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At least 307 records · Page 17Linked to original sources
PubMed1983

Mandibular traction for relieving respiratory distress in the Pierre Robin Anomaly. A case report.

A case of Pierre Robin Anomaly with severe, prolonged respiratory distress and feeding difficulties is presented. The respiratory distress is adequately relieved by mandibular forward traction. The procedure employing a mandibular suspension and elastic traction system is described. Feeding under the traction was successful, providing more effective self-control of the tongue. The authors recommend the mandibular traction device described here as a very simple life-saving approach to the problems in the Pierre Robin Anomaly.

Airway Obstruction↗
PubMed1997

The history of modern spinal traction with particular reference to neural disorders.

The last 200 years of the history of spinal traction is described in the present article. The study starts at the end of the 18th century with the works of JA Venel (1789) who tried to apply the Hippocratic idea to modern surgery. Orthopedic specialists of the last century were mostly preoccupied with corsets and the method gained broader popularity when neurologists paid attention to the similar method of suspension. The Russian neurologist Osip Mochutkovsky described suspension as a method for the treatment of tabes dorsalis in an article published in the Russian magazine 'Vratch' in 1883. His works became known in Europe when JM Charcot paid attention to it and published a special short monograph on this subject in 1889. This work was translated into English (1889) and Russian (1890) and the method became popular in the treatment of tabes dorsalis and other neurological diseases. The eminent Russian neurologist VM Bekhterev proposed the combination of body suspension with cervical traction (1893). Some years later Gilles de la Tourette promoted the use of spinal traction in his neurological clinic (1897). Unfortunately neurologists worked without the cooperation of orthopedic specialists. During the first decades of the 20th century suspension was also replaced by traction in neurology. This method was used by both neurologists and orthopedic specialists but in the last decades neurologists lost their interests in it and it found greater use in traumatology and in spinal surgery where it is still in use today.

History, 19th Century↗
PubMed2002

Artefacts produced by suture traction during incisional biopsy of oral lesions.

The aim of this study is to compare the artefacts ascribed to the technique of incisional biopsy using a punch or scalpel and the influence of suture use for traction and delivery of the specimen. A total of 160 samples were obtained from 10 fresh pig tongues by four experienced oral surgeons. Handling artefacts (squeeze artefacts): crush, splits, fragmentation and pseudocysts were assessed. No differences were identified in terms of crush, fragmentation or pseudocysts between samples obtained with a punch or scalpel. Splits were more frequent in those biopsies taken with a scalpel (chi2 = 9.26; P= 0.0023). Artefacts in the punch biopsy group were significantly less than in the group that combined punch and suture traction (P < 0.01). The scalpel and suture traction group showed significantly more artefacts than the group without suture. It is concluded the use of a stitch for traction in small incisional biopsies causes squeeze artefacts, so its use should be restricted to specimen orientation.

Animals↗
PubMedDate not supplied

Hip arthroscopy without traction: In vivo anatomy of the peripheral hip joint cavity.

PURPOSE: To describe the in vivo anatomy of the peripheral compartment of the hip joint using a systematic sequence of examination without traction. TYPE OF STUDY: Case series. METHODS: We performed 35 hip arthroscopies without traction from an anterolateral portal in the supine position. Free draping and a good range of movement of the hip joint were used to relax parts of the capsule and increase the intra-articular volume of the area that was inspected. Each procedure was documented on a standard protocol including detailed information on technical features and normal and pathologic intra-articular findings. RESULTS: A comprehensive inspection of the peripheral compartment was obtained from the anterolateral portal. A systematic sequence of examination was developed separating the periphery of the hip joint into 7 areas: anterior neck area, medial neck area, medial head area, anterior head area, lateral head area, lateral neck area, and posterior area. The arthroscopic in vivo anatomy of each area is described. In 3 patients, 1 to 3 loose bodies were removed. In 1 patient with a synovial chondromatosis, 40 chondromas were retrieved. In osteoarthritis, impinging osteophytes were trimmed in 3 cases and partial synovectomy was performed in 10 patients. The following complications were observed: a temporary sensory deficit of the lateral femoral cutaneus nerve in 1 patient, scuffing of the anterior surface of the femoral head in 3 patients, detaching of an osteophyte in 1 patient, and partial tears of the anterior synovial fold in 10 patients. CONCLUSIONS: Arthroscopy without traction allows for a complete evaluation of hip anatomy without the loaded articular surfaces, the acetabular fossa, and the ligamentum teres. For a complete overview of both the central and peripheral part of the hip, traction is necessary for the central part.

Arthroscopy↗
PubMed1999

Dynamic traction for unstable fractures of the distal radius.

We have designed a flexible distracter through which dynamic traction is applied to fractures of the distal radius. The distraction is maintained during flexion and extension as well as radial and ulnar deviation. The results in 30 patients showed that the majority of the fractures maintained reduction during the period of dynamic traction. In several patients the radiological variables even improved during dynamic traction. The median radial shortening was 0 mm, the palmar angulation 7 degrees, and the radial inclination 23 degrees. Continuous dynamic traction applied to fractures of the distal radius did not lead to redisplacement of the fracture, and the overall functional results were good.

