Traction

Question 1

Definition

Answer 1

application of a specific amount of pulling force ina specific direction to an extremity or other body part

Question 2

Uses

Answer 2

Preoperative
Intraoperative
Postoperative

Question 3

Purposes

Answer 3

Prevent or reduce muscle spasm and pain
Correct, lessen, or prevent deformities, including contractures
Promote rest and exercise while maintaining the position of a diseased or injured extremity.
Treat joint disorders.
Reduce a fracture or dislocation, maintain alignment, or realign bone fragments until calllus forms and calcification begins

Question 4

Methods of application

Answer 4

Manual
Skin
Skeletal

Question 5

Manual traction definition

Answer 5

Hands exert a pulling force on a bone that is to be realigned

Question 6

Manual traction purpose

Answer 6

Reduce displaced fractures or dislocations before splinting or immobilization in a cast

Question 7

Skin traction defintion

Answer 7

Application of adhesives directly to the skin

Question 8

Skin traction contraindications

Answer 8

Fractures requiring more than 5kg longitudinal force
When continuous traction will be applied for more than 2-4 weeks
When contolling limb rotation is of importance

Question 9

Skin traction purpose

Answer 9

Temporary means of stabilization

Question 10

Skeletal traction definition

Answer 10

Application of forces directly to the bone using pins, wires, or screws

Question 11

Removal of skeletal traction

Answer 11

Never removed without physician’s orders

Question 12

Skeletal traction purpose

Answer 12

Unstable or fragmented fractures

When muscle forces must be overcome to maintain fracture fragments

Question 13

Common sites of skeletal traction pin insertion

Answer 13

Proximal tibia
Calcaneous
Distal femur
Olecrenon

Question 14

Bed frame types

Answer 14

Single overhead straight
Offset
Balkan (four-poster)

Question 15

Single overhead straight frame

Answer 15

Used in basic traction with IV posts

Patients weighing less than 200lbs (91kg)

Question 16

Offset frame

Answer 16

Offset bar at the head of the bed to allow for clearance of overhead light fixtures

Question 17

Balkan (four-poster)

Answer 17

Stronger and more stable for patients weighting more than 200lbs (91kg)
Special traction setups

Question 18

Pulleys

Answer 18

Attached to traction frame
Provide proper line of pull
NEVER LUBRICATE AFTER SETUP - can alter balance of system

Question 19

Ropes

Answer 19

Run from the attachement points on the patient through the pulleys, to a weight.

Question 20

Weight

Answer 20

Metal or bags filled with sand or shot
Never add or remove weight without physician’s orders
Applied gradually with the bed in the lowest position
Never positioned above the patient’s body

Question 21

Principles of traction

Answer 21

Maintaing body position - supine, centered on bed
Provide resistance - patient is counterweight
Avoid friction - maintain proper equipment
Apply continuous force
Maintain the original line of pull
Add vecotrs of force

Question 22

Bryant’s Traction

Answer 22

Guided abduction
Vertical, bilateral traction system
Treatment of femur fractures and developmental dysplasia in children weighing less than 30 lbs (14kg)

Question 23

Cervial Traction

Answer 23

Distraction via head halter

Question 24

Traction on the humerus - use

Answer 24

Reduce fractures or dislocations of the humerus with or without involvment of the shoulder and clavicle.

Question 25

Side Arm

Answer 25

Supine, 90/90 perpendicular to humerus

Question 26

Overhead

Answer 26

90 deg forward flexion, 90 deg elbow flex, long axis humerual distraction

Question 27

Pelvic Belt

Answer 27

William's position (head slightly elevated with hips and knees slightly flexed) Wide belt around pelvis to distract lower spine

Question 28

Buck's Traction

Answer 28

Short-term, continuous traction Supine with foot of bed elevated Knee-length boot provides long-axis distraction of the hip

Question 29

Bohler-Braun Frame

Answer 29

Used with skin or skeletal traction to elevate the entire leg while in a supine position Used in treatment of complex lower extremity injuries Useful for patients requiring transportation

Question 30

Balanced suspension

Answer 30

Suspends or floats a body part Brady splint Thomas splint

Question 31

Russell's traction

Answer 31

Buck's traction with a knee sling Doubles the force of traction without added weight Treats lower extremity

Question 32

Set-up

Answer 32

Explain how the traction will be applied. Determine any contraindications. Inspect the area. Gather and inspect all equipment

Question 33

Requirements of traction set-up

Answer 33

Align the distal fragment to the proximal fragment Remain constant Allow for adequate exercise and diversion Allow for optimum nursing care Never reuse rope - risk of infection

Question 34

Primary indication for skin traction

Answer 34

Treatment of fractures or dislocations requiring a moderate amount of force for a short period of time

Question 35

Steinmann Pins vs. Kirshner Wires

Answer 35

Main difference is diameter | Steinmann larger than Kirshner

Question 36

Avoiding pressure - UE

Answer 36

Elbow bony prominences Anterior elbow soft tissue Wrist bony prominences Volar surface of the wrist

Question 37

Avoiding pressure - LE

Answer 37

``` Peroneal nerve at proximal fibula Hamstring tendons Ankle bony prominences Heels Anterior ankle and dorsum of the foot soft tissue Greater trochanters ```

Question 38

Avoiding pressure - Trunk

Answer 38

Spinal bony priminences Scapular borders Iliac crest Sacrum