2.Balance Skeletal Traction

7/29/2019 2.Balance Skeletal Traction

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The Balance SkeletalTraction


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The traction is the act of pullingand drawing which is associated

with counter traction


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INDICATION

to reduce fracture

For immobilization

For support

To reduce pain and muscle spasm

To maintain good alignment

To prevent and correct deformity


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PREPARATION

1. check the doctors order Patients name

Extremity to be placed on BST

Weight to be applied

2. Prepare patient psychologically

Introduce yourself

Inform patient on what is to be done

The purpose of the treatment

Expectation from the patient


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3. prepare the bed and equipment needed

A. orthopedic bed Firm mattress

Fracture board

Bed elevator/ shock block Balkan frame (cross bar, curve bar, vertical,

horizontal and diagonal bar)

3pulleys

3clamps

Overhead trapeze


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B. traction equipment

Thomas splint (with half ring)

Pearson attachment

Rest splint

Steinmanns pin holder

Braun bohler splint Slings with clips or pins

3sash cords (thigh rope, traction rope,

suspension rope) 2weights (traction weight 10% of the patients

weight; suspension weight of traction weight)

Foot pedal or foot board


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PRINCIPLES

1. patient should be in dorsal recumbentposition

2. there must be counter traction (pt. weight)

3. there must be continous traction 4. the line of the pull should be in line with the

deformity (the first pulley is in the line with theinguinal area, the 2nd pulley is in the line with

the knee, the 3rd pulley is in the line with the 1stand 2nd pulley


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5. avoid friction There should be no knots near the pulley

Cords should be running along the grooves of

the pulley Weights should be hanging freely

Observe for the wear and tear of the bags and

the cords


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APPLICATION

1. measure the distance form the lateral side ofthe trochanter to the knee by using one of thecords

2. position the pearsons attachment under the

thomas splint according to above measrementscrew them together

3. apply the rest splint

4. apply the slings following the principles below

A. start from the medial aspect to the thomassplint and fasten at the lateral aspectwith pins(to prevent injury)


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B. apply slings snugly, no too tight (so as not

to impede circulation) nor too loose (w/cdefeats the purpose to support)

C. the smooth surface of the sling shouldcome in contact with the patient skin (to

prevent skin irritation)

D. provide approximately an inch spacebetween slings (for ventilation)

E. if slings is too long, fanfold it F. number of slings will vary on the size of

patinets leg


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G. keep the ankle and the popliteal area free

from slings (these are highly vascular areas) H. the broader and longer of the slings are for

the thigh area while the narrower and shorter

ones are for the leg area

5. Using a slip knot , tie one end of the thighrope at the junction of the medial upright ofthe thomas splint (done before the petientsleg is placed on the thomas splint for privacy)


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6. decide on the three manpower

A. insert TS and PA correctly without moving the

leg inappropriately B. provides continous manual traction and

pushes braun bohler splint away from the workarea

C. supports leg with palm of the hand

7. Instruct the patient on the following:

A. hold on the overhead trapeze

B. flex the unaffected leg and lift the buttocks C. at the count of 3, swing the body so that we

simultaneously transfer the affected leg on thethomas splint


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8. at the count of 3, transfer the affected legwhile providing manual traction

9. using a slip knot, tie one end of thetraction cord at the steinmanns pin holder.Pass the cord along the groove of the 3rd

pulley, then attach the traction weightbag(10% of the weight of the client) to theother end of the traction cord using any kindof knot. There should be 1foot distance from

the pulley to the knot or the bottom part ofthe bag should be at the level of the bed.Consume the rope


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10. tie the other end of the thigh cord to the lateralaspect of the thomas splint using a slip knot

11. using again a slip knot, tie one end of thesuspension cord to the middle of the thigh cord.Pass the cord along the groove of the 1st pulley,

then to the suspension weight bag (1/2 of the

weight of the traction weight), temporarily hang

the weight bag over the pulley. Then pass the

same cord along the groove of the 2nd pulley,

down to the other side of the traction cord, thenunder the rest splint. Tie it over the end of thethomas splint using a clove-hitch knot and another

clove-hitch knot at the end of the pearsons

attatchment. Consume the rope


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12. release the suspenson weight aandremove the rest splint

13. apply foot pedal using a ribbon knot. Theshorter the cords should be tied at thethomas splint while the longer cords are tied

to the pearsons attatchment in between thelast and the second to the last sling

14. check for the effeciency of traction by

swinging backwards and forward thensideway


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HOW TO REMOVE THE TRACTION

1. hang the suspension weight 2. apply the rest splint

3. remove the suspension cord andsuspension weight

4. apply manual traction and remove thetraction weight

5. tie the traction rope instead to the rest

splint using a single knot, then to the thomassplint and to the pearsons attatchment usingthe clove-hitch knot


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Nursing care

Hygeine and comfort Avoid infection

Proper nutrition

Prevent pressure sores Exercise of the unaffected extremity and of

affected extremity

Prevent pulmonary problems Diversional activity

Attend to any complaint of the patient


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Nursing Management
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2.Balance Skeletal Traction

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