Femoral Traction Splints in Mountain Rescue Prehospital Care: To Use or Not to Use? In this case, the risks associated with using a traction splint, As with any other tools we utilize on the job, training is of utmost importance to ensure. Popular anti-shock pants can be quickly and easily applied over the KTD. Initial radiographs or CT are commonly performed prior to the removal of the splint. application. 2. Results: The use of the traction splint for a femur fracture in the pre-intervention stage was found to be underutilised (Median 16%). "Good judgement comes from experience. Hyman G. Rickover. ADVERTISEMENT: Supporters see fewer/no ads. Secure and check support straps. Currently, four traction splints that have been awarded NATO Stock Numbers are in use: the CT-6 Leg Splint, the Kendrick Traction Device (KTD), the REEL Splint (RS), and the Slishman Traction Splint (STS). Skin traction is to be Reapplied Daily, to allow for Skin inspection & Ensuring its re- applied & maintains its traction (ensuring no slippage has occurred in the bandaging). Traction splints come in many different variations, each with its own unique methods of application and operation. Traction splints may also be used in ankle and knee injuries. Length adjustments can be made by loosening the knurled sleeves on each side of the tubular aluminum frame. Some calls may have resources available to place a splint while other interventions are being done for a patient that will see a long transport. SAGER FORM III Traction Splints S300 $482.95 -$681.95. Suitable for use on adults or children - adjustable traction pole. There are several different types of commercially made traction splints available. Lock the ankle attachment. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Botz B, Murphy A, Traction splint. One person application in under 2 minutes. -Household 6. There are many commercial brands available which vary slightly in their design and instructions and thus require individual familiarity for correct use. Call Toll-Free : 866.388.4599 Carrying the full line of Kendrick EMS products. Kendrick ORGKTD Traction Device, Colored Medi X Choice Opens in a new window or tab Pre-Owned C $122.49 or Best Offer from United States Sponsored Kendrick Boot Hitch Traction Device Leg Splint **NEW** Military Grade Black Opens in a new window or tab Brand New C $187.77 Top Rated SellerTop Rated Seller Buy It Now from United States Sponsored : IFA-EDT367940. Kendrick Traction Device Replacement Parts - Replacement Elastic Strap Ankle, Green - Model KE-805 . A femur you are going to give up to 15# of traction (because we have precise ability to measure ). It also can be adjusted to treat both adult and paediatric patients. You are using an out of date browser. This is for "Replacement Elastic Strap Ankle, Green" only. Apply the traction splint Rescuer #1 slides the traction splint under the patients injured leg, as rescuer #2 elevates the leg and continues manual traction via the ankle hitch. It is during this war that the Thomas traction splint created its lasting legacy, reportedly reducing mortality from military femoral fractures from 80% to 15.6% by 1918 (13). Who gets a traction splint? (half-ring, Hare, Sager, etc). Traction Splint, Slishman $ 250.00 Buy Now Slishman Traction Splint (STS) The innovative STS design has the traction mechanism positioned at the patient's hip. Position any leg support straps as directed (eg, 2 above the knee and 2 below). 6- 28 TRACTION SPLINTING NOTE: A traction splint is the splint of choice and is to be used only for a painful, swollen, deformed mid-thigh injury with NO lower leg injury. "It ain't what you don't know that gets you into trouble. Splints: Brand: Kendrick: Feature: Size Adjustable, Single Person Use: Use: Nurse Assistance: Body Part Application: Limbs: Suitable For: Adults, Paediatric Patients: Faqs. Campagne, D., Cagle, K., Castaneda, J., Weichenthal, L., Young, M., Anastopoulos, P., & Spano, S. (2020). Carefully tighten ratchet to the point that splint holds adequate traction. But wouldn't removal of the boot be necessary for assesment of PMS? Kendrick Traction Device Replacement Parts - Replacement Elastic Strap Ankle, Green - Model KE-805. There have been documented cases of nerve palsies due to the amount of force required and the placement of straps/tethers/anchors with contraindicating injuries (Campagne et al., 2020). . It's what you know for sure that just ain't so." Can be used on all ages: adults, children and pediatric. The Curaplex Traction Splint effectively realigns a fractured femur to proper position, reducing pain, restoring profusion and inhibiting vascular, nerve, bone and muscle damage. Traction splint is very helpful when in pre-hospital. "It is necessary for you to learn from others' mistakes. The orginial traction splint, Kendrick - KTD, (Kendrick