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1. WO2020108722 - MODULE D'ATTELLE UNIVERSEL

Note: Texte fondé sur des processus automatiques de reconnaissance optique de caractères. Seule la version PDF a une valeur juridique

[ EN ]

Universal splint module

FIELD OF THE INVENTION

The present invention relates to a non-invasive medical equipment which enables supporting, fixing, and/or immobilising post-traumatic muscu!o-skeieta! limb injuries.

The invention is intended for use by trauma medicine specialists of militaiy and civil rescue services in complicated field conditions requiring the use of lightweight and compact splints enabling fast installation.

BACKGROUND of the invention

Various special-purpose splints are known in the state of the art. Some of those are described below. More specifically, a cardboard splint is described which Is the closest solution to the present invention in the state of the art.

Vacuum splint

Vacuum splints are made of airtight composite textile panels, filled with small plastic pellets. Vacuum splints are wrapped around the injured limb and when the air is pumped out, the splint will harden. Vacuum splints come with various sizes and shapes, as foe shape of each splint corresponds to foe shape of the specific limb. Using such a solution requires a specific splint as well as a specific air pump. Pumping in field conditions is time-consuming. Vacuum splints do not function if the splint panel has been punctured. The drawbacks of this solution are its dimensions and the weight of foe set of vacuum splints, which causes the need to always use some means of transport, and therefore, it is not suitable for complicated field conditions.

Pneumatic splint

Pneumatic splints are made of airtight composite plastic panels. Pneumatic splints are wrapped around foe injured limb and when the air is pumped in, foe splint will harden. Pneumatic splints come with various sizes and shapes, as the shape of

each splint corresponds to the shape of the specific limb. Using such a solution requires a specific splint as well as a specific air pump. Pumping in field conditions is time-consuming. Pneumatic splints do not function if the splint panel has been punctured. The drawback of this solution is low reliability in field conditions. Also, the pneumatic splint cannot ensure the structural rigidity needed for immobilizing bone injuries.

Malleable sheet splint

Malleable sheet splints are typically made of an aluminium sheet covered with a thin layer of soft foam plastic. Sheet splints are bendable in multiple directions, which enables crafting various shapes and angles suitable for different shapes of limbs. The drawback of this solution is the low structural rigidity of sheet splints: during evacuation activities, the splint may bend or deflect, and cause secondary injuries to the injured limb. In practice, sheet splints are suitable only for splinting metacarpus, the wrist, and the ankle joint.

Wire soiint

Wire splints are made of bendable wire and their shape resembles a ladder. Contemporary wire splints are surrounded by a soft padding made of cellular plastic and film wrapping material. Wire splints are bendable, which enables crafting various shapes and angles suitable for different shapes of limbs. Using this solution requires a special wire-cutting tool and plenty of time. The drawback of this solution is the difficult material: when using a wire splint, it is difficult to change the already bent shape. In practice, it is difficult for a trauma medicine specialist to carry along a wire splint in field conditions due to its dimensions.

Fieid-exoedient splint

Several armed forces worldwide teach the students of combat medicine to craft a splint of handy materials found in field conditions. Typically, such improvised splints consists of tape and flat wooden slats. The splint is fixed around the injured limb with triangular bandages or strips tom from foe clothes of the casualty. The correct use of an improvised splint requires extensive special training and suitable component materials in field conditions. The drawback of this solution is also the very long time needed for making and installing the splint.

Traction splint

Traction splints are devices enabling the application of traction or longitudinal pulling force on the muscles of the lower limb. The device does not enable the fixation of the lower limb in the lateral direction. The use of traction splints is indicated only in case of a femur Injury. Although a traction splint can be folded in the centre, the device is still very large and awkward to use in field conditions.

Cardboard solint

Cardboard splints are known as foe closest solution to foe present invention.

