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Take care when using a traditional fracture splint

By Vision Reporter

Added 13th September 2009 03:00 AM

TRADITIONAL broken bone (fracture) splints are locally made pieces of wood knitted together with either pieces of clothes, banana fibres, or sisal to form a rigid framework that can be used to splint (immobilise) broken limbs.

By Dr. Michael Kisige

TRADITIONAL broken bone (fracture) splints are locally made pieces of wood knitted together with either pieces of clothes, banana fibres, or sisal to form a rigid framework that can be used to splint (immobilise) broken limbs.

With the increasing number of physical motor accidents and people falling off heights, like mango trees, tall buildings under construction and overloaded lorries, victims sustain broken bones of either the upper or lower limbs.

Since there are no ambulances in local communities, people resort to making simple wooden splints to support the injured limb which facilitates healing.

The locally made wooden splints existed long before the British bone-setter, Hugh Owen Thomas (1834- 1891), invented the famous hospital Thomas’ splints.

In Buganda, traditional wooden sticks (Obuuti) or reeds and banana fibres or cloth were used to make splints.
In northern Uganda, bamboo sticks (kor in Luo) with pieces of cloth or fibres from the back of trees are used for splints.

The knitted splint or sticks are organised well round the injured limb and strapped by the pieces of cloths, sisal or banana fibres.

Ideally, preventing mobility on the broken bone entails splinting the joint above and below the injured site, such that no movement is possible at the joints adjacent to the broken bone site.

During splintage (immobilisation), the pressure exerted through the skin must be adequate enough to stop excessive movement of broken bones during transportation or muscle contractions.

It should not compromise blood supply to the distal part of the injured limb.
There should be adequate padding between the skin and the splint using cotton wool, cloths or any cushioning material to minimise pressure to the skin that can cause blisters.

Some people have used the normal limb to splint the injured one especially for lower limb fractures.

Blood flow to the fractured limb is keenly observed to ensure a proper flow to its distal region which could be the hand or foot.

However, splints do not adequately stop mobility at the two joints close to each other, to allow the fracture ends to move freely.

This causes further injury to soft tissues. At this point, the bone ends may pierce and protrude through the skin in a lot of pain. It may even pierce blood vessels causing severe bleeding or loss of the limb.

Bone exposure could contaminate the flesh with soil or grass which predisposes the patient to tetanus or other bacterial infections.

In such a case, the patient should be taken to a health unit as soon as possible for medical attention.

Tight wrapping of the fracture site may interrupt blood flow to the hands, paralysing them. A patient’s arms or legs could be amputated.

Sometimes, a tight splint causes pain making people think it is arising from the broken bone.

If the splint has become too tight, or has stayed on the limb for more than two hours, relax the inelastic straps and take the patient to a health centre.

Ensure that wooden splints do not have spikes or thorns which can pierce the skin causing puncher wounds or sores.

Pad the skin with cotton cloth and use smooth round or rectangular pieces of wood that are long enough to immobilise the joint above and below the broken bone site.

Traditional splints reduce pain at the fracture site as there are no movements between broken bone fragments.

However, once applied to the injured limb it is advisable to seek medical attention two hours after its application. This is to avoid complications developing on the limb that could lead to amputation.                                                                                                                    

The writer is an orthopaedic surgeon, Gulu Regional Referral Hospital

Take care when using a traditional fracture splint

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