EMS) is without a doubt, the best traction splint on the market. From my experience pulling traction gives almost instant relief. I would rather do that than try and wrestle a cold boot off on the hill. Depending on the material of the splint it can be between well visualized to relatively radiolucent/low density in imaging. It takes up little space in vehicles or aircraft and can easily be strapped to jump bags and backpacks. Enter your email & get special weekly discounts, Kendrick Traction Device Replacement Parts - Replacement Elastic Strap Thigh, Red - Model KE-803, Kendrick Traction Device Replacement Parts - Replacement Upper Thigh System, Street Orange, Kendrick Traction Device Replacement Parts - Ankle Hitch, Street Orange - Model KE-806, Each, Kendrick Traction Device Replacement Parts - Replacement Bag, Street Orange - Model KE-809, Each, Kendrick Traction Device Replacement Parts - Pole Assembly, Gold - Model KE-807, Each, Kendrick Traction Device Replacement Parts - Replacement Pole Assembly, Black - Model KE-817, Each. First, a traction splint stretches out the powerful muscles of the thigh (and the surrounding fascia), which compresses blood vessels embedded in the muscles and holds the bone ends in place. Developed over 30 years ago, the Hare Traction Splint is the original traction splinting appliance.-n o o 9. Assess distal neurovascular function. Kendrick Traction Device. The Kendrick Traction Device (KTD) is a lightweight splint used in a pre-hospital environment to restore anatomical alignment to the leg. The #EM3 team demonstrates the steps required to apply the Kendrick traction device (KTD) for immobilising femur fractures, along with additional advice for . There is still a wide variety in use today as more compact and easier to use products continue to roll out. Attach the strap to the thigh. I was always taught to check pulses before and after splinting. Unlike other traction devices, the Kendrick KTD allows the ability to work around any hip or groin trauma. Second, it prevents the broken bone ends from driving further into the surrounding soft tissue, which helps ease the pain. Traction splints are most typically used to treat severe mid-shaft fractures of the femur but also fractures of other limbs. This all sounds great, what does the evidence say? I can imagine, also, that ski patrol is one area where one might be more likely to see bilateral femur fxs as compared to other settings, and the Sager would definitely come in handy in those situations, although rare I'm sure. Yes, we see midshaft, lower 3rd, and upper 3rd on a regular basis, we had one today "I like my coffee black, my cigarettes unfiltered, and my 68Ws trained for combat." However, little standardization of equipment and training exists within the United States Armed Forces. BELT LINE OR PELVIC CREST . Apply traction by extending the splint to 10% of the patient's body weight. https://www.galls.com/dyna-med-hare-traction-splint, http://www.ferno.com.au/products/emergency-and-rescue/immobilisation/traction-splints/kendrick-traction-device-%28ktd%29, https://doi.org/10.1016/j.wem.2015.01.006, https://www.armstrongmedical.com/products/sager-form-iii-splints/, https://www.emsstuff.com/slishman-traction-splint/, Hare Traction Splint. Filters. Quick view Choose Options. . Includes: * Carrying case * 4 leg straps . Weighs less than. The diaphysis of the femur has a normal anatomic alignment that is 5 to 7 degrees from the physiologic axis of the femur, which can be drawn from the center of the femoral head to the center of the knee. Hare Traction Splint-An industry standard in traction splinting. In my mind, this is a bit too simplistic. The human femur takes an enormous amount of force to break and is, therefore, an injury often associated with some of the higher acuity patients seen in emergency medicine. *Estimated delivery dates - opens in a new window or tab include seller's handling time, origin ZIP Code, destination ZIP Code and time of acceptance and will depend on shipping service selected and receipt of cleared payment. The Kendrick Traction Device (KTD) ensures that you never need to roll your patient or raise their leg when applying traction. Retrieved November 5, 2021, from. It can also be used in patients with pelvic fractures. There are many factors that cannot be excluded or consolidated as they vary too broadly among different services. There is no need for patient roll-over or unnecessary leg raising. Position any leg support straps as directed (eg, 2 above the knee and 2 below). Can be apply within 2 minutes - only one person needed. With the Kendrick EMS KTD, you never need to roll your patient or raise their leg when applying. Forgive me, I'm not WEMT or ski patrol or anything. Because the Kendrick Traction Device / OTD may be fitted without rolling a patient or raising their