Cardboard splints are made of cardboard or nowadays also of three-layer comigated plastic. Cardboard splints include a base panel supporting foe injured limb and side panels stabilizing the limb. The panels are mutually laterally connected with at a 90" angle. When using a cardboard splint, the limb of foe injured person must be fixed inside the splint with plenty of padding material, as foe splint does not follow the anatomic shape of the injured limb and foe injured limb can start moving in the gap between foe limb and the splint, which may cause secondary Injuries. Furthermore, splints with a different length should be carried along to splint injuries of low or upper limbs.

A drawback of cardboard splints is its insufficient structural rigidity, poor pliability into U- or C-shape. In order to find a suitable size, foe medical personnel must carry along many splints with various sizes. Another drawback of cardboard splints is foe material itself, which may easily degrade upon contact with moisture or water.

In conclusion, although the category of splints is broadly covered, there Is still no splint that would be suitable for demanding field conditions. Such a solution should be light, compact, and ensure the structural rigidity for external fixation. The solution should also enable splinting most or all common types of muscu!o-skeletal

injuries and be suitable for injured persons with different anatomic parameters. This would enable preventing carrying along several different types and sizes of splints. The installed splint must ensure orthopedically correct embracing of the injured limb in a comfortable manner for the user to ensure good ventilation and minimize the risk of pressure ulcere.

Summary of the invention

The object of the invention is to provide a universal splint module for post-traumatic splinting of musculo-skeletal limb injuries, where:

- the Identical shape of splint sheets and the identical location of fixing elements enables to create a splinting functionality from similar splint sheets for fixing any different possible musculo-skeletal limb injuries of human casualties;

- folding grooves of the splint sheet and their location enable configuring the width and length dimensions of the splint to be orthopedically suitable for the anatomic dimensions of the limbs of different human casualties;

- identical shape of splint sheets, identical location of fixing elements, and folding grooves of splint sheet and their location enable easy supplement and/or replacement of splint sheets as part of a splint set;

- the identical shape of splint sheets, the identical location of fixing elements, and the folding grooves of the splint sheet and their location enable packaging the device into a compact transport and package position;

- the folding grooves and folding apertures of the splint sheet arid their location enable folding back the tip of the material sheet, thus creating a support with ah orthopedically neutral angle for splinting metacarpus and the wrist;

- the folding grooves and folding apertures of the splint sheet and their location enable bending fixing wings out of the material sheet for splinting the injured lower limb of a human casualty, the comers of which retain the fixing or binding means fixing the device around the limb.

All the above listed properties form complete objects of the invention, which can be met with a single technical solution, i.e. the proposed universal splint module for post-traumatic splinting of all muscuio-skeieta! limb injuries.

The present invention proposes a universal splint module comprising a material sheet with folding grooves and folding apertures and fixing elements, which enable joining several universal splint modules for making special-purpose splinting functionalities.

A universal splint module is basically a rectangular sheet with horizontal, vertical folding grooves. Folding grooves can also be diagonal or angular. The location of folding grooves enables configuring the width and length of the splint into an orthopedically suitable size for the limb of the specific casualty.

The location of the fixing elements of the universal splint module enables joining the modules with each other. Joining the modules enables forming splints with various sizes and functionalities for splinting most musculo-skeletal limb injuries.

The fixing elements of a splint module can be rivets, dowels, snaps, tenons, swivels etc. The fixing elements are homogenous with the sheet or added separately. The fixing elements may join the splint sheets with each other as follows:

1. with tiie tower ends or the lower and upper ends of the universal splint module into an L-shaped splint, where splint sheets form a U-shape;

2. with the lower ends, or lower or upper ends, or upper ends of the universal splint module, where splint sheets are located on each other in a U-shape, enabling forming an extended splint.

By folding the upper part of the universal splint module back along the upper folding line, a metacarpus support can be formed to achieve an orthopedically neutral support angle needed for splinting metacarpus and the wrist

The universal splint module has fixing lugs, which can be bent outwards and the comers of which retain the fixing or binding means fixing the device around the limb.

