If you have ever worked in emergency medicine or spent time training for backcountry rescues, you've probably heard someone rave about the kendrick traction splint and how it changed the game for treating femur fractures. It's one of those tools that looks surprisingly simple—almost like a high-tech tent pole—but when you're standing over someone who has just snapped the largest bone in their body, it's the one thing you'll be glad you have.
The femur is a beast of a bone. When it breaks, especially in the middle of the shaft, the massive muscles in the thigh go into a state of shock and start spasming. These muscles are incredibly strong, and they start pulling the broken ends of the bone past each other. This is called "overriding," and it's about as painful as it sounds. Not only does it hurt like crazy, but those jagged bone ends can tear up blood vessels and nerves. That's where the kendrick traction splint comes in to save the day by pulling everything back into alignment.
Why this tool is such a big deal
Back in the day, if someone broke their leg on a hiking trail or a ski slope, the options for traction were pretty bulky. You had these massive, heavy metal frames that took up half an ambulance and were a nightmare to carry up a mountain. The kendrick traction splint, or KTS as a lot of people call it, flipped the script because it's incredibly lightweight and compact.
The whole point of traction is to apply a steady pull on the limb. This counteracts those muscle spasms, lines the bone back up, and—most importantly—drastically reduces the patient's pain. It also helps minimize internal bleeding, which is a huge concern with femur fractures since you can lose a lot of blood into the thigh cavity without even seeing a drop on the ground.
How the Kendrick Traction Splint actually works
I remember the first time I saw a kendrick traction splint out of the bag. It didn't look like much. But the design is actually pretty clever. It uses a folding pole (again, very similar to what you'd use for a tent) that sits along the outside of the leg.
You've got a few key components: the pole itself, an ankle hitch, a groin strap (sometimes called the ischial strap), and some elastic straps to keep the leg secured to the pole. The magic happens when you tension the system. By securing the top at the groin and the bottom at the ankle, you can "crank" or pull the leg into a neutral position.
What's really cool about the KTS is that it doesn't require you to lift the patient's leg nearly as much as the older styles of splints do. When someone has a broken femur, the last thing they want is you moving their leg around more than absolutely necessary.
The Ankle Hitch
The ankle hitch is usually the first thing that goes on. You wrap it around the patient's boot or ankle. One of the best things about the kendrick traction splint is that you don't even have to take their shoes off. In a cold environment or a messy accident scene, that's a massive win. You just wrap it, secure the velcro, and you're halfway there.
Setting the Pole
Next, you've got the pole. You adjust the length so it's a few inches past the foot. The top of the pole fits into a little "bucket" on the groin strap. Once that's locked in, you use a pull-tab or a ratcheting system to apply the actual traction. You can literally watch the patient's face change from pure agony to relief as that bone stops grinding and the muscles finally relax.
Kendrick vs. the old-school Hare splint
If you talk to some of the old-timers in the field, they might still swear by the Hare traction splint. And look, the Hare is great—it's solid and provides excellent stability. But the Hare is a "bipolar" splint, meaning it has two bars that go on either side of the leg. It's heavy, and it's a pain to store.
The kendrick traction splint is a "unipolar" splint. It only has one bar. This makes it way smaller and easier to pack into a backpack or a small compartment in a fly-car. If you're a search and rescue tech who has to hike three miles into the woods, you are choosing the KTS every single time.
Another huge advantage is that the KTS doesn't stick out way past the patient's foot like some of the older models. If you're trying to close the back doors of an ambulance or fit a patient into a helicopter, those extra six inches of metal on a Hare splint can be a real problem. The kendrick traction splint stays pretty tight to the body, making transport a lot less of a headache.
When should you actually use it?
It's important to remember that the kendrick traction splint isn't a "fix-all" for every leg injury. It's specifically designed for mid-shaft femur fractures.
If the break is up in the hip or down near the knee, you generally want to avoid using traction. Applying pull to a broken hip can actually make things worse, and the same goes for the knee. You also have to be careful if there's a lower leg fracture (tibia/fibula) on the same side. If the ankle or lower leg is smashed, you can't really use it as an anchor point to pull against.
But for that classic mid-thigh break? It's the gold standard.
A few tips for better application
If you're ever in a spot where you need to use a kendrick traction splint, here are a few things to keep in mind that they don't always emphasize enough in the manuals:
- Communicate with the patient: Applying traction feels weird at first. Tell them what you're doing. As soon as you start pulling, they'll feel the difference, but the initial setup can be scary.
- Check your pulses: Always, always check the pulse in the foot before and after you put the splint on. You want to make sure you're helping the blood flow, not cutting it off.
- Don't over-tighten the groin strap: You want it snug so it doesn't slip, but you don't need to cut off circulation to the rest of their body. It just needs to be a solid anchor.
- Practice makes perfect: The KTS has a lot of straps. If you haven't looked at it in six months, you're going to be fumbling with it while someone is screaming in pain. Take it out once in a while and practice putting it on a coworker.
Is there a downside?
Honestly, the only real "downside" to the kendrick traction splint is that it feels a little bit more "fiddly" than a rigid splint. Because it's so lightweight and uses elastic straps, it can feel a bit flimsy until everything is tensioned down. Some people also worry about the pressure it puts on the groin area, but if you've padded it correctly and applied it right, it's usually not an issue.
There's also the cost. Like most specialized medical gear, it isn't exactly cheap. But considering it can prevent a patient from going into hemorrhagic shock from a femur bleed, it's worth every penny.
The bottom line
At the end of the day, the kendrick traction splint is one of those pieces of equipment that changed how we handle trauma in the field. It took a complicated, bulky process and made it something that one or two people can do in the dirt, in the dark, or in the back of a moving vehicle.
It's not just about "fixing" a leg; it's about pain management and preventing further injury. If you're putting together a high-level trauma kit or outfitting a rescue team, the kendrick traction splint is a total "must-have." It's compact, it's effective, and when the pressure is on, it's the tool you want in your hands to make a bad situation a whole lot better.