splint and tractions

SPLINTS AND

TRACTIONS

Rangeen Chandran

SPLINT Any material used to support a fracture

is known as splint. Unconventional. Conventional.

INDICATIONS Temporary immobilization of sprains,

fractures, and reduced dislocations Control of pain Prevention of further soft tissue or

neurovascular injuries

CRAMER-WIRE SPLINT

CRAMER-WIRE SPLINT

Ladder splint. Used for temporary splintage of

fractures during transportation. Made of 2 thick parallel wires with

interlacing wires. Can be bent into different shapes.

THOMAS KNEE-BED SPLINT

Thomas splint. Devised by Hugh. Owen Thomas. Initially used for immobilisation for

tuberculosis of the knee.

PARTS OF THOMAS SPLINT Consist of: Ring Medial bar Lateral bar

USE Immobilisation of lower limb

BOHLER BRAUN SPLINT

Bohler’s modification of braun splint. Consisted of only 1 pulley.

• Pulley a-calcaneal/distal tibeal traction.

• Pulley b-distal femoral/proximal tibial traction

• Pulley c-change angle of traction

ADVANTAGES Angle of traction can be changed

without changing traction arrangements.

Simultaneous tractions possible.

DISADVANTAGE Not suitable for transportation.

DENNIS BROWN SPLINT

Use-Club foot(CTEV)

ALUMINIUM FINGER SPLINT

COCK-UP WRIST SPLINT

KNUCKLE BENDER SPLINT

VOLKMANN’S SPLINT

AEROPLANE SPLINT

SOMI BRACE

ASHE BRACE

TAYLOR’S BRACE

MILWAUKEE BRACE

BOSTON BRACE

CARE OF A PATIENT IN A SPLINT

Splint should be properly applied, well padded at bony prominences and at the fracture sites

Bandage of the splint shouldn’t be too tight nor too loose.

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

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

Daily checking and adjustments should be made.

TRACTION Traction is a method of restoring

alignment to a fracture through gradual neutralisation of muscular forces.

USESa) Reduction of fractures and dislocations.b) Immobilising painful and inflamed joint.c) Preventing deformities.d) Correction of soft tissue contractures.

TYPES OF TRACTION FIXED TRACTIONCounter-traction is provided by a part of the body. SLIDING TRACTIONWeight of the body under influence of gravity provides counter-traction.

METHODS OF APPLYING TRACTION SKIN TRACTION SKELETAL TRACTION

SKIN TRACTION Adhesive/non

adhesive strap is applied on skin and traction applied.

Acts over large area.

Max.wt permissible- 6.7kg.

SKELETAL TRACTION Traction applied through pin/wire driven

through bone.

Pins used-1. Steinmann pin2. Denham’s pin

K wire(Kirschner’s wire)

COMMON SITES FOR SKELETAL TRACTION

Olecranon Greater trochanter Lower end of femur Upper end of tibia Lower end f tibia Calcaneum

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

Over distraction Loss of position Pressure sores Pin track infection Injury to vessels or nerves

CARE OF PATIENT IN TRACTION

a. Traction should be made comfortable.b. Proper functioning of traction unit must

be ensured.c. Sensations over toes and fingers

should be normal.d. Proper position of fracture ensured by

taking check xrays in traction.e. Physiotherapy of limb should be

continued to minimise muscle wasting.