The location of folding grooves of foe universal splint module furthermore enables packaging foe splint into a compact transport and package position.

List of illustrations

The above mentioned and other properties and advantages of the invention are described more in detail below together with references to foe appended figures, which illustrate the preferred embodiments, where

figure 1 is the view of tire universal splint module from above;

figure 2 is a general view of a wrist splinted with foe universal splint module;

figure 3 illustrates a forearm, elbow joint, and humerus splinted with foe universal splint module;

figure 4 illustrates an ankle joint splinted with the universal splint module;

figure 5 illustrates a tibia and knee joint splinted with the universal splint module;

figure 6 illustrates a femur splinted with foe universal splint module;

Example of an embodiment

Figure 1 illustrates splint sheet 1 of foe universal splint module with visible horizontal recessed grooves 2 and vertical recessed grooves 3, which facilitate folding foe splint. Splint sheet 1 has fixing wings 4, which can be beht out, and cutouts 5. Splint sheet 1 has apertures 6 and 7 for locating foe fixing elements to form a splint from splint sheets 1 of the universal splint module. Splint sheet 1 has wrist and metacarpus support 8, which can be bent out.

Shape and construction of a sheet

The shape of splint sheet 1 consists of a rectangular basic form. The upper or shorter edge of the rectangle is 20-40 cm long. The height of the rectangle is 40-60 cm.

All comers of the outer contour (inner as well as outer comers) are rounded with a radius of 0.01-25 mm.

Recessed lines

The recessed lines in the splint sheet are straight grooves with a depth of 0.1 mm to ¾ thickness of the sheet on the top and bottom surface of toe sheet

Horizontal recessed lines 2 perpendicular to the longitudinal axis of the sheet or folding lines extending over the entire splint sheet are following:

21 At the distance of 3-8 cm from the upper edge of splint sheet 1 over the entire splint sheet, except for the wrist support in the centre of the splint sheet;

22 At the distance of 13-25 cm from the upper edge of splint sheet 1 or approximately one third of the total length over the entire splint sheet;

23 At the distance of 20-29 cm from the upper edge of splint sheet 1 or in the central part of the splint sheet over the entire splint sheet;

24 At the distance of 13-25 cm from the lower edge of splint sheet 1 or approximately one third of the total length over the entire splint sheet.

25 At the distance of 2-4 cm from the upper edge of splint sheet 1 , between the upper edge and recessed line 21, extending 3-4 cm on both sides of the longitudinal axis.

26 At the distance of 16-18 cm from the upper edge of splint sheet 1 , between recessed lines 21 and 22 closer to recessed line 22, extending 2-4 cm on both sides of the longitudinal axis.

Vertical recessed lines 3 extending over the entire splint sheet

31 On the longitudinal axis of the splint sheet 1 ;

32 On both sides of foe longitudinal axis of the splint sheet 1 , 3-7 cm from the longitudinal axis;

2.3. At the distance of 3-8 cm from the outer longitudinal edges of the splint sheet 1 at the side of the longitudinal axis.

Cut-outs

Splint sheet 1 has straight or curved cut-outs 5 extending mirrored In relation to the longitudinal axis. The cut-outs start from the ends of recessed line 25 and end at the ends of recessed lines 26, forming wrist and metacarpus support 8. The cutouts are 0.1-3 mm wide.

Splint sheet 1 has C-shaped or trapezoidal cut-outs starting from recessed lines 33, which form fixing wings 4 when bent out, whereby foe parallel sides of foe trapezoid are vertical at +- 10 degrees; the shorter side of the trapezoid is located on recessed line 33 and the cut-out extends only along the legs and longer side of the trapezoid; and foe comers of foe trapezoid may be rounded. The legs of the trapezoid or foe highest and foe lowest point of foe C-shaped cut are located between recessed lines 21 and 22, 1-8 cm from each line. The cut-outs extend from recessed lines 33 with an outward direction from foe longitudinal axis. The longer side of foe trapezoid may be rounded towards the longitudinal axis of the splint sheet.

