Treating Fractures in the Field
Lesson 4: Fractures of the Lower
Extremities
4-6
4-6. IMMOBILIZE A FRACTURED OR DISLOCATED ANKLE (TWO WIRE LADDER SPLINTS)
A wire ladder splint (see figure 4-10) is made from steel. It is about 31 inches long and about 3.5 inches wide. It contains 48 crosspieces and weighs about a half pound. The wire ladder splint can be bent to conform to the shape of the injured limb. The following paragraphs give instructions for applying two wire ladder splints to a fractured or dislocated ankle. The splints can also be used for a fractured foot.
Figure 4-10. Wire ladder splint.
a. Position Casualty. The casualty may be either sitting up or lying down.
b. Expose Injury. Cut the boot laces on the injured foot. Then cut the boot tongue on the outside edge from top to bottom all the way down.
c. Check Pulse. Check the casualty's pulse along the top of the foot. If a pulse is absent, the casualty should be evacuated as soon as the splint is applied.
d. Form Rigid Splint.
(1) Bend the prongs (sharp ends) of the two splints away from the flat side of the wire ladder splint.
(2) Bend one splint into an "L" shape so that the flat surface is on the inside and the bottom of the "L" fits the length of the casualty's boot. Bend the longer (top) end of the "L" back onto itself so it is even with the top of the casualty's boot. Use the casualty's uninjured foot for measurement.
(3) Bend the other splint into a "U" shape with a flattened bottom so the bottom of the soldier's boot fits the bottom of the splint and the ends of the "U" will go up the sides of his boots. Use the uninjured foot for measurement.
(4) Joint the L-shaped splint and the U-shaped splints together by fitting the U-shaped splint around the L-shaped splint to form a cradle and protective case for the injured ankle.
e. Apply Rigid Splint.
(1) Gently lift the casualty's foot, ankle, and lower leg.
(2) Slide the cradle under the casualty's boot until the sole of the boot touches the bottom of the L-shaped splint.
(3) Lower the casualty's foot until the boot fits into the cradle.
(4) Apply padding to the sides, if needed. The boot should be sufficient padding.
f. Secure the Rigid Splint With Cravats. Figure 4-11 shows a two-piece wire ladder splint applied to a left ankle.
Figure 4-11. Wire ladder splint (two pieces) applied to a fractured ankle.
(1) Apply a cravat immediately above the ankle. Begin on the outside of the leg, bring the tails to the inside, cross them, bring them to the outside again and tie the tails in a non-slip knot on the outer part of the U-shaped wire ladder splint.
(2) Check the casualty's pulse. If a pulse could be felt before but is no longer present, loosen and retie the cravat. If the pulse still cannot be felt and you can slip two fingers beneath the knot, evacuate the casualty as soon as possible after the splint is applied.
(3) Apply the second cravat below the ankle. Cup the heel of the boot in the center of the cravat and bring the tails up across the top of the boot. Cross the tails on the top of the boot toe, take
them down under the sole of the boot, and tie the tails in a non-slip knot on the outer aspect of the rigid splint.
(4) Check the casualty's pulse. If a pulse could be felt before but is no longer present, loosen and retie the cravat.
(5) Apply the third cravat at the top of the splint in the same manner as the first cravat. Tie the cravat in a non-slip knot on the outer aspect of the rigid splint.
(6) Check the casualty's pulse. If a pulse could be felt before but is no longer present, loosen and retie the cravat.
