DIFFERENT SPLINTS AND TRACTION USED IN ORTHOPEDICS

SPLINT:

    Any material used to support a fracture is known as a splint.

Ø  Unconventional.

Ø  Conventional.

  INDICATIONS:

Ø  Temporary immobilization of sprains, fractures and reduced dislocations.

Ø  Control pain

Ø  Prevention of further soft tissue or neurovascular injuries.

     CRAMER-WIRE SPLINT:

Ø  Ladder splint.

Ø  Used temporary splint for fractures during transportation.

Ø  Made of 2 thick parallel wires with interacting wires.

Ø  Can be bent into different shapes.

     THOMAS KNEE-BED SPLINT:

Ø  Initially used for immobilization for tuberculosis of the knee.

     BOHLER BRAUN SPLINT:

Ø  ADVANTAGES: Angle of traction can be changed without changing traction arrangements. Simultaneous tractions possible.

Ø  DISADVANTAGE: Not suitable for transportation.

     DENNIS BROWN SPLINT:

        

     COCK-UP WRIST SPLINT:

      TAYLOR’S BRACE:

CARE OF A PATIENT IN A SPLINT:

Ø  The splint should be properly applied, well-padded at bony prominences and at the fracture sites.

Ø  The bandage of the splint shouldn’t be too tight nor too loose.

Ø  The patient should be encouraged to actively exercise the muscles and the joints inside the splint as much as permitted.

Ø  Any compression of a nerve or vessel should be detected early and managed accordingly.

Ø  Daily checking and adjustments should be made.

     AIRPLANE SPLINT:

     MILWAUKEE BRACE:

                                   

                                      

TRACTION:

            Traction is a method of restoring alignment to a fracture through gradual neutralization of muscular forces.

USES:

Ø  Reduction of fractures and dislocations.

Ø  Immobilizing painful and inflamed joint.

Ø  Preventing deformities.

Ø  Correction of soft tissue contractures.

TYPES OF TRACTION:

Ø  FIXED TRACTION

         Counter-traction is provided by the part of the body.

Ø  SLIDING TRACTION

         The weight of the body under influence of gravity provides counter-traction.

METHODS OF APPLYING TRACTION:

Ø  Skin traction:

·        The adhesive/nonadhesive strap is applied to the skin and traction is applied.

·        Acts over a large area.

·        Maximum weight permissible 6-7 kg.

                               

 

Ø  Skeletal traction:

Traction applied through pin/wire driven through bone.

	SKIN TRACTION	SKELETAL TRACTION
AGE	Children	Adults
APPLIED WITH	Adhesive plaster	Pin, wire
APPLIED	Skin	Bone
SITE	Below knee	Upper tibial pin traction
Wt. PERMITTED	3-4 kg	20kg
DURATION	Short	long

COMPLICATIONS OF TRACTION:

Ø  Over distraction.

Ø  Loss of position.

Ø  Pressure sores.

Ø  Pin track infection.

Ø  Injury to vessels or nerves.

CARE OF PATIENT IN TRACTION:

Ø  Traction should be made comfortable.

Ø  Proper functioning of the traction unit must be ensured.

Ø  Sensation over toes and fingers should be normal.

Ø  Proper position of fracture ensured by taking check x-rays in traction.

Ø  Physiotherapy of the limb should be continued to minimize muscle strength(wasting).

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