Capillary refill time can also indicate vascular status. Capillary refill time greater than 2 seconds may indicate vascular injury. Vascular injury occurs most commonly with displaced fractures of the long bones. On-field reduction should be attempted only if vascular compromise is suspected. Reduction is usually accomplished by applying gentle in-line traction to the distal fracture segment while stabilizing the proximal segment.
Several principles apply in splinting.
Splints should be well padded to avoid damage to skin and superficial tissues. This is often accomplished by wrapping elastic bandages around the splint material or by using a soft material such as a cotton prewrap to cover the injured limb. When possible, the joints above and below the injury should be immobilized with the splint. Elastic bandages are generally used to apply the splint. Care must be taken to avoid applying these dressings too tightly and thus impairing distal perfusion.