The upper part of splint sheet 1 includes quadrangular, rectangular, or circular cutouts located 0.5-5 cm from the edges of the sheet, which form apertures 6 for fixing details.

The lower side of the splint sheet 1 includes quadrangular, rectangular, or circular cut-outs located 0.5-5 cm from foe edges of foe splint sheet, which form apertures 7 for fixing details.

Fixing elements

Splint sheet 1 has fixing elements 9, which are rivets, snaps, loops, buttons, eyelets, swivels, etc. Fixing elements 9 are inserted into relevant apertures 6, 7 at the upper and lower edge of splint sheet 1. Fixing elements enable joining splint sheets 1 of the universal splint module with each other to obtain a splint with required length.

Splint sheet

Splint sheet 1 is made of thin sheet material, which can be cellulose-based, thermoplastic, plastic, sandwich, composite, etc. material. Splint sheet 1 may be transparent or opaque. The material may be slightly flexible in longitudinal, transverse, and other directions. The material can also be composite or sandwich material, the different layers of which have different properties, e.g. an upper layer or layers with cut-outs of non-flexibie material, and flexible intermediate or cover layer, which would ensure similar spatial behaviour e.g. in the case of a polypropylene sheet with thinned bending lines. The relation between the location of bending lines and the properties of the material defines the final flexibility of splint sheet 1. The sheet may include, partially or to the full extent, softening elements, e.g. a neoprene layer, which ensures the better compatibility of the sheet with the splinted limb during splinting. The bending of the splint sheet around the limb around the longitudinal axis of splint sheet 1 defines the final rigidity of splint sheet 1 as a splint. Splint sheet 1 may have apertures for aeration or for providing support for bandage or other fixing elements In various locations. Splint sheets may have different cut-outs in different locations, which form different shapes upon folding to ensure better support to the injured limb. The thickness of splint sheets can be from 0.1 mm to 5 mm, preferably 2 mm. Splint sheets can have different sizes, e.g. 60 x 25 cm. The length of splint sheets can be changed by folding at recessed lines 2, 3 or elsewhere. Furthermore, splint sheets can be cut mechanically with cutting means.

Use

Usage scenario 1 : Infantry squad/platoon

A fire contact is made with an adversary. The fire contact results in a casualty. Contemporary typical injury mechanisms: handgun fire (bullet), indirect fire (mine, shell, rocket, grenade fragment), explosion (mine fragment, shooting foreign objects from an improvised explosive, as well as air overpressure, throwing the casualty against surrounding objects).

Stage (1): Care Under Fire

The battle buddy of the casualty provides life-saving first aid to the casualty near the contact line, i.e. installs tourniquet on the limb and/or opens airways, if necessary. If the tactical situation allows, i.e. the suppressive fire laid down by the casualty's unit suppresses the adversary, so that handgun fire is no more efficient, the casualty is evacuated by dragging away from the area of influenced by direct small arms fire of the adversary. The distance depending on the landscape and tactical situation is approximately 25-150 meters. For dragging, the battle buddy grabs the accoutrements/bulletproof vest or clothes of the casualty. If possible, the conscious casualty must assist dragging as much as possible.

Stage (2): Tactical Field Care

The combat paramedic of the squad or platoon level provides life-saving stabilising first aid to the casualty. The physician operates based following the CABCDE or MARCH(E) (from slide no. 13) algorithm. Time Is limited (1-10 min) and at any moment, a change in the tactical situation may cause the need to terminate all operations based on an algorithm, and evacuate the casualty immediately to the next stage of aid.

In the CABCDE or MARCH(E) stage, the ETHR universal splint modules will be used. The combat paramedic takes universal splint modules 1 from their medical bag, opens vacuum package, and places splint module 1 beside the casualty.

