Traction (orthopedics)

In orthopedic medicine, traction refers to the set of mechanisms for straightening broken bones or relieving pressure on the skeletal system. There are two types of traction: skin traction and skeletal traction.

It is largely replaced now by more modern techniques, but certain approaches are still used today:
* Bryant's traction
* Buck's traction - hip fractures
* Dunlop's traction - humeral fractures in children
* Russell's traction
* Milwaukee brace

keletal traction

Although the use of traction has decreased over the years, there is an increasing number of orthopedic practitioners that are using traction in conjunction with bracing (see Milwaukee brace). The section below provides some details on traction and its use.

Bryant's Traction

Bryant's traction is mainly used in young children who have fractures of the femur or congenital abnormalities of the hip. [cite web | url = http://www.kaleidoscope.org.au/docs/GL_Traction_Kal.pdf | title = Traction Guidelines | accessdate = 2007-07-01] Both the patient's limbs are suspended in the air vertically at a ninety degree angle from the hips and knees slightly flexed. Over a period of days, the legs hips are gradually moved outward from the body using a pulley system. The patient's body provides the countertraction.

Purpose

The purpose of traction is to:

* To regain normal length and alignment of involved bone.
* To reduce and immobilize a fractured bone.
* To lessen or eliminate muscle spasms.
* To relieve pressure on nerves, especially spinal.
* To prevent or reduce skeletal deformities or muscle contractures.

In most cases traction is only one part of the treatment plan of a patient needing such therapy. The physician’s order will contain:
*Type of traction
*Amount of weight to be applied
*Frequency of neurovascular checks if more frequent than every four (4) hours.
*Site care of inserted pins, wires, or tongs
*The site and care of straps, harnesses and halters
*The inclusion of any other physical restraints / straps or appliances (eg. mouth guard)
*the discontinuation of traction

Responsibility of initial application

The physician is typically responsible for initial application of traction and weights while the adjustment or removal (to perform ablution functions / physiotherapy) of skeletal traction weights will be based on the doctors charted plan.

In most cases cervical traction may be adjusted or temporarily removed, per physician order, by an orthopedic nurse who has documented competency to do so.

The alignment and moving of the patient will only be changed on physician's directive and the affected extremity will need to be maintained in proper alignment at all times with the ropes and traction straps - making sure the mentioned is unobstructed and weights hanging freely.

If it is necessary to move the patient while skeletal traction is in place, the patient should be moved in the bed with weights hanging freely.

In most cases traction will be applied for a number of weeks to months and Neurovascular checks will need to be performed by a nurse as ordered by the physician or as dictated per traction unit policy.

Traction is an appropriate treatment for a number of medical problems including spinal deformities such as scoliosis.

References

External links

* [http://orthopedics.about.com/cs/brokenbones/g/traction.htm About]
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* [http://www.cincinnatichildrens.org/health/info/orthopaedics/treatment/split-russells.htm "Split Russell's / Buck Traction"]
* - Bryant's traction