Non-surgical techniques: Traction Flashcards
In the hip which muscles are flexors and which are extensors?
Flexors = psoas and quads Extensors = hamstrings
What is the principle behind traction as a holding method?
Increases muscle tone which surround the fracture and maintain alignment of the broken fragments - allows movement as fracture heals - helps t induce callus formation and bone healing
In general what load is required for traction of the lower limb?
10N per 100N of body weight
How is a counter force achieved to stop the patient being pulled out of bed?
Tilting the bed backwards (using the weight of the body and the frictional resistance between the patient and the bed)
What are the 2 ways in which a load can be applied to the limb in traction?
Skin traction
Skeleta traction
What is skin traction and when should it be used?
Load applied via a foam or sticky bandage applied to the skin (attachment dependent on adhesiveness of bandage or frictional resistance of the foam)
Can only be used up to 50N
What is skeletal traction?
Load applied via pin inserted through the bone
What are the advantages of skeletal traction?
Can be used to apply large loads
Load can be precisely relative to the long axis of the bone (important when traction is being used in dynamic situations)
What is the principle disadvantage o skeletal traction?
Risk of causing bone infection at the pin bone interface
What are the 3 ways of using traction?
Static (fixed) traction
Dynamic traction
Balanced traction
What is static (fixed) traction?
Load is applied to the limb and attached to a splint so the splint itself provides the counter force
Example of static traction
Thomas Splint
Why is static (fixed) traction only acceptable for a week or two?
Prevents joint movement
Does not induce axial movement at the fracture site
Leads to muscle disuse
What is static (fixed) traction mainly used for? Why?
Treating childrens fraction - because they do not cope well with complicated traction and their fractures heal quickly
What is dynamic traction?
Same principles as in static traction but patient is encouraged to use their joints
Load is arranged so that irrespective of limb position the net pull is maintained along the axis of bone
What are the 2 functions of the pulleys in dynamic traction?
Alter the direction of the fore (by being statically mounted on a surrounding bed frame)
Alter the magnitude of the traction force (by being mounted on the limb or ‘free floating’ within the traction cord system)
What is the commonest form of traction?
A simple system with static pullets
When are free floating pulley systems useful?
When the physio wants to counter the weight of a limb segment so that very weak muscles can be exercised without the full weight of the limb early in treatment
What are the uses of balanced traction?
Used principally to offset pressure effects caused by splints
May be used as a supplement to static or dynamic traction
Example of when balanced traction is needed and why?
Thomas splint - counter force is applied to the groin (pressure effect can be offset by applying a small load to the splint as a whole which tends to draw pressure off the groin area)
What are the clinical complications of traction?
Bed sores
Chest infections
UTI
Disuse atrophy of muscles and bone
Why has traction fallen into some disuse as a technique?
Requires prolonged hospitalisation (up to 3 months at least) - inconvienient for patients and expensive for hospitals
Why is traction the safest method for treating fractures?
Easy access to the fracture
Difficulties with alignment can be easily observed and corrected
