Orthopaedic Traction Methods - Stellenbosch …• Vascular obstruction • Peroneal nerve palsy •...
Transcript of Orthopaedic Traction Methods - Stellenbosch …• Vascular obstruction • Peroneal nerve palsy •...
Orthopaedic Traction Methods
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OrthopaedicOrthopaedicTraction MethodsTraction Methods
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Skin TractionSkin Traction
Indications for Skin Traction
• Children• Tempory traction -
• preoperative• pain
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Skin TractionSkin Traction
Contraindications
• Force required > 5kg• Skin damage or sepsis in area
Orthopaedic Traction Methods
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Skin TractionSkin Traction
Dangers of Skin Traction
• Distal Oedema• Vascular obstruction• Peroneal nerve palsy• Skin
• allergy• pressure points
Femoral TractionFemoral TractionGallowsGallows
Indications
• Child < 12 kg• Femoral fractures• Skin must be intact
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Femoral TractionFemoral TractionOlder ChildOlder Child
Indications
• Child > 12 kg• Femoral fractures• Skin must be intact
Orthopaedic Traction Methods
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Femoral TractionFemoral TractionOlder ChildOlder Child
Orthopaedic Traction Methods
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Femur FracturesFemur FracturesForces DisplacingForces Displacing
Abducted
Psoas
Flexes
Adductors
Distal only
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Forces DisplacingForces Displacing
Treatment
• align
distal with proximal
= Flexion and Abduction
Conservative AdultConservative Adult
Orthopaedic Traction Methods
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Conservative AdultConservative AdultDenham PinDenham Pin
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Conservative AdultConservative AdultDenham PinDenham Pin
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Cervical TractionCervical TractionHalterHalter
Halter - for short-term cervical traction
Orthopaedic Traction Methods
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Cervical TractionCervical TractionHalterHalter
Problems• Uncomfortable• Pain tempero-mandibular• Contraindicated in mandible fractures• Difficult to control flexion - extension
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Cervical TractionCervical TractionSkeletalSkeletal
Indications Cones Calipers
• Long term cervical injuries
• fractures• instability
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Cervical TractionCervical TractionSkeletalSkeletal
Direction and Weights
• Force - 2.5 kg head + 1/2 kg for each vertebra*• Direction Neutral- line with Auditory meatus• Flexion needed - raise pulley• Extension needed - use double matress ending @ shoulders
Orthopaedic Traction Methods
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Cervical TractionCervical TractionSkeletalSkeletal
Complications
• Bleeding - temoral artery• Pressure sore on skull -avoid downwards vector to rope• Sepsis - from skin to subural abscess• Worsening neurological status• Squint from 6th nerve fallout
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Cervical TractionCervical TractionSkeletalSkeletal
Contraindications
• Children• Local sepsis• Skull fracture
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Cervical TractionCervical TractionSkeletalSkeletal
Reduction of vertebrae
• Locked facets etc• Load - serially up to 15 kg with neck flexed
Orthopaedic Traction Methods
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Dunlop Traction
• Supracondyalarfractures in children• Allows swollen elbow to settle• Contraindicated in open fractures and skin defects
Dunlop Traction
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BackacheBackache
Pelvic traction for sciatica
Orthopaedic Traction Methods
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