leg, it can be applied by just one person. Use about 10% of the patient's body weight or up to about 7 kg (15 pounds). These patients require a surgeon in most cases, so what are we to do as prehospital clinicians? Critical Care Paramedic Scott Hardy demonstrates the application and use of the Kendrick Traction Device. (n.d.). Comes in a 9.5" x 3.5" (24cm X 8.9cm) pouch. Journal of emergencies, trauma, and shock, 13(4), 296300. It may not display this or other websites correctly. One person can properly apply the KTD in less than 2 minutes! Model #: KE-805, Categorization: Extrication - Patient Transport > Splints. Kendrick Traction Device Replacement Parts - Replacement Elastic Strap Ankle, Green - Model KE-805. This is for "Replacement Elastic Strap Ankle, Green" only. We have adult and pedi Hare traction splints, but we just got a Kendrick and have been playing with it. Radiolucent design enables X-Rays and Catscans to be taken without . 101 points will be rewarded to you when you buy this item. LINE2design Traction Splints Child provide mechanical traction to relieve pain and reduce the possibility of further vascular and nerve damage on patients with suspected long bone fractures of the lower extremities. A traction splint most commonly refers to a splinting device that uses straps attaching over the pelvis or hip as an anchor, a metal rod (s) to mimic normal bone stability and limb length, and a mechanical device to apply traction (used in an attempt to reduce pain, realign the limb, and minimize vascular and neurological complication) to the limb. Features Cost-effective Adjustable for pediatric and adult sizes A single person can properly apply the KTD in less than one minute. The most common traction splints in the EMS field are the Hare (bipolar) and the Sager (unipolar). Also, there is no ischial bar, which eliminates the problems of needless pressure. Traction splints are widely used for immobilisation of fractures of the lower limb. Optional replacement parts for the Kendrick Traction Device. The traction pole instantly adjusts for adult, child or pediatric use. Carry case included. Sager Form III splint. Traction Splints are used in prehospital care to immobilize and support fractures of a patient's femur. Patient Factors & Considerations It is primarily used on patients with mid-line femur fractures. Hard to get supporting evidence if we dont actually have any data. The traction splint has been around since the 1800s with a fair share of modifications and improvements since. Because so many of our patients are evacuated by air, in both SAR and SP, many (if not most) use Sager splints. The loss of a supporting structure for the large muscles of the leg will often cause the upper leg to collapse as the muscle pulls the two broken halves together. Wow! Key product features: No uncomfortable ischial bar Easy to apply - one person application in under two minutes Suitable for use on adults or children - adjustable traction pole The kinetic energy necessary for such an injury, along with the close proximity of major vessels and nerves, provides an opportunity for significant bodily harm. Commonly used tractions are Thomas, Hare, Sager, Kendrick, CT-6, Donway, and Slishman traction splints. Experience is the result of poor judgement". JavaScript is disabled. Features. The proposed benefits of traction splints are to minimize blood loss, pain, and other adverse sequelae while achieving realignment of bone fragments.9 It is important to note that proposed benefits of traction beyond typical splinting are purely anecdotal. t.~ spine beard, board '--splint, tying legstoqether orany other accepted method. Original use of the traction splint, first popularized by Dr. Thomas during the First World War, included the use of the device for femur fractures resulting from gunshot wounds, which by definition are open fractures. (paraphrase of Veneficus), mid shaft femur fx are not unheard of, although i have not run into on on the mountain yet, as for boot, here it is protocol to remove the boot, also for cms. Hard to get supporting evidence if we dont actually have any data. Traction is a medical term the refers to the process of slightly. Traction splints should be changed to skin traction by an orthopaedic specialist as soon as possible. The indirect risk of taking a long time to apply a traction splint to a patient who needed surgical intervention can certainly bear negative consequences down the road. Armstrong Medical. The traction splint has evolved to be 1. Marcela De La Hoz Polo, Amandeep Sandhu, Elika Kashef, Christopher Aylwin, Duncan Bew, Maribel Manikon, Elizabeth Dick. The limited amount of retrospective evidence available illustrates the unfortunate reality that in most cases. Prehospital Traction Splint Use in Midthigh Trauma Patients. Secure the patient and splint to long