The combat paramedic must deckle the necessary configuration of the splint of splint sheets 1 of the universal splint module. They take splint modules 1 needed for the required configuration and join them with fixing elements 9. The combat paramedic checks the suitability of the length and width of the splint on the

uninjured limb of the casualty. If necessary, the combat paramedic makes the splint smaiier/shorter or larger/longer.

Usually, two pairs of hands are required for splinting. One keeps the injured limb in a fixed position. The other installs and fixes the splint onto the injured limb. The rule of ‘two neighbours' is followed during fixing the splint. I.e„ in the case of a bone injury, the joints located on both sides of the bone are fixed; in the case of a joint injury, the bones located on both sides of the joint are fixed.

The splint is fixed around injured limb with triangular bandages, dressing, elastic bandage, tape, elastic tape, self-adhesive tape, Velcro strip, other fixing straps with fixing elements at the ends (e.g. fast fixing snaps, buckets, eyes) or strips tom from the clothes of the casualty.

If the time and tactical situation allow it, the physician must perform a secondary examination based on the BATLS algorithm. During this examination, the physician checks if the splint has been correctly fixedc and if a distal pulse can be detected (i.e. on the wrist, behind the ankle joint).

When tiie casualty has been splinted, the casualty will be placed into an evacuation device or onto an evacuation stretcher. The immobile casualty will be rolled onto the bag by using the‘single piece method*. If the height position of the casualty must be changed (i.e. in relation to the vertical axis of the evacuation device), the ‘diagonal sawing method* is used. The casualty can stay on the evacuation device lying on the back or in the‘coma position*, i.e. permanently on the side.

The combat paramedic organises the transport or lifting of the casualty with the help of the other combatants of the subunit of the casualty. Usually, the combat paramedic does not evacuate the casualty to tiie next aid stage themselves. The casualty Is taken by dragging or carrying to the Ambulance Exchange Point.

Stage (3): Tactical Evacuation

The casualty has been evacuated to the Ambulance Exchange Point. Here, the casualty must be loaded onto the evacuation vehicle. The Ambulance Exchange Point must have an armed guard, but may not have a physician, who would handle actively the casualty until the arrival of the evacuation vehicle.

In an ideal situation, toe casualty and toe evacuation vehicle reach the Ambulance Exchange Point at the same time. However, in practice, toe casualty often waits toe evacuation vehicle in a 'packaged state*. Such a delay is caused by the tactical situation and long distances, as well as the overload of evacuation vehicles. During this waiting period, the decrease of body temperature becomes especially dangerous to toe health condition of toe casualty (a decrease of toe body temperature accelerates toe weakening of blood coagulation factors). If the time and tactical situation allow it, the primary and secondary examination will be repeated.

Upon the arrival of toe evacuation vehicle, toe casualty is handed over to the accepting party. In toe course of this procedure, the MIST (Mechanism of injury, Injuries, Signs and symptoms, Treatments) report card or combat casualty card is read out loud, toe casualty is lifted onto the stretcher of the vehicle and then onto the evacuation vehicle.

Evacuation vehicles are divided into two categories: MEDEVAC (Medical Evacuation, i.e. a medical evacuation vehicle with clear marking and a team with special skills and equipment) and CASEVAC (Casualty Evacuation, i.e. any evacuation vehicle without marking arid which may lack a team with special skills and equipment). CASEVAC vehicles often lack temperature control, i.e. there is a risk that toe body temperature of toe casualty may decrease further.

Upon the arrival of toe MEDEVAC vehicle, a trained combat paramedic or combat !ifesaver will receive toe casualty at the Ambulance Exchange Point. They must monitor the casualty during tactical evacuation. If necessary, toe receiving person will repeat toe primary examination during transport based on toe CABCDE or MARCH(E) algorithm.

