[医药卫生]骨科牵引.pptVIP

Orthopaedic Traction Prepared By: shuye yang Traction is the application of a pulling force to a part of the body Purpose: to minimize muscle spasm; to reduce, align, and immobilize fractures; to reduce deformity; to increase space between opposing surfaces General Considerations Safe and dependable way of treating fractures for more than 100 years Bone reduced and held by soft tissue Less risk infection at fracture site Allows more joint mobility than plaster Disadvantages Costly in terms of hospital stay Hazards of prolonged bed rest Thromboembolism Decubiti Pneumonia Requires meticulous nursing care Can develop contractures(挛缩) History Skin traction used extensively in Civil War for fractured femurs Known as the “American Method” Skeletal traction by a pin through bone introduced by Steinmann and Kirschner Beds And Frames Standard bed has 4-post traction frame Ideal bed for traction with multiple injuries is adjustable height with Bradford frame Mattress moves separate from frame Beds and Frames Bradford frame enables bedpan and linen changes without moving pt Alternatively bed can be flexible to allow bending at hip or knee Knots Ideal knots can be tied with one hand while holding weight Easy to tie and untie Overhand loop knot will not slip Knots A slip knot tightens under tension Up and over, down and over, up and through Traction may be applied to the skin (skin traction) directly to the bony skeleton (skeletal traction). Skin Traction:indication Child fracture of shaft of femur Adult epiphysis Fracture pelvic fracture no evident displace Child joint contracture or adult light joint contracture Forearm Skin Traction Adhesive strip with Ace wrap Useful for elevation in any injury Can treat difficult clavicle fractures with excellent cosmetic result Risk is skin loss Double Skin Traction Used for greater tuberosity or prox humeral shaft fx Arm abducted 30 degrees Elbow flexed 90 degrees 7-10 lbs on forearm 5-7 lbs on arm Risk of i