traction in orthopaedic farry

7/24/2019 Traction in Orthopaedic Farry

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Orthopaedic and Traumatology Department


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DefinitionTraction is the use of a pulling force to treat muscle and

skeleton disorders

PurposesPulling the limb into a straight positionEnds muscle spasmRelieves pain


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The pull is exertedagainst the fixed point

Traction cord tied to

distal end of thomassplint and pull the legdown until theproximal


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Traction cord tiedover pulley and loadedby weight, therefore

the countertractionloaded by body weight


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Tapes are tied to theend of the splint andanother traction cord

tied over pulley andloaded by weight


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Skin Traction

!pplied " cm distal from the # site

!dhesive and $on!dhesive

%ax& weight '( !dhesive' )" lbs *+&kg-( $on !dhesive' ). lbs */&"kg-

0ontraindications' skin disorder, 1kin 2n3ury


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Skin Traction !nteromedial and

posterolateral position foradhesive tape

Protect heel with small softpillow for prevent pressure sore

Re 4 evaluate in 5 weeks

0omplication' allergic,excoriation, pressure sores,peroneal nerve palsy


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1keletal traction 6hen more pulling force is needed

Pin transfixing into the bone

( 76ire

( 1teinmann pins

0omplication'infection, incorrect placement, distraction of the #

site, ligamentous damage, Epiphyseal damage,depressed scar&


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8ateral surface of thefemur mid way

between the anterior

and posterior surfaceof femur

) inch below the mostprominent part of

greater trochanter


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Predisposes to kneestiffness 59 weeks

must be removed :replaced by proximal tibia

traction )stmethod'

( Draw a hori;ontal line at thelevel of upper pole patella

( Draw a vertical line at theanterior to the head fibula

( 2nsert 1teinmann pin wherethe 5 lines intersect


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5ndmethod'( )&5" inches *9 cm-

proximal to thearticulation betweenlateral femoral condyleand lateral tibialplateau


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< inch *5 cm- behindthe crest and belowthe tubercle of tibia


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5 inches *" cm- abovethe level of ankle 3oint,mid way between the

anterior and posteriorborder of tibia


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< inch *5 cm- belowand behind lateralmalleolus

)&5" inches *9 cm-below and behindmedial malleolus


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=se general : local anesthesia( 8ocal anesthesia the skin and periosteum on both

sides of the limb must be infiltrated

1have the skin =se full aseptic precautions *mask, cap, gown,gloves, and drapes-

Paint the skin with povidone iodine

Drape skin towels under and around the limb !sk an assistant to hold the limb in the samedegree of lateral rotation as the normal limb


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>old the pin hori;ontally and at right angle to thelong axis of the limb

Drive the pin from lateral to medial, through the

skin and bone with a gentle twisting motion ofthe forearm, while keeping the flexed elbowagainst the side of the body

!pply on each side a small cotton wool pad,

soaked in Tincture ?en;oin, around the pin toseal the wounds @it the ?Ahler stirrup !pply guards over the ends of the pin


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>ead >alter 0onservative th: of neck pain,

stable acute in3ury

0onsists 5 pads, occiput and chin&

6eight never exceed " lbs


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0rutchfield Tongs

Reduce a dislocation or fracturedislocation of cervical spine,maintain position after fusion, nerve root compression


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>alo Ring( Direction of traction can be control

( !llow patient out of bed

( 0omplication'pin track infection


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0otrel( 2diopathic scoliosis( Dynamic traction( 6eight' less than )" lbs


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Dunlop( 1upracondyler and transcondyler ofhumerus in children, where distalfragment is displaced posterolaterally

( !bduct the shoulder about /",flexed the elbow /", weight .,"),.kg

( 0omplication 'ischemic contracture&


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Olecranon 1upracondyler , shaft humerus

fracture

Olecranon pin traction

0omplication 'compartment syndrome


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0hinese finger trap( Reduction of 0olles fracture or other distal forearm

in3ury


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Pelvic 1ling( Pelvic fracture with minimal displaced


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=pper femoral 1keletaltraction(!cetabular fracture

displaced

( 2nsertion screw to greater trochanter to

neck femur


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?uck Extention 8ower back, hip, femur, or knee

1kin traction

Risk' edema, vascularobstruction, skin necrosis


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?ryant *Ballows-

1haft of the femur in the children,up to 5 yo

>ip flexion C..,knee extention&

ascular complication


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$inetyC. degrees

1ubtrochanter and shaft middlethird of femur

7nee and hip flexed to C. degrees,weight /,+C,5 kg

7nee stiffness, hip flexioncontracture, in3ury of epiphysealplate, neurovascular damage


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>amilton Russel

@emoral shaft fracture, post hiparthroplasty

Resultant of 5 forces pull in theline of shaft femur

!dult 6eight 9,+ kg, infant.,5), th


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?ohler?raun

Tibia or femur fracture

1kin traction or skeletal traction

6eight 9,5/," kg

0omplication' lateral bowing


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Thank Fou

traction in orthopaedic farry

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