Upon tile arrival of the CASEVAC vehicle, a person without special skills must receive the casualty (e.g. the driver or another person). They have no skills for intervention if the condition of the casualty worsened at the stage of tactical evacuation.

The evacuation vehicle takes the casualty to get medical help of the next level. The destination may vary depending on the injury and health parameters of the casualty, as well as on the tactical situation and logistical capabilities. The options are: Role 0 Casualty Collection Point or Forward Medical Post, Role 1 Batallion Aid Station, Role 2 Brigade Field Hospital, or Role 3 Combat Support Hospital or a regional or central hospital in a civil hospital system.

Not depending on the aid level, when the casualty reaches the next aid level with tactical evacuation, the receiving operations are the same. The arrival of the evacuation vehicle transporting the casualty has been generally announced in advance over the radio. The evacuation vehicle arrives at the Vehicle reception area.

The transferor reads out the MIST report or combat casualty card of the casualty to a member of the triage team of the receiving party. The member of the triage team must decide based on the MIST or combat casualty card to which department the casualty must he transferred (typically, the casualty is first transferred to the triage area or to the emergency room if spare resources are available, but rarely directly to the operating theatre).

The casualty is unloaded from the vehicle, loaded from the stretcher of the vehicle to the stretcher of the receiving aid level institution, and then taken to the department specified by the triage team member.

The transferor moves together with the casualty to the relevant department and reads there once more out loud the MIST or combat casualty card of the casualty to tiie receiving person of the department. The transferor answers any detailed questions. After that, the transferor is allowed to return to the vehicle, and leaves. Here, the stage of tactical evacuation ends.

In the receiving department, the primary (based on the CABCDE or MARCH(E) algorithm) and secondary examinations (based on the BATLS algorithm) are repeated.

When the examination of the casualty has been completed in the receiving department, the casualty may be transferred to emergency medical, operating, intensive care, or nursing department In the receiving department, an X-ray radiograph is taken with a mobile X-ray device. This will be the basis for the decision if the limb injury of the casualty can be fixed on the spot with a permanent solution (gypsum splint) or the casualty must be evacuated to a higher aid level.

In the operating department, the splint modules can be removed so that a surgeon can fix the bone injury.

Used splint modules are discarded to waste together with other disposable medical supplies. Waste is collected and disposed (typically by incineration on high temperature).

In the transport position, the splint sheet is folded together. This Is possible due to recessed lines 1 of the splint, located transversely to the splint.

In practice, the field physician uses folded splint modules for compact storage and transport in their field bag.

Figure 2 illustrates a universal splint module rolled into a C- or U-shape in relation to the longer axis used for splinting a joint. Another option is a universal splint module rolled into a C- or U-shape in relation to the longer axis, whereby a curved wrist support is formed in the upper part of the sheet by folding back the edge.

in practice, the field physician uses a single splint module for fixing small injuries, e.g. injuries of the metacarpus or the wrist. If the injury requires the supporting of the metacarpus (e.g. a stable fracture of the wrist joint), the physician decides to use curved wrist support 8 of the splint module. If the character of the injury does not require supporting the metacarpus or if the nature of the injury excludes

supporting the metacarpus (e.g. a blunt trauma of the metacarpus), the physician decides not to use curved wrist support 8 of the splint module.

Figure 3 illustrates two universal splint modules joined at the tower parts of foe sheet and rolled into a C- or U -shape. As another option, two universal splint modules are joined through foe tower part of the sheet whereby one universal splint module is folded shorter with foe folding line of the closer axis located on foe sheet.

In practice, the field physician decides to use two or more splint modules if major injuries need to be splinted, in the case of which the longitudinal dimension of a single module may not be sufficient. Or, the functionality of a single module is not sufficient for fixing the injury.

The configuration of two splint modules illustrated in figure 3, where the modules are joined at an angle through foe lower parts, is suitable for fixing bone or soft tissue injuries of foe forearm, elbow joint, humerus, and humeral joint.