board for transport. i-gel . The system is made up of a folding snap out aluminum pole, color coded elastic leg straps. This includes but is not limited to your mode of transport, traction device, transport times, patient acuity, and resources. Whilst the patient has either a Kendrick splint in situ or the skin traction applied then the nursing staff will be expected to perform Neurovascular observations a . Here in NY State, whatever type or brand traction splint, CONTRA-Indicated to use for fx leg if possible tib-fib involvement. Item No. You may enter multiple email addresses separated by semicolons. The Slishman Traction Splint (STS) is an innovative traction device that solves many of the current problems with other tactical traction splints. CT-EMS Traction Splint with Blue Carrying Bag, Civilian Version, Pediatric/Adult, Orange Straps By: FARETEC, INC. We do have Hares, half-rings and a Kendrick available to us. Why would you remove the boot in the field with a simple midshaft femur fx? Wilderness Environ Med. Kendrick ORGKTD Traction Device, Colored Brand: KENDRICK 14 ratings | 3 answered questions Amazon's Choice for "traction splint" $14748 FREE Returns See images Colored style Unit count: 1.0 Specifications for this item Frequently bought together Total price: $175.38 Add all three to Cart These items are shipped from and sold by different sellers. Most of all, know your equipment and become proficient in applying the device in order to minimize complications including potential delays in patient care. [1] On the other hand, the use of a traction splint was associated with fewer blood products infused and a shorter hospitalization (Syme 2020). Wilderness & environmental medicine, 26(3), 305311. It allows the ability to work around any hip or groin trauma There is no ischial bar to deal with, so any concerns of causing unnecessary pressure and additional pain are not an issue A single person can properly apply the OTD in . The only 3 acute pathologies are trauma, toxins and infection. The limited amount of retrospective evidence available illustrates the unfortunate reality that in most cases we dont use them (Runcie and Greene, 2015)(Syme 2020). It may differ . The ischial ring of the traction splint must be against the bony prominence of the buttocks (ischial tuberosity). EMT-B, CPR/AED Instructor, Wilderness First Aid Instructor, NASAR TechII, Wife, Mom, Damn good cook. Furthermore, there is no ischial bar to deal with, so any concerns of . The traction pole instantly adjusts for adult, child or pediatric use. Note:anti-shock trousers mayeasilybe applied overthe KTD. Never try to teach a pig to sing; it wastes your time and it annoys the pig. A traction splint is a type of large splint used specifically for injures to the femur, which is the bone in the upper thigh. Splint as required. Min. The Kendrick Traction Device (KTD) is relatively simple to apply as long as you are familiar with the various parts. Feature 5. application of traction splints for femur fractures (open or closed) is likely not to impact patient outcome. The STS applies traction from the hip and is infinitely adjustable. Traction splints are external devices primarily used in the pre-hospital acute management for the reduction and immobilization of femoral shaft fractures. You are describing Traction Into Position (TIP) which is not the equivalent of applying manual traction to an isolated midshaft femur preceding mechanical traction (splint). The CT-6 helps relieve patient pain and prevents further damage to surrounding muscle and tissue while reducing the risk of death caused from severed arteries. This can be extremely painful but also very dangerous as the two sharp fractured ends sit unsupported in soft tissue. This helps reduce bleeding. Figure 4, Kendrick traction splint. Ferno. Traction splints interfere with many litters, are by design only useable for 1 type of injury, and require a significant amount of highly specific training. Kendrick Traction Device (KTD) Sager Bilateral Splint. Why would you remove the boot in the field with a simple mid-shaft femur fx? Traction splints are a temporary form of immobilization, as prolonged use of traction splints can cause pressure sores. FernoTrac Traction Splint. Apply longitudinal traction on the ankle to straighten and lengthen the shortened leg to the length of the contralateral leg. How does a traction splint work? The KTD comes complete with a convenient 9" wide by 3" tall storage pouch & easy-to-follow instructions. As with any other tools we utilize on the job, training is of utmost importance to ensure proper and efficient application. One of the most common types of traction splints is the Hare splint, which features metal rods with a series of adjustable straps for security. Cost effective, compact and lightweight, the Kendrick Traction Device (KTD) is ideal for remote area operations and outdoor activities. As low as 155.94 129.95. Free shipping for orders over $100 in the contiguous USA. Relieve the tissue pressure on fractured leg avoiding further hemorrhages, shock and secondary nervous, vascular, bone and muscular . Femur traction is applied through the extension of the pole segments creating a pushing force on the ankle strap instead of pulling distally from the foot. Traction splinting, such as a Kendrick traction splint, are used in suspected or isolated fractures of the mid-shaft femur, acting to hold the femur in correct position against action of the large thigh muscle mass. This natural alignment provides the necessary support for the muscles as well, easing painful spasms. Secure the ankle strap with the patient's foot in an upright position and attach it to the splint. The company that makes the Hare traction splint gives the sole indication as a suspected femur fracture, and the sole contraindication as an open femur fracture. Kendrick Traction Device (KTD) $ 129.95 Color: SKU: KTD1 Quantity: An intelligent compact traction device for splinting lower extremities. I'm gonna stay in Florida, where all we have to worry about removing are flip flops. The answer to this question is going to be a little murky, directly reflective of the quality of evidence we have so far on the topic. A Kendrick extrication device ( KED) is a device used in extrication of victims of traffic collisions from motor vehicles. 2. Emergency Traction Splint Pole Carbon Fiber / Polymer Black, Emergency Traction Splint Pole Carbon Fiber / Plastic Black 3 X 4 X 11 Inch, FernoTrac Emergency Traction Splint Mechanical Aluminum Black, Consumers: Please visit SimplyMedical.com, It allows the ability to work around any hip or groin trauma, There is no ischial bar to deal with, so any concerns of causing unnecessary pressure and additional pain are not an issue, A single person can properly apply the OTD in less than one minute, The traction pole instantly adjusts for adult or pediatric use, Designed to be carried in a trauma box, jump bag or first aid kit, The Improved Carbon Fiber Traction Pole does not conduct heat away fro , The traction pole is made from x-ray translucent carbon fiber, The ankle hitch is designed to bring added comfort to the patient by p , Designed for pre-hospital and patient transport, Primarily used on patients with mid-line femur fractures, Helps relieve patient pain and prevents further damage to surrounding , Mechanical traction to relieve pain and reduce the possibility of furt , Designed for little patients with suspected long-bone fractures of the , Wide elastic support straps maintain the injuured leg within the frame . The CT-6 is a Leg Traction Splint designed for Pre Hospital Care and Patient transport, specifically in combat scenarios. Sold by the each. .more .more 105 Dislike. In the end, I'm not saying that traction splinting isn't without benefits. We are told that the traction and Hare type splints are not to be used if transport is more than an hour due to circulatory issues from the hip side of the splint. Do Palpable Pulses Correlate to Systolic Blood Pressure in Hypotensive Trauma Patients? The Kendrick Splint The benefits of traction & splinting are to reduce blood loss, pain and tissue damage. No uncomfortable ischial bar. Following the intervention period, however, traction splint use increased significantly (Median 50%). Product code: . That Is the Question. The Traction Splint is designed to be used on those patients with a suspected limb fracture. This manual contains general instructions for the use, 6.6 Adapting the KED for Use as a Splint..27 (Kendrick Extrication Device, An intelligent compact traction device for splinting lower extremities. The force of the traction splint works to put the bone back into natural alignment while also preventing excess movement. Wide elastic support straps maintain the injured leg within the frame of . PMID: 25819110. Optimum Traction Device O.T.D. Galls. who would you want to take your ski boot off. - Mark Twain. The Kendrick Traction Device (KTD) is an intelligent compact traction device for splinting lower extremities. Mustang Bilateral traction splint Mustang Single Traction Splint for Humeral fracture Single Pole Traction Device . (n.d.). Syme, K. (2020). Manufacturer: Emergency Products Research. Lock the ankle attachment. That Is the Question. Manufactured by Faretec, Ferno, KTD, Genstar Technologies, EP and R. Kendrick traction device, Hare traction splints protect the patient from additional bone, muscular, nerve damage. Retrieved November 5, 2021, from, Kendrick traction device. You must log in or register to reply here. Specifications: Replacement Elastic Strap Ankle. 