THE USE AND ABUSE OF THE ANATOMIC SPLINT IN THE TREATMENT OF FRACTURES OF THE LOWER EXTREMITY

¹ Surgical Service of the United States Naval Hospital, National Naval Medical Center, Bethesda, Maryland

It is felt that the anatomic splint is not a panacea, but that it is an important addition to the armamentarium of fracture equipment. Its advantages have been enumerated by Bradford and Wilson, and by its originator. Its particular forte in military surgery is that it enables the patients to get out of bed almost at once, allows them to be evacuated readily, maintains length and position where there is loss of bone substance, and permits wounds to be dressed without disturbing the fracture.

The anatomic splint is not a complicated machine, and its use can be readily mastered by one trained in the mechanics of any of the numerous mechanical-reduction units. The new interchangeable units which have been recently introduced by Anderson to replace the rigid half-pin units simplify its use still further. The latitude which they allow in the placement of the pins, and the ease with which fixation can be obtained with the new clamps and rods is a considerable improvement over the old half-pin units. The author believes it marks an advance in technique which will render the Anderson method still more adaptable in the treatment of high, oblique fractures of the femoral shaft. These new pins also offer a simpler means of controlling a loose third fragment, which has always been such a difficult problem. However, it is necessary to learn to use this splint correctly. One cannot be in a hurry.

Asepsis must be maintained. The anatomic splint is, therefore, not a device which can be properly used in first-aid or battle-dressing stations, or in casualty-clearing stations close to the line of battle. Nor can it be safely employed by one not experienced in the treatment of fractures.

The importance of not distracting the fragments by overextension cannot be overemphasized. The author has been able to obtain knee motion of about 25 degrees at once with this splint, but has not been able to obtain any marked increase of knee motion until the pins have been removed. There is usually some pain and a little discharge about the pins, but this does not mean infection.

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