Consideration is owed to toileting, particularly in older children for whom nappies are inappropriate. This style of traction bed is typically used for c-spine immobilisation, such a Halo traction. Rarely this may also be used for Hamilton-Russel traction for proximal femur fractures.
Using the cross clamp, fix the plain end of the long bar to the top of the proximal U-frame, as pictured. Attach the 2 remaining cross clamps to the proximal u-frame and fit the cross bar into the cross clamps so the cross bar sits approximately level. Clamp a pulley to the middle of the cross bar- Ensure there is enough space between the pulley and the end of the bed for the weights to hang unobstructed.
Clamp a medium bar to the frame. Fix a small bar with pulley to the cross bar. This type of traction is used to immobilise femur fractures in children under two years of age with a maximum weight of 12 kgs. Affix the cross clamps evenly to the head and foot of the cot, ensuring sufficient space for the child to lay comfortably.
Clamp a short bar with a pulley to the part of the long bar that hangs over the outside of the cot. Should I use adhesive or non-adhesive traction sets? Adhesive sets are most commonly required on younger, smaller patients, who require a smaller weight.
The use of adhesive traction sets, pulls the entire traction force through the skin, which can result in shearing type injury; wherein the top layer of the skin is pulled off.
We have run out of weights for traction sets, and have an acute admission. What can I do? One option is to ring the Adult Orthopaedic Service and ask to borrow weights from them. Alternatively the use of 1 litre saline bags can be a beneficial short term solution.
Each bag weighs 1Kg. Where do we apply traction for acute femur fractures? It is up to the discretion of CED and in collaboration with the orthopaedic nursing team to ensure this is co-ordinated appropriately.
In instances where it is inappropriate or impractical to apply traction in CED, it should be done on the ward. Use of benzodiazepines for the management of spasms Effective analgesia, in combination with traction, in most cases is sufficient to relieve muscle spasms associated with femoral fractures. There is evidence to support the use of diazepam for the management of spasms in children.
When spasms are not relieved by the application of an additional half to one kilogram, diazepam may be administered to children over the age of 1 as per the New Zealand Formulary for Children and as directed by the orthopaedic team. Skin traction is used to immobilise and partially realign femur fractures, this optimises patient comfort. When applied correctly, the patient should require minimal analgesia and have no requirement for diazepam.
Explain procedure to patient and family, and ensure they have had all their questions satisfactorily answered. Measure the unaffected leg to determine the required height to the traction tapes. Ensure the tapes stop distal to the fracture. The assistant slowly raises the affected leg to the minimum height required to pass the bandage wrap under the leg. Once in a satisfactory position the assistant will gently apply traction to the affected leg and hold it in this position.
The foam should cover the bilateral malleoli. Tapes should stop distal to the fracture site. The bandage wrap is then applied, starting immediately superiorly to the malleolus, wrap the bandage twice around the traction tapes and leg, this anchors the bandaging.
See Picture 1. See Picture 2- the arrows illustrate the direction of the bandaging. The patient may require some bandage wrap over their distal thigh. Repeat steps 12 and 13 stopping immediately below the tapes.
Tie a simple knot in the rope at the foot of the stirrup, allow for as much length on one side as able Secure with brown tape. Gallows traction is used to immobilise femur fractures in children under two years of age with a maximum weight of 12Kgs. Apply traction sets to both legs following the process outlined above in setting up the Gallow Traction Cot.
First position the unaffected leg so that the traction cord runs directly into the pulley and apply weight. When applying halo traction, it is imperative to ensure proper alignment of the head, shoulders and hips. If the child is seated, the pulley should sit directly above their head, their head should sit squarely above their shoulders and their hips and shoulders should be in-line.
If they are lying in bed the same applies. The bed should be tilted with the head slightly raised to optimise positioning and provide counter-traction. Always ensure the weights are off the floor and the line of traction runs directly through the pulleys to the weights and not blocked by posts or pillows.
Less force is applied during skin traction to avoid irritating or damaging the skin and other soft tissues. Skin traction is rarely the only treatment needed. During cervical traction, a metal brace is placed around your neck. The brace is then attached to a body harness or weights, which are used to help correct the affected area.
Cervical traction might be used in two different situations. First, it may be done to gently stretch the neck muscles so muscle spasms can be relieved or prevented. It may also be performed to immobilize the spine after a neck injury.
These programs often consist of physical and occupational therapy to help you regain your strength and relearn skills that may have been affected by your injury. A therapist can also teach you new skills to compensate for any pain, weakness, or paralysis you may have experienced as a result of being injured. The first few days after traction is performed can be difficult.
The muscles are often weak since you must spend a lot of time in bed after traction is performed. Moving around and walking may be challenging and can make you tired.
Traction used to be considered a state-of-the-art treatment. In recent years, however, other surgical techniques have become more advanced and more effective in correcting fractures, damaged muscles, and spinal conditions. Traction saved many lives during World War II by allowing soldiers to be transported safely without injury to their surrounding tissues. However, traction can be beneficial in treating certain conditions.
You and your doctor can discuss whether traction is the best option for your particular condition. Cervical traction refers to exercises your physical therapist can guide you through to help relieve your neck pain. There are also devices that allow…. Lower back pain and coughing often go hand-in-hand.
Nursing Center, 33 6 , Parker, M. Handoll, P. Pre-operative traction for fractures of the proximal femur in adults. The Cochrane Collaboration, Hedin, H. A cost analysis of three methods of treating femoral shaft fractures in children. Acta Orthopaedic Scand, 75 3 , Orthopaedic Traction: Care and management Pressure area prevention management clinical practice guideline Saygi, B.
Bullentin of the NYU Hospital for joint diseases, 68 1 Smith, C. Nursing the patient in traction. Nursing Times, Stewart, J. Traction and orthopaedic appliances 2 nd edition.
Styrcula, L. Traction Basics. Orthopaedic Nursing, 13 2 , Trompeter, A. Femoral shaft fractures in adults. Orthopaedics and Trauma, 27 5 , Wilson, D.
The child with musculoskeletal or articular dysfunction. In Hockenberry, M.
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