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Splinting & traction

1

Dr. Ashish GohiyaMS (Orth), FIAS, FIOS (UK)

Associate Professor Department of Orthopaedics & Traumatology

Gandhi Medical College, Bhopal

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Earthquake

Dr. Ashish Gohiya 2

Tsunami

Dr. Ashish Gohiya 3

Mumbai Blast

Dr. Ashish Gohiya 4

Taj Attack

Dr. Ashish Gohiya 5

Dr. Ashish Gohiya 6

Dr. Ashish Gohiya 7

Dr. Ashish Gohiya 8

Dr. Ashish Gohiya 9

Dr. Ashish Gohiya 10

Why do we Splint

•To stabilize the extremity

•To decrease pain

•To avoid further injury

•To treat the injury


Which limbs need splinting

Physical signs of a fracture: Swelling Tenderness Deformity (seen or felt) Impaired function Abnormal movement in a limb Crepitus or grating between the bone ends Pain on stressing the limb by bending or

longitudinal compression


On- Site Splinting


Air Splints


Emergency splints


Thomas Splint


Sir Hugh Owen Thomas

Bohler Braun Splint


Plaster

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Above elbow Below elbow

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Above knee Below knee

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Complications of Splinting

• Abrasions

• Sores

• Neurovascular compromise (tight fitting splints)

• Contact dermatitis

• Pressure ulcers

• Thermal burns



The pain is worsening after

splint application

Remove Splint /Plaster

Watch for 5 P’s

Compartment syndrome

Pain

Pallor

Pulse less Paralysis

Paresthesia


Traction

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Trauma to bone, joint, soft tissue

Spasm of muscles

Deformity & impaired function


TRACTION

Control movement of the part

Controls pain

Reduces Fracture

Maintains reduction

Prevents and

corrects deformity


National PG Instructional Course,

Bhopal

TRACTION

•Based on duration •Continuous traction•Intermittent traction

•Cervical•pelvic

TRACTION

•Based on principle •Fixed traction•Sliding traction

COUNTER TRACTION

FIXED TRACTION

• Traction is applied to the leg against a fixed point of counter pressure.

• Fixed traction in Thomas’s splint

• Roger Anderson well-leg traction

SLIDING TRACTION

• When the weight of all or part of the body, acting under the influence of gravity, is utilized to provide counter-traction.

SLIDING TRACTION

SLIDING TRACTION

• Exact weight required is determined by trial.

• For the fracture of femoral shaft an initial weight of 10% of body weight

• Foot end is elevated so that the body slides in opposite direction.

• 1 inch (2.5 cm) for each 1 lb (0.46 kg) of traction weight

TRACTION

•Based on application •Skeletal traction•Skin traction

•Adhesive •Non – adhesive

TRACTION

Skin Traction

Adhessive Non- Adhessive

Skeletal Traction


Skin Traction

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SKIN TRACTION

COMPLICATIONS

• Allergic reactions to adhesives.

• Excoriation of skin.

• Pressure sores over bony prominences and tendoachillis.

• Common peroneal nerve palsy.

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2 cm distal & posterior to tibial tuberosity

UPPER TIBIAL PIN


LOWER FEMORAL PIN


LOWER TIBIAL PIN

5 cm proximal to ankle joint


CALCANEAL PIN

2.5 cm distal & posterior to Lateral Malleolus

DR. ASHISH GOHIYA

SKELETAL TRACTION

COMPLICATIONS

• Infection

• Cut out

• Application of splint difficult

• Distraction at fracture site

• Ligament damage

• Physeal damage

• Depressed scars

HAMILTON RUSSEL TRACTION

TOMBERLIN TRACTION

• variation of Russell traction

• Pearson attachment is attached to a tibial Steinmann pin and held in place by a traction bow

NINETY / NINETY TRACTION

GALLOW’S TRACTION

• Children up to age of 2 yrs.

• Weight of child should be less than 15- 18 kg

• B/L Above knee

GALLOWS TRACTION

National PG Instructional Course, Bhopal

MODIFIED BRYANT’S TRACTION

DDH (1 YR) After 5 days Abduction increased by about 10 degree alternate days

DUNLOP TRACTION

Uses ?

LATERAL UPPER FEMORAL TRACTION

2.5 cm

Screw eye

AGNES HUNT TRACTION

FOR THE CORRECTION OF FLEXION DEFORMITYOF THE HIP.

ROGER ANDERSON WELL LEG TRACTION

CHARNLEY’S TRACTION UNIT

Any Questions ?



• What is traction ?

• How it works ?

• Where it is used ?

• What are the types of traction ?

• How the traction is applied ?

• What are the complications of traction ?

• Few named tractions ?

? ? ? ? ? ?

Summary

Dr. Ashish Gohiya BTLS – GMC. 05/01/2009

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On Site

Emergency Splints

Any hard thing

Use other limb

Summary


69

In Hospital

Thomas Splint

BohlerBrown splint

Plaster Slab

Summary


70

Traction

Skin Traction

Skeletal Traction

splinting & tractiongohiyaorthoclinic.com/.../2015/07/traction-and-splints.pdfbohler braun...

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