traction in orthopaedics
TRANSCRIPT
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AJIMSHA SHOUKATH09M2386
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WHAT IS TRACTION ?
Traction - the application of a force to stretch certain parts of the body in a specific direction
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WHY DO WE NEED TRACTION ?
Reduction of fractures and dislocations and
their maintenance
For immobilizing a painful, inflamed joint
For the prevention of deformity, by
counteracting the muscle spasms associated
with painful joint conditions.
For correction of soft tissue contractures by
stretching them out
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TRACTION
Controls pain. Reduces fracture. Maintain reduction. Prevents & corrects deformity.
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TRACTION
Based on principle Fixed tractionSliding traction
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FIXED TRACTION
Traction is applied to the leg against a fixed point of counter pressure.
Fixed traction in Thomas’s splint Roger Anderson well-leg traction Halo-Pelvic Traction
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THOMAS SPLINT
Used for # shaft of femur Counter traction provided by ischeal
Tuberosity
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SLIDING TRACTION
When the weight of all or part of the body, acting under the influence of gravity, is utilized to provide counter-traction.
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TYPES OF TRACTION ON APPLICATION
Skin traction Adhesive Non – adhesive
Skeletal Traction
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SKIN TRACTION
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SKIN TRACTION
Traction force is applied over a large area of skin
Applied over limb distal to fracture site
Anteromedial and posterolateral part should be covered with cotton.
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SKIN TRACTION
Adhesive skin traction: Maximum weight 6.7 kg
Non-adhesive skin traction Maximum weight should not exceed
4.5 kg Used in thin and atrophic skin, skin sensitive to adhesive strapping.
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COMMON SKIN TRACTIONS
Buck’s Traction Hamilton Russel Traction Tulloch Brown Traction Gallow’s or Brayant’s Traction Modified Brayan’s Traction
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Buck’s Traction
Often used preoperatively for femoral fractures
Can use tape No more than 5 kgs
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HAMILTON RUSSEL TRACTION
Below knee skin traction is applied A broad soft sling is placed under
the knee
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BRYANT’S (GALLOW’S ) TRACTION
the treatment of fracture shaft femur in children up to age of 2 yrs.
Weight of child should be less than 15- 18 kg
Above knee skin traction is applied bilaterally
Tie the traction to the over head beam.
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MODIFIED BRYANT’S TRACTION
Sometimes used as a initial management of developmental dysplasia of hip (1 YR)
After 5 days of Bryant’s traction, abduction of both hips is begun increased by about 10 degree alternate days.
By three weeks hips should be fully abducted.
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SKIN TRACTION
COMPLICATIONS Of Adhesive Skin Traction :
Allergic reactions to adhesives. Excoriation of skin. Pressure sores over bony
prominences and tendoachillis. Common peroneal nerve palsy.
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SKELETAL TRACTION
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SKELETAL TRACTION
pin or wire more frequently used in lower limb
fractures Should be reserved for those cases in
which skin traction is insufficient. Generally used when more weight is
needed to give traction. To treat fractures conservatively.
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SKELETAL TRACTION
SITES
Upper tibial Lower femoral Lower tibial Calcaneus Olecrenon Metacarpel
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SOME SKELETAL TRACTIONS
Lateral or Upper Femoral Traction Nintey / Nintey traction Olecrenone traction Perkin’s Traction
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LATERAL or UPPER FEMORAL TRACTION
For the management of central fracture dislocation of the hip
about 2.5 cm from most prominent part of greater trochanter mid way between ant. And post. surface of femur
threaded screw Attach weight upto 9 kgs Traction to continued for about 4-6
wks
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NINETY / NINETY TRACTION Used for sub trochanteric fractures
and those in the proximal third of the shaft of the femur
Management of fractures with posterior wound is easier
Traction is given through lower femoral pin, which is more efficient, or by upper tibial pin.
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SKELETAL TRACTION
COMPLICATIONS
Infection Cut out Distraction at fracture site Nerve Injury
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CERVICAL TRACTIONS
SKIN TRACTION Head Halter traction
SKELETAL TRACTION Crutchfield tongs Cone or Barton tongs
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Head Halter traction
Simple type cervical traction
Management of neck pain
Weight should not exceed 3 kg initially
Can only be used a few hours at a time
Head end should be elevated to give counter traction
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CERVICAL TRACTIONS
LEVELLEVEL MAX. WTMAX. WT
C2C2 4.5-5.4 Kg 4.5-5.4 Kg
C3C3 4.5-6.7Kg 4.5-6.7Kg
C4C4 6.7-9.0Kg 6.7-9.0Kg
C5C5 9.0-11.3Kg 9.0-11.3Kg
C6C6 9.0-13.5Kg 9.0-13.5Kg
C7C7 11.3-15.8Kg 11.3-15.8Kg
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