splints and traction

SPLINTS AND TRACTION

SPLINTS• Any material used to support/immobilize afracture • Holds broken bones in place as it heals• Prevent/decrease muscle contraction• Reduces pain, swelling and muscle spasm

Unconventional splints : umbrella, cardboard-temporary/first aid

Conventional splints : Plaster of Paris, Thomas splint-refined/first aid/definitive

Plaster of Paris

Chemical formulaTypesFormsWhy it’s ideal

Fiberglass

Thomas Splint

Padded metal oval ring ; at 120 degrees to inner bar

Angle at outer bar ; 2 inches below ring

‘W’ shaped notch

Sidebars; outer bar longer

• Use : Immobilization of hip and femur injuries/fractures

TB knee Traction

Gives support to the lower limb and remove the weight of the body from the knee joint by transferring it to the pelvis.

• Parts : 1) Padded metal oval ring -at an angle of 120 degrees to inner bar-why?

2) 2 sidebars- outer bar longer

3) Angle at outer bar- 2 inches below padded ring- to clear greater trochanter

4) ‘W’ shaped notch- at distal end- to ensure uniform force of traction

• Size : chosen based on suitable ring size and length of splint

Ring size = thigh circumference at highest point of groin + 2 inches

Length = length of highest point on medial side of groin to heel + 6 inches

• Application :

• Contraindications : - Fracture of neck of femur; ring will lie on

fracture site- Dislocation of hip; difficult to hold reduction

• Complications : - Pressure sores at tibial tuberosity- Common peroneal nerve palsy

Bohler-Braun Splint

Cramer wire splint (Ladder splint)

• Temporary splintage during transportation• 2 thick parallel wires with interlacing wires• Can be cut to the desired length.• Also, it can be bent to support a limb in any

desired position.

Care of splints

• Padding – well padded at bony prominences and injury sites

• Bandage – tied with optimum pressure• Exercises – active exercises of joints and muscle• Checking – daily checking and adjustments• Neurovascular status

TRACTION

• Traction is force applied by weights or other devices to treat bone or muscle disorders or injuries.

• Types : Skeletal traction Skin traction

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.

Concerns of surgeon

• 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

SKIN TRACTION

• Indications :- Children- Temporary traction (few days; preoperative)- small force required to maintain reduction; <5 kg- Fragile/delicate skin – elderly patients

• Contraindications :– Force required >5 kg– Skin damage/ sepsis in area

SKELETAL TRACTION

• Indications : - Adults requiring >5 kg traction force- Skin damage requiring dressings- Long term

• Avoid use in children – growth plates can be easily damaged by skeletal pins

• http://ps.cnis.ca/wiki/index.php/70._Plaster