If the physician has decided to use two splint modules, they must assess which is the best possible way for correcting the dimensions of the joined splint modules to ensure that the limb of the casualty is compactly and firmly surrounded and supported by the joined splint modules.

In this case, foe physician has decided to correct foe module surrounding the humerus by folding it back from foe side feeing the humeral joint so that foe folded edge of the splint module fits comfortably under the armpit of foe casualty while providing correct support to foe area of humerus.

The physician has also decided to apply anatomically neutral wrist support 8. If the forearm of the casualty is longer than the length of the splint module modelled based on the average length of the forearm of a male person, so that the wrist and metacarpus of the casualty extend over the location of anatomically neutral wrist support 8 or over the edge of the splint module, the module supporting forearm and wrist can be extended with a third splint module. The excess length of the

extension module can be corrected by folding back the unconnected side of the extension module.

VWien the physician has prepared the splint modules in a suitable configuration, they must check foe suitability of the configuration on the uninjured limb of the casualty. If necessary, the dimensions of joined splint modules can be additionally corrected longitudinally as well as laterally by folding or cutting with scissors.

Figures 4 and 5 illustrate two universal splint modules joined into an L-shape through the lower part of the universal splint module. As an option, one universal splint module can be added, which is folded shorter with foe folding line of foe closer axis located on splint sheet 1 , and the third splint sheet 1 is fixed to the upper end of foe fUIMengfo sheet.

In practice, foe field physician decides to use two or more splint modules if major Injuries need to be splinted, in the case of which the longitudinal dimension of a single module may not be sufficient. Or, the functionality of a single module is not sufficient for fixing the injury.

In practice, the field physician decides to use the configuration of two spiint modules illustrated in figure 4 in foe case of injuries of foe ankle joint and foot. An L-shaped configuration of the splint modules ensures anatomically neutral support for fixing foe foot and ankle joint. In such a case, the physician must measure the length of the prepared configuration of splint modules on foe uninjured limb of the casualty.

Cut-outs of fixing wing 4 can be bent out from foe back folded part of the splint module fit under foe foot. Bandage, tape, and other bandaging material fixing the configuration of the splint modules to the foot and ankle joint can be fastened behind the comers of these cut-outs.

In practice, the field physician decides to use the configuration extended with a third splint module illustrated in figure 5 in the case of injuries of foe tibia or knee joint. This ensures the fixing of the foot and ankle joint as well as the leg and knee joint. In a special case with a very tall casualty, the configuration of foe three splint modules can be extended with a fourth splint module to ensure the reach of the splint over the knee joint to half of the femur. If necessary, foe dimensions of foe fourth module can be additionally corrected by folding or cutting with scissors.

Figure 6 illustrates two universal splint modules joined through foe tower part of the sheet, whereby one splint sheet 1 Is folded shorter with the folding line of foe closer gods located on foe sheet, and third splint sheet 1 is fixed to the upper end of full-length sheet 1 , while foe fourth splint sheet 1 is fixed to its lower end, which is folded shorter with horizontal folding lines, if necessary.

In practice, foe field physician decides to use foe configuration extended with a fourth splint module illustrated in figure 6 in the case of a femur injury. In such a case, the physician must measure the length of the prepared configuration of splint modules on the uninjured limb of the casualty. It is important to ensure that foe splint module readies over the pelvic bone of foe casualty to foe hip. The excess length of foe extension module can be folded back or cut off with scissors.

In foe case of femoral splint, foe splint is first fixed to foe injured limb. Then, the injured splinted limb is fixed to foe uninjured limb of the casualty with additional material enabling bandaging. This operation enables preventing the pivoting movement of the ends of the injured femur during evacuation in relation to each other, and thus minimise pain and the risk of secondary injuries. As an additional recommended measure, a pelvic splint can be installed to foe casualty, which helps to fix pelvis and hip joints, and thus minimise pain and the risk of secondary injuries.