In treating tuberculosis (TB) of an articular joint, Hugh Owen Thomas long ago said that
rest must be prolonged, uninterrupted, rigid and enforced
and for this purpose, the Thomas Splint was, for a long time, considered the best.
Traction was key to the Thomas Splint, which either used a frame and heavy bandaging around the leg, and the weights attached to an overhead sling system or suspended at the end of the bed, or it was ‘skeletal’ traction with the weights attached to a pin driven through the tibial tubercle. The splint was also used extensively for the treatment of fractured shafts of the femur, where traction, sometimes achieved by lifting the foot of the bed, allowed gravity to reduce muscle spasm and maintain good alignment until the fractured bone ends began to unite.
Thomas’s splint was first used in 1875 as a way to immobilise the leg and the patient. Thomas specialised in treating patients with TB, polio, and rickets, and believed that the body would heal itself given sufficient time and rest. The splint was not widely adopted initially, but came to prominence in World War I when orthopaedic surgeon, Robert Jones (Thomas’s nephew), advocated for its use in the treatment of battlefield leg fractures. The portability and stability of the splint stabilised the injury, gave surgeons access to the leg, and patients reassurance. Together with better wound management, it was argued that the Thomas Splint dramatically reduced mortality from fractures during the war.
Description provided by David Nicholls of New Zealand.
References:
Apley A & Soloman L. 1982. Apley’s system of orthoapedics and fractures (6th ed.). Butterworth.
Robinson PM & O’Meara MJ. 2009. The Thomas splint: It’s origins and use in trauma. The Journal of Bone and Joint Surgery, 91-B(4), 250, 540 – 543. Accessed online at https://www.researchgate.net/publication/24248663_The_Thomas_splint_Its_origins_and_use_in_trauma
