Care of Patients With Traction

8/12/2019 Care of Patients With Traction

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DEFINITION OF TERMS:

1. Counter traction

- pulling force equal and opposite the traction weights. Usually the patients body

weight and bed position adjustment.

2. Fixator

- metallic plate or screw placed on the bone to provide support. It fixes the originof prime movers so that the muscle acts in an exerted at the insertion

3. Traction- is the application of a pulling force, used to stretch soft tissue and to separate

join surfaces on bone fragments . It involves applying as a force of sufficientmagnitude and duration while simultaneous resisting movement of the body

4. Trapeze

- an overhead patient helping device to promote mobility in bed. A triangular devicehung from the ceiling or from a bar over the bed which can be adjusted to thepatients reach. Patient should be assisted upon changing positions or sitting.


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PURPOSE:

used primarily as a short term intervention until other

modalities such as external or internal fixator are possible

reducing the risk of disuse syndrome

to relieve pain

reduce, align and immobilize fractures, to reduce deformitiesand to increase space between opposing surfaces

to maintain proper alignment until bone develops


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INDICATIONS:

to reduce fracturesthe application of traction overcomes the

injured limbs tendency to shorten ( due to muscle spasm) andholds the limb constantly in a position of corrective extension

with the ends of the fractured bone aligned

immobilization of an area before surgery

control and relieve of painful muscle spasm

stretching adhesions


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degenerativejoint disease

relief from general, vague back pain

treatment of painful arthritis, sore muscles and ligaments,

dislocations, degenerated or ruptured intervertebral disks and

spinal cord compression


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CONTRAINDICATIONS:

Patients with structural diseases secondary to tumor or

infection, rheumatoid arthritis and severe vascular compromise

Acute strains, sprains and inflammation conditions

Malignancy

aneurysm


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1. SKIN TRACTION

- in skin traction, the pull is applied to the client's skin which

transmitted the pull to the musculoskeletal structures. A belt,head halter, foam rubber wrapped with an elastic bandage, or a

foam boot is applied to the client's skin before the appendage is

attached to traction.


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a. Pelvic Traction


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used in pelvic fractures to support separated bones. Thistraction may be applied by either a belt or a sling. The pelvic beltcauses downward pull on the pelvis, while the pelvic sling supportsthe pelvis off the bed. With a pelvic belt, the upper rim of the belt

should rest at the top of the iliac crest and not around the abdomen.This type of traction is a running traction that is used to reducedmuscle spasm of the lower back, relieve sciatica, immobilize afractured pelvis, or correct lateral deviations of the spine.

It is usually applied intermittently, on 2 hours, off 2 hours,while the client is awake. Weights on the traction are increasedgradually. Never remove or changed the weights on any tractiondevice without a physician's order.


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Care for patients with pelvic traction:

1. Ensure that the pelvic girdle is properly size for patient

2. Ensure that pelvic girdle fits snugly over iliac crests and pelvis

3. Inspect skin areas over iliac crests for pressure points q4h4. Provide perineal area hygiene after bedpan use

5. Ensure integrity by providing back care q4h

6. Maintain sling placement beneath lower back with buttockselevated from mattress. Replace soiled sling.

7. Lift and turn patients use of trapeze if it alters compressive forceson pelvis

8. Maintain bed in flat position

9. Change bed linen from head to foot rather than from side to side


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is a running skin traction that can be used temporarily to

immobilize a fracture of the hip/femur until it is possible to do

surgery. It can also be used to relieve muscle spasms in the

lower back, to prevent contracture after computation, or torealign the vertebrae in a client with scoliosis.

the leg is wrapped with an elastic roller bandage or tape.

Traction is applied through a weight attached to a spreader barbelow the foot. A foam boot may also be used. The traction pull

is toward the pulley at the bottom of the bed.


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Care of patients with Bucks Traction:

Ensure skin integrity by avoiding pressure on heel, dorsum

or foot, fibular head, or malleolus

Maintain counteraction by elevating foot of bed or keepinghead of bed flat

Encourage independence with use of trapeze


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Care of patients with Russells Traction:

1. Assure skin integrity by avoiding pressure on heel, dorsum

of foot, fibular head, or malleolus

2. Maintain counteraction by elevating foot of bed or keeping

head of bed flat

3. Encourage independence with use of trapeze

4. Ensure sling is smooth and does not apply undue pressure

on popliteal space or peroneal nerve or lateral aspect of

knee


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Care for patients with Bryants Traction:

1. Raise buttocks slightly from mattress2. Observe bandages carefully for slippage and bunching over

heel cords

3. Observe for skin sloughing on both legs

4. Check feet for color, pulses, warmth, and sensation q2h toq4h

5. Use harness restraint to prevent turning over

6. Avoid thick, wide diapers between legs


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7. Used in children younger than 3 years, weighing less than 30lb

8. Apply bilaterally with hips with hips flexed 45 degrees and legs in

extension

9. Ensure skin integrity with nonadhesive straps and wraps that donot impair neurovascular status

10. Ensure buttocks are elevated 1 to 2in. from mattress

11. Ensure parents understanding of the purpose and use of traction

12. Utilize jacket or vest restraint to prevent child from rotating in thebed


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2.SKELETAL TRACTION

-is a applied directly to the bone with wires or pins that are

inserted during surgery.


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Care of patients with Skeletal Traction: Cover ends of pin with cork

Observe site of insertion

Redness

Swelling

Discharge

OdorBleeding

Clean skin around puncture sites as ordered


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TYPES OF FIXATOR

E X T E R N A L F IX A T O R


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-is the device is used to manage complex fractures that

associated with soft tissue damage or with open wounds

in the fractures area. A physician inserts multiple pins that

protrude through the clients of skin into the bone

fragments. The external fixation device is a metal frame

that, on the outside of the body, holds the pins in place

and maintains immobilization. The picture shown is anexample of external fixator being used in the treatment of

a fractured radius bone.


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I N T E R N A L F I X A T O R


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Internal fixation is done through open reduction, thesurgeon places a pin, wire, screw, plate, nail or rod into

or onto the bone to keep it reduced (properly aligned),immobilized, or both. This procedure is called openreduction, internal fixation (ORIF) and is the treatment ofchoice for certain fractures in which casting is generallyimpossible (hip fracture).

Internal fixation can be performed using various devices.It is most frequently with fractures of the legs long bones,in which case the spike is called intermedullary nail

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Care of Patients With Traction