Download - 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.