Traction (orthopedics)
Encyclopedia
In orthopedic medicine
, traction refers to the set of mechanisms for straightening broken bone
s or relieving pressure on the spine
and 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:
). The section below provides some details on traction and its use.
Mirror image (opposite posture)
postural corrective exercises and a
new method of trunk-list traction
resulted in 50% reduction in trunk
list and were associated with nearly
resolved pain intensity in this patient
population. The findings warrant
further study in the conservative
treatment of chronic low back pain
and spinal disorders.
or congenital abnormalities of the hip. 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 hips are gradually moved outward from the body using a pulley system. The patient's body provides the countertraction.
In most cases traction is only one part of the treatment plan of a patient needing such therapy. The physician’s order will contain:
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.
"mirror image methods" (lateral translation exercise and
traction) were found to produce statistically significant
and clinically significant reductions in pain and trunklist
posture, a finding not observed in the control group.
160
In fact, the control group’s lateral thoracic translations
were slightly worse at follow-up, possibly indicating
progression of the disorder. Because these trunk-list
postures are commonly associated with lumbar disc
herniation and lower back pain, randomized controlled
trials should be performed to evaluate the clinical significance
of restoration of normal spinal-alignment
biomechanics in chronic LBP pain subjects. Due to
discrepancy between our study findings and a previous
report, it is suggested that AP lumbo-pelvic radiographs
and posture of the trunk should both be used as outcome
measures in the treatment of the trunk-list deformity.
Orthopedic surgery
Orthopedic surgery or orthopedics is the branch of surgery concerned with conditions involving the musculoskeletal system...
, traction refers to the set of mechanisms for straightening broken bone
Bone fracture
A bone fracture is a medical condition in which there is a break in the continuity of the bone...
s or relieving pressure on the spine
Vertebral column
In human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...
and 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 fractureHip fractureA hip fracture is a femoral fracture that occurs in the proximal end of the femur , near the hip.The term "hip fracture" is commonly used to refer to four different fracture patterns and is often due to osteoporosis; in the vast majority of cases, a hip fracture is a fragility fracture due to a...
s - Dunlop's traction - humeral fractures in children
- Russell's traction
- Milwaukee braceMilwaukee braceThe Milwaukee brace, also known as a cervico-thoraco-lumbo-sacral orthosis or CTLSO, is a back brace used in the treatment of spinal curvatures in children. It is a full-torso brace that extends from the pelvis to the base of the skull...
Skeletal traction
Although the use of traction has decreased over the years, an increasing number of orthopaedic practitioners are using traction in conjunction with bracing (see Milwaukee braceMilwaukee brace
The Milwaukee brace, also known as a cervico-thoraco-lumbo-sacral orthosis or CTLSO, is a back brace used in the treatment of spinal curvatures in children. It is a full-torso brace that extends from the pelvis to the base of the skull...
). The section below provides some details on traction and its use.
Mirror image (opposite posture)
postural corrective exercises and a
new method of trunk-list traction
resulted in 50% reduction in trunk
list and were associated with nearly
resolved pain intensity in this patient
population. The findings warrant
further study in the conservative
treatment of chronic low back pain
and spinal disorders.
Bryant's Traction
Bryant's traction is mainly used in young children who have fractures of the femurFemur
The femur , or thigh bone, is the most proximal bone of the leg in tetrapod vertebrates capable of walking or jumping, such as most land mammals, birds, many reptiles such as lizards, and amphibians such as frogs. In vertebrates with four legs such as dogs and horses, the femur is found only in...
or congenital abnormalities of the hip. Both the patient's limbs are suspended in the air vertically
Vertical direction
In astronomy, geography, geometry and related sciences and contexts, a direction passing by a given point is said to be vertical if it is locally aligned with the gradient of the gravity field, i.e., with the direction of the gravitational force at that point...
at a ninety degree angle
Right angle
In geometry and trigonometry, a right angle is an angle that bisects the angle formed by two halves of a straight line. More precisely, if a ray is placed so that its endpoint is on a line and the adjacent angles are equal, then they are right angles...
from the hips and knees slightly flexed. Over a period of days, the 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
- 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.
Evidence basis
Lumbar spinal manipulation followed by Harrison"mirror image methods" (lateral translation exercise and
traction) were found to produce statistically significant
and clinically significant reductions in pain and trunklist
posture, a finding not observed in the control group.
160
In fact, the control group’s lateral thoracic translations
were slightly worse at follow-up, possibly indicating
progression of the disorder. Because these trunk-list
postures are commonly associated with lumbar disc
herniation and lower back pain, randomized controlled
trials should be performed to evaluate the clinical significance
of restoration of normal spinal-alignment
biomechanics in chronic LBP pain subjects. Due to
discrepancy between our study findings and a previous
report, it is suggested that AP lumbo-pelvic radiographs
and posture of the trunk should both be used as outcome
measures in the treatment of the trunk-list deformity.
External links
- About
- "Split Russell's / Buck Traction" - Bryant's traction
- Traction in Physiotherapy