Sager Traction Splint: Manual, Application, S304 Model, Bilateral Setup, Procedure Chart, and Instructions

Sager Traction Splint:

• What is Sager Traction Splint?
• Manual
• Application
• S304 Model
• Bilateral Setup
• Procedure Chart
• Instructions

What is Sager Traction Splint?

A Sager Traction Splint is a medical device used by EMS providers, paramedics, and trauma teams to stabilize and treat mid-shaft femur fractures. Unlike traditional traction splints that extend externally along the leg, the Sager design uses a midline traction bar positioned between the patient’s legs. This provides controlled, measurable traction without significantly moving or rotating the injured leg.

The Sager splint is known for its ability to be applied quickly, even in confined spaces like ambulances or crash scenes. It also allows for bilateral application—an advantage over many traction splints—and provides constant, quantifiable traction measured in kilograms or pounds. Its design minimizes further damage, reduces muscle spasms, and decreases pain while preventing excessive blood loss from femoral fractures.

Manual

The Sager Traction Splint manual provides detailed instructions on assembly, cleaning, sizing, traction calculations, and troubleshooting. It covers identifying proper landmarks on the patient, preparing the splint, and ensuring traction is applied safely. The manual emphasizes patient assessment, including checking for distal pulses, sensation, bleeding, and contraindications.

Common manual features include diagrams showing leg positions, correct application angles, and traction force charts. The manual also explains maintenance procedures such as cleaning with non-corrosive disinfectants, lubricating mechanical parts, and storing the splint properly. Providers are encouraged to undergo training and practice frequently to ensure smooth application in real emergency scenarios.

Application

Application of the Sager Splint begins with ensuring the scene is safe and assessing the patient for life-threatening conditions. The EMT stabilizes the injured leg manually while another rescuer prepares the splint. The splint is placed in between the legs, with the ischial pad positioned firmly against the pelvis. The thigh and ankle straps are secured before traction is applied.

Traction is applied by pulling the handle until the desired traction force is reached—typically around 10–15% of the patient’s body weight per leg. Throughout the process, the rescuer monitors for pain increase, misalignment, or loss of distal pulses. Once applied, the splint stabilizes the fracture and allows safer patient movement and transport. Reassessment every few minutes is essential.

S304 Model

The Sager S304 Model is a commonly used configuration featuring adjustable traction rods, padded ischial support, and secure Velcro straps. It is designed for rapid deployment in prehospital settings and includes a built-in traction scale for precise control. The S304 is lightweight, durable, radiolucent, and compatible with both adult and pediatric patients.

This model also supports bilateral use, meaning two S304 splints can be applied simultaneously if both femurs are fractured. The S304’s materials allow X-rays to be taken without removing the device, reducing the risk of worsening the injury. Its compact size also makes it easy to store in trauma bags or ambulance compartments.

Bilateral Setup

One unique advantage of the Sager system is its ability to allow bilateral traction. When both femurs are fractured—a serious and potentially life-threatening condition—two Sager splints can be positioned between the patient’s legs, one on each side of the midline. This maintains proper alignment for both legs without excessive spreading.

To set up bilateral traction, each leg is secured with its own ischial pad and thigh/ankle straps. Traction rods are extended independently, following the traction calculation for each leg. Constant reassessment is critical due to increased risk of blood loss, nerve injury, or compartment syndrome. Bilateral traction capability significantly improves safety compared to traditional splints.

Procedure Chart

A Sager Traction Splint procedure chart typically includes the following steps:

• Assess for femur fracture (shortening, deformity, pain, rotation)
• Check contraindications (pelvic fracture, knee injury, amputation)
• Expose and manually stabilize the injured leg
• Position Sager splint between legs with ischial pad seated properly
• Apply thigh and ankle straps
• Pull traction handle to desired tension (10–15% body weight)
• Confirm alignment, pain reduction, and distal perfusion
• Secure leg to splint and monitor continually

Charts may also include traction measurement guidelines, pediatric adjustments, and troubleshooting tips for improper traction, slipping straps, or resistance during application.

Instructions

Instructions for using the Sager Traction Splint emphasize smooth teamwork, precise traction calculation, and patient safety. Providers must ensure the ischial pad is correctly positioned because it serves as the counterforce to traction. Leg straps must be snug but not overly tight. Traction should never exceed recommended force, and the splint should not be used if a pelvic fracture is suspected.

After application, follow-up steps include checking pulses, motor function, and sensation every 5 minutes; reassessing traction during movement; and documenting the traction amount used. Proper training, familiarity with the device, and frequent practice are essential to mastering Sager splint application in real emergencies.