Traction ,cast and fixation nursing care

Outlines:

• Introduction of musculoskeletal system.

• Definition of traction.• Purpose of traction.• Types of traction.• Definition of cast. • compare & contrast plaster &

fiberglass casts. • Explain the care required while a

plaster cast dries.• definition of external and internal

fixation. • nursing management for client with

traction ,cast and fixation.

Objectives:◦Define the traction, cast and fixation

nursing care.

◦Discuss the nursing management for client with traction ,cast and fixation.

◦Explain the care required while a plaster cast dries .

traction

traction

Traction is the application of a pulling force to a part of the body.

refers to the set of mechanisms for straightening broken bones or relieving pressure on the spine.

The purpose of traction is to:

regain normal length and alignment of involved bone.

relieve pressure on nerves, especially spinal.

To minimize muscle spasm. To reduce align, and immobilize fractures To reduce deformity

Types of traction:Skin traction: Skin Traction : is

maintained by direct application of a pulling force on the client’s skin . It is generally used as a temporary measure.

Skeletal traction: Skeletal Traction : is attached directly to bone , providing a strong steady, continuous pull, and can be used for prolonged periods .

Modern techniques:

• Buck's traction- involving skin traction. It is widely used for femoral fractures, low back pain, acetabular fractures and hip fractures

• Dunlop's traction – humeral fractures in children

• Milwaukee brace• Bryant's traction

Nursing management:Alteration in Peripheral Tissue Perfusion:

Circulatory Care: tissue perfusion is enhanced by client exercises within the limitations of the traction.

Exercises, regular deep breathing and coughing, adequate fluids, and elastic stocking work together to prevent deep venous thrombosis.

Teaching the client about anti-coagulant is essential.

cast

Definition of cast : • A protective shell of fiberglass, plastic,

or plaster, and bandage that is molded to protect broken or fractured limb

Compare between plaster/fiberglass cast

Care required while the plaster cast dries

once applied heat is given off for ~ 15 minutes & may be uncomfortablewhile the plaster sets, the cast will remain soft & touching may lead to indentations which may then create pressure spots

until dry handle the cast with palms of hands only - not fingers

do not rest cast on hard surfaces or sharp edges

fixation

fixation

• Fixation in orthopedics is the process by which an injury is rendered immobile. This may be accomplished by internal fixation, using intramedullary rod, Kirsches wire or dynamic compression plate; or by external fixation, using a spanning external fixator, Taylor Spatial Frame or Ilizarov apparatus.

Fractures can be treated conservatively or with external and internal fixation

Internal fixationsurgical procedure that stabilizes and joins the ends of fractured (broken) bones by mechanical devices such as metal plates, pins, rods, wires or screws

External FixationA device placed outside the skin that stabilizes bone fragments with pins or wires connected to bars

“Relative stability“ Healing with callus

Nursing care of halo fixation

Summary Traction:

refers to the set of mechanisms for straightening broken bones or relieving pressure on the spine

Cast : A protective shell of fiberglass, plastic, or plaster, and bandage that is molded to protect broken or fractured

limbFIXATION:

Fixation in orthopedics is the process by which an injury is rendered immobile. This may be accomplished by internal fixation, using intramedullary rod, Kirsches wire or dynamic compression plate; or by external fixation, using a spanning external fixator, Taylor Spatial Frame or Ilizarov apparatus

Resource :• https://en.wikipedia.org/wiki/Traction_(or

thopedics)• http://www.ncbi.nlm.nih.gov/pubmed/

14615566• https://en.wikipedia.org/wiki/Fixation