for the patient than a well-reduced fracture itself. Augment the padding on the ring and try to position the patient more comfortably with pillows. Ensure the patient has adequate analgesia. Check that the scrotal and labial tissues have not been impinged.

## Risks

## References