| Traction (orthopedics) | |
|---|---|
| Intervention | |
Early Greek traction device, from a Byzantine edition of Galen's work in the 2nd century AD. |
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| ICD-9-CM | 93.4 |
| MeSH | D014143 |
In orthopedic medicine, traction refers to the set of mechanisms for straightening broken bones or relieving pressure on the spine and skeletal system. There are two types of traction: skin traction and skeletal traction.
It is largely replaced now by more modern techniques, but certain approaches are still used today:
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Although the use of traction has decreased over the years, an increasing number of orthopaedic practitioners are using traction in conjunction with bracing (see Milwaukee brace). The section below provides some details on traction and its use. Mirror image (opposite posture) postural corrective exercises and a new method of trunk-list traction resulted in 50% reduction in trunk list and were associated with nearly resolved pain intensity in this patient population. The findings warrant further study in the conservative treatment of chronic low back pain and spinal disorders.
Bryant's traction is mainly used in young children who have fractures of the femur or congenital abnormalities of the hip.[1] Both the patient's limbs are suspended in the air vertically at a ninety degree angle from the hips and knees slightly flexed. Over a period of days, the hips are gradually moved outward from the body using a pulley system. The patient's body provides the countertraction.
The purpose of traction is to:
In most cases traction is only one part of the treatment plan of a patient needing such therapy. The physician's order will contain:
The physician is typically responsible for initial application of traction and weights while the adjustment or removal (to perform ablution functions / physiotherapy) of skeletal traction weights will be based on the doctors charted plan.
In most cases cervical traction may be adjusted or temporarily removed, per physician order, by an orthopedic nurse who has documented competency to do so.
The alignment and moving of the patient will only be changed on physician's directive and the affected extremity will need to be maintained in proper alignment at all times with the ropes and traction straps - making sure the mentioned is unobstructed and weights hanging freely.
If it is necessary to move the patient while skeletal traction is in place, the patient should be moved in the bed with weights hanging freely.
In most cases traction will be applied for a number of weeks to months and Neurovascular checks will need to be performed by a nurse as ordered by the physician or as dictated per traction unit policy.
Traction is an appropriate treatment for a number of medical problems including spinal deformities such as scoliosis.
Lumbar spinal manipulation followed by Harrison "mirror image methods" (lateral translation exercise and traction) were found to produce statistically significant and clinically significant reductions in pain and trunklist posture, a finding not observed in the control group. 160 In fact, the control group’s lateral thoracic translations were slightly worse at follow-up, possibly indicating progression of the disorder. Because these trunk-list postures are commonly associated with lumbar disc herniation and lower back pain, randomized controlled trials should be performed to evaluate the clinical significance of restoration of normal spinal-alignment biomechanics in chronic LBP pain subjects. Due to discrepancy between our study findings and a previous report, it is suggested that AP lumbo-pelvic radiographs and posture of the trunk should both be used as outcome measures in the treatment of the trunk-list deformity.