Fracture Management - Traction

Question 1

How does traction work?

Answer 1

Muscles around the fractured limb are subject to a slight increase in load so as to increase muscle tone - the increased muscle tone provides a cuff of muscle around the fracture to maintain alignment.

As the bone heals the patient will feel able to move a little, increasing muscle contraction in an irregular way, inducing micro motion and callus formation and subsequent bone healing

Question 2

How is the counter force to traction achieved?

Answer 2

tilting the bed backwards

Question 3

What two ways is load applied to a limb?

Answer 3

skin traction via adhesive bandage - possibility of injuring skin with high loads

skeletal traction - pin inserted through the bone - important in dynamic situations but there is a risk of infection of the bone pin

Question 4

What 3 ways can the principle of traction be used?

Answer 4

static
dynamic
balanced

Question 5

What is static traction

Answer 5

load is applied to the limb and attached to a splint so that the splint itself provides counterforce

Question 6

Name an example of static traction

Answer 6

Thomas splint

Question 7

Name a disadvantage of static traction

Answer 7

immobility prevents joint movement and causes muscle disuse

Question 8

What patients can static traction be used for?

Answer 8

children - dont cope well with complicated traction and fractures heal quickly

Question 9

What is dynamic traction

Answer 9

the same as static traction but the patient is encouraged to use their limb so the load is arranged so that irrespective of position, the net pull is maintained along the bone axis

Question 10

How is dynamic traction achieved?

Answer 10

use of pulleys

Question 11

What is balanced traction?

Answer 11

a process used to supplement dynamic or static traction that is principally used to offset pressure effects from splints

Question 12

What are some complications of traction treatment?

Answer 12

bed sores 
chest infection 
urinary infections 
disuse atrophy of muscles 
bone atrophy

Question 13

What factors must be taken into consideration when deciding fracture treatment?

Answer 13

the patient - age, fitness, functional requirements

the injury - closed, open, ligament injury, nerve damage, blood vessel damage

available facilities - setting, country, surgeon experience, environment

skills of the operator - properly trained surgeons