orthopaedic traction methods - stellenbosch …• vascular obstruction • peroneal nerve palsy •...

Orthopaedic Traction Methods

ICM Robertsonhttp://www0.sun.ac.za/ortho 1

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OrthopaedicOrthopaedicTraction MethodsTraction Methods

Mb. Mb. ChBChB. 5 & 6. 5 & 6

I an RobertsonI an Robertson

Skin TractionSkin Traction

Indications for Skin Traction

• Children• Tempory traction -

• preoperative• pain



Contraindications

• Force required > 5kg• Skin damage or sepsis in area





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


Femoral TractionFemoral TractionOlder ChildOlder Child

Indications

• Child > 12 kg• Femoral fractures• Skin must be intact




Femoral TractionFemoral TractionOlder ChildOlder Child




Femur FracturesFemur FracturesForces DisplacingForces Displacing

Abducted

Psoas

Flexes

Adductors

Distal only


Forces DisplacingForces Displacing

Treatment

• align

distal with proximal

= Flexion and Abduction

Conservative AdultConservative Adult




Conservative AdultConservative AdultDenham PinDenham Pin


Conservative AdultConservative AdultDenham PinDenham Pin


Cervical TractionCervical TractionHalterHalter

Halter - for short-term cervical traction




Cervical TractionCervical TractionHalterHalter

Problems• Uncomfortable• Pain tempero-mandibular• Contraindicated in mandible fractures• Difficult to control flexion - extension


Cervical TractionCervical TractionSkeletalSkeletal

Indications Cones Calipers

• Long term cervical injuries

• fractures• instability



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





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



Contraindications

• Children• Local sepsis• Skull fracture



Reduction of vertebrae

• Locked facets etc• Load - serially up to 15 kg with neck flexed



Dunlop Traction

• Supracondyalarfractures in children• Allows swollen elbow to settle• Contraindicated in open fractures and skin defects

Dunlop Traction


BackacheBackache

Pelvic traction for sciatica




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orthopaedic traction methods - stellenbosch …• vascular obstruction • peroneal nerve palsy •...

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