4. Shop Kendrick EMS Products Your choice for EMS Supply needs and Emergency Equipment Kendrick EMS The cases where they were used generally showed no change in morbidity or mortality. Medical and surgical devices in the emergency and trauma patient: what the radiologist should know, and how they can add value. (n.d.). Applying a Hare Traction Splint (3 of 3) Connect loops of ankle hitch to end of splint as your partner continues traction. The indirect risk of taking a long time to apply a traction splint to a patient who needed surgical intervention can certainly bear negative consequences down the road. Traction splints for femoral fractures made their pre-hospital debut in 1915 during World War I (12). Corrosion resistant first aid adjustable EMS Aluminum leg kendrick traction splint for military and civilian use. Radiographic features 124417 brands . The rest of the modern pathology requires years and decades to create an acute event; if possible to manage or reverse, it takes years. Check for errors and try again. What is a Kendrick splint used for? We use KTDs. Commonly carried on ambulances, a KED is typically used by an emergency medical technician, paramedic, or another first responder. kendrick splint, kendrich splint URL of Article Traction splintsare external devices primarily used in the pre-hospital acute management for the reduction and immobilization of femoral shaft fractures. The system is made up of a folding snap out aluminum pole, color coded elastic leg straps, adjustable ankle hitch, and adjustable groin strap. Sager Traction Splints are indicated in 93% of all femoral fractures (treats mid-shaft and proximal third fractures).As such, they have a much broader range of application and use than other traction splints. It is most commonly used for fractures of the femur (thigh bone). Emergency Traction Splint Pole Tactical Black, I.T.D. KENDRICK TRACTION DEVICE APPLICATION INSTRUCTIONS (A) ANKLE HITCH (B) UPPER THIGH SYSTEM (C) TRACTION POLE (D) KNEE ELASTIC STRAP (E) THIGH ELASTIC STRAP . This splint features a telescoping design along with directions printed on the nylon leg straps to ensure quick application. Order: 1 Piece. Devices supposed to only be used for Femur fx. I don't do SP, but I do SAR and know some SPers. Femoral traction splints are designed to apply traction to the lower portion of the leg, distal to the fracture, usually by pulling the ankle away from a stabilized pelvis. We present a case of skin complication. It may differ from the image in size, color, features, etc. Significant knee injury. Traction Splint, Kendrick $ 88.75 Buy Now Compact and lightweight, this traction device can be carried in a trauma box, first-aid kit or backpack. Personally I love the KTD's (Kendrick Traction Devices) as mentioned above. Thomas half-rings are still around?! Traction splint is categorized as adult traction splint, child traction splint, Kendrick traction device, and fracture splint. 5% Back and Free Shipping on all orders over $49! Product Images Compare . The mean pounds of traction created for each device with the 95 % confidence intervals listed in parentheses were Hare traction, mean of 13 . (n.d.). Our main traction splint is the Sager. Lock the device in place as directed. 1. This allows femur traction to still be applied and leaves the lower leg accessible for other splinting or bandaging. alleviate leg organizations pressure through traction, so to avoid further bleeding, and the nerves, blood vessels, bones and muscles secondary damage. What type of traction splinting do you use? Kendrick Traction Device (KTD) - YouTube 0:00 / 9:31 Kendrick Traction Device (KTD) 52,730 views Mar 13, 2015 BUY TODAY AT http://www.liveactionsafety.com/kendr. The splint has a pole with adjustable length, and several attachments at the level of the ankle, lower leg, and thigh 2. Contraindications for . For a better experience, please enable JavaScript in your browser before proceeding. Kendrick Traction Splint Manual, Pab 5400 Manual, Black Decker Ct06301 User Manual, Metco 9 Mp Operation Manual, Us Army Field Manual 1943, Cv 30 User Manual, Abacus 64 Manual Kendrick Traction Splint Manual - 2021 Ford F-150 Owner's Manual. The cases where they were used generally showed no change in morbidity or mortality. The STS weighs only 21 ounces and is 23" W x 3" H in size. Dimensions Air Splint - Full Arm. Attach the leg support straps. A)o o 3 o =! From field to hospital: When applied, Sager Splint model SX404 is radiolucent to all areas of a femoral fracture. Medical Warehouse. The STS also works with both adults and pediatrics. Traction splints use a combination of straps, rigid poles, and mechanical advantages to provide a pulling force to the affected leg. A) I a o o-o 0) =o-o E q). Epub 2015 Mar 24. An improvement was also noted in staff perception and understanding of the management of femur fractures. 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