Traction in orthopaedics


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  • No matter how complicated a fracture might appear to be, traction will often times pull the fragments into alignment very nicely.
  • the traction cords are tied to the distal end of the splint and the counter-traction force passes along the side bars of the splint to the ring and hence to the body proximal to the attachment of the muscles in spasm.
  • Initially more weight for reduction then reduce
  • Traction in orthopaedics

    1. 1. AJIMSHA SHOUKATH 09M2386
    2. 2. WHAT IS TRACTION ? Traction - the application of a force to stretch certain parts of the body in a specific direction
    3. 3. 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
    4. 4. TRACTION  Controls pain.  Reduces fracture.  Maintain reduction.  Prevents & corrects deformity.
    5. 5. TRACTION  Based on principle Fixed traction Sliding traction
    6. 6. FIXED TRACTION  Traction is applied to the leg against a fixed point of counter pressure.  Fixed traction inThomas’s splint  Roger Anderson well-leg traction  Halo-PelvicTraction
    7. 7. THOMAS SPLINT  Used for # shaft of femur  Counter traction provided by ischealTuberosity
    8. 8. SLIDING TRACTION  When the weight of all or part of the body, acting under the influence of gravity, is utilized to provide counter-traction.
    9. 9. TYPES OF TRACTION ON APPLICATION Skin traction  Adhesive  Non – adhesive SkeletalTraction
    10. 10. SKIN TRACTION
    11. 11. 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.
    12. 12. 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.
    13. 13. COMMON SKIN TRACTIONS  Buck’sTraction  Hamilton RusselTraction  Tulloch BrownTraction  Gallow’s or Brayant’sTraction  Modified Brayan’sTraction
    14. 14. Buck’s Traction  Often used preoperatively for femoral fractures  Can use tape  No more than 5 kgs
    15. 15. HAMILTON RUSSEL TRACTION  Below knee skin traction is applied  A broad soft sling is placed under the knee
    16. 16. 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.
    17. 17. MODIFIED BRYANT’S TRACTION  Sometimes used as a initial management of developmental dysplasia of hip (1YR)  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.
    18. 18. SKIN TRACTION COMPLICATIONS Of Adhesive SkinTraction :  Allergic reactions to adhesives.  Excoriation of skin.  Pressure sores over bony prominences and tendoachillis.  Common peroneal nerve palsy.
    20. 20. 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.
    21. 21. SKELETAL TRACTION  SITES  Upper tibial  Lower femoral  Lower tibial  Calcaneus  Olecrenon  Metacarpel
    22. 22. SOME SKELETAL TRACTIONS  Lateral or Upper FemoralTraction  Nintey / Nintey traction  Olecrenone traction  Perkin’sTraction
    23. 23. 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
    24. 24. 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.
    25. 25. SKELETAL TRACTION COMPLICATIONS  Infection  Cut out  Distraction at fracture site  Nerve Injury
    26. 26. CERVICAL TRACTIONS  SKINTRACTION Head Halter traction  SKELETALTRACTION Crutchfield tongs Cone or Barton tongs
    27. 27. 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
    28. 28. CERVICAL TRACTIONS LEVELLEVEL MAX. WTMAX. WT C2C2 4.5-5.4 Kg4.5-5.4 Kg C3C3 4.5-6.7Kg4.5-6.7Kg C4C4 6.7-9.0Kg6.7-9.0Kg C5C5 9.0-11.3Kg9.0-11.3Kg C6C6 9.0-13.5Kg9.0-13.5Kg C7C7 11.3-15.8Kg11.3-15.8Kg