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Thomas Splint All That We Need To Know

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By Admin

Salient features:-

  • Designed by Hugh Owen Thomas (Father of British Orthopaedics) & first used for his wife, affected with TB knee (1876).

Parts:-

AB- well padded circular oval ring. Attached to two bars on either side which exactly dissect the ring , making it universal (can be used for both left and right side). In case of swollen or injured limb the circumference of the ring is calculated by adding 5cm (2”) to the oblique circumference of the opposite side normal limb measuring from crotch (root of the thigh) and going along the inguinal ligament,gluteal fold and ischial tuberosity.

C- about 5 cm (2”) below the level of the ring to adopt greater trochanter prominence.

BCD- Lateral or Outer bar.

AE- Medial/Inner bar. Attached to the ring at an angle 120 degree ( angle BAE). Lengh of inner bar is calculated by adding 20cm (6-9”) to crotch (root of the thigh) to heel distance.

EFD- W-shaped groove for tying traction cord for providing fixed traction.

Preparation:-

U-shaped bandage layers applied, then Gamjee/ Cotton roll, again covered with single layer of bandage. Adhesive leucoplast can be applied. Finally 6” crape bandage can be wrapped around the thigh to prevent side to side movement of the leg. Distal 5 cm of leg (distal 25 cm of Thomas splint) should be uncovered to prevent pressure sore over heel and tendo achilles. The patient should be encouraged for regular physiotherapy to prevent sore, stiffness and deformity. Portable xray can be done biweekly for first 2 wks and wkly for next 2 wks.

Use:-

  1. Fixed traction unit- counter traction is provided by the proximal body part (proximal to the attachments of muscle in spasm) by getting purchase through the thomas’s ring. It is used to maintain the reduction.
  2. Sliding traction unit (Buck’s Traction)- counter traction is provided by gravity by hanging weights over a pulley. It is used to both obtain and maintain reduction. To prevent sliding of body due to application of weight, foot end is elevated about 1” for 1 pound.

Modifications:-

  1. Tobruk splint- plaster cast (groin to toe) over Thomas Splint with ankle in neutral.
  2. Fisk Splint- Thomas splint with Pierson’s attachment for knee mobilization (hinge joint).