Adult↗
PubMedDate not supplied

[Commentary on the article "Is the mechanical traction of the cervical spine still acceptable?" by R. Dorian ].

Referring to literature Dorian reported on severe complications after apparative traction of the cervical vertebral column up to cross-sectional paralysis and sudden death during treatment. Based on these reports he presents a list of contraindications which comprises nearly all diseases of the cervical vertebral column. The author summarizes his statements claiming that the apparative traction at no means can be a routine method because of it's inherent extreme risks. The comment in hand states that none of the complications claimed have been exemplified by the author in the original paper. Neither authors are named in the text, nor such complications are mentioned in the papers cited in the publication index. A request to the author for completion of literature proofs remained negative. Such complications were also not encountered by 36 orthopedic surgeons in practice who together survey 375 years of treatment with this method. On the contrary a corresponding inquiry yielded that in opposition to the statement of Dorian the apparative traction of the cervical vertebral column is indeed a widely spread standard method in orthopedic practice. The incidents claimed are also unknown to various experts an to importers of traction devices neither from their own experience nor from the literature. Consequently none of the essential statements in Dorian's contribution is proven and therefore the conclusions are unallowable.

Cervical Vertebrae↗
PubMedDate not supplied

[Osteoporosis and halo traction in scoliosis patients (author's transl)].

In 54 patients who underwent halo traction for an average of 80 days each, there was no laboratory evidence of any change in calcium metabolism. Histologically, there were slight but significant bony changes after termination of halo traction treatment, principally "low-turnover" osteoporosis, which was possibly more prevalent in female patients. Where a slight osteoporosis already existed prior to halo traction, it generally became more severe. The study seems to show that no relationship exists between the etiology of scolioses and the development of osteoporosis. It proves that in respect of the development of osteoporosis also, permanent halo traction is not a neutral procedure.

Adolescent↗
PubMed1980

[Preoperative halo-gravity traction in scoliosis (author's transl)].

Clinical experience gained with halo-gravity traction since 1974 is described. The advantage of halo-gravity traction as compared to other types of traction treatment is discussed. Measurements are described, which serve to monitor the treatment and which can be used to predict the final result of the preoperative traction treatment.

Adolescent↗
PubMedDate not supplied

Intermittent cervical traction for cervical radiculopathy caused by large-volume herniated disks.

OBJECTIVE: To describe the use of intermittent cervical traction in managing 4 patients with cervical radiculopathy and large-volume herniated disks. CLINICAL FEATURES: Four patients had neck pain radiating to the arm. The clinical examination was typical in all cases for radiculopathy of cervical origin. Magnetic resonance imaging (MRI) of the cervical spine revealed large-volume herniated disks in all patients. INTERVENTIONS AND OUTCOME: The treatment consisted of intermittent on-the-door cervical traction under the supervision of our physiotherapists. Complete symptom resolution for each patient occurred within 3 weeks. One patient who had an episode of recurrence 16 months after the first treatment was successfully managed again with cervical traction and physiotherapy. CONCLUSION: Cervical spine traction could be considered as a therapy of choice for radiculopathy caused by herniated disks, even in cases of large-volume herniated disks or recurrent episodes.

Adult↗
PubMed1999

MR evaluation of the articular cartilage of the femoral head during traction. Correlation with resected femoral head.

OBJECTIVE: The purpose was to evaluate the articular cartilage of the hip joint with MR during traction and compare the findings with the resected specimen or arthroscopic findings. MATERIAL AND METHODS: Eight healthy volunteers, 5 patients with osteonecrosis, 5 with acetabular dysplasia, and 5 with advanced osteoarthrosis underwent MR imaging to evaluate the articular cartilage of the hip joint. Coronal fat-suppressed 3D spoiled gradient-echo (SPGR) images were obtained during traction. Identical imaging was performed of all the resected femoral heads of the osteonecrosis and advanced osteoarthrosis patients, and was correlated with the macroscopic pathological findings. RESULTS: The traction was effective and the femoral articular cartilage was clearly identified in all 8 control subjects, and in all cases of osteonecrosis and acetabular dysplasia. In 4 cases of osteonecrosis, chondral fracture was identified in the boundary between the necrosis and the normal area. In all cases of advanced osteoarthrosis, cartilage was identified only at the medial side. The MR images of osteonecrosis and advanced osteoarthrosis corresponded well with the MR images of the resected femoral heads and the macroscopic findings. CONCLUSION: Fat suppressed 3D-SPGR during continuous leg traction was useful in detecting cartilage abnormalities.

Adult↗
PubMed1977

Cervical traction. Review of literature and treatment guidelines.

This article is a review of the literature on cervical traction. The various mechanical factors most relevant to cervical traction are organized and discussed. The factors presented are 1) neck position, 2) traction force, 3) duration of traction, 4) angle of pull, and 5) position of the patient. Treatment guidelines are suggested based on interpretation of the literature.

Biomechanical Phenomena↗
PubMed1979

Effect of pelvic-femoral position on vertebral separation produced by lumbar traction.

The purpose of this study was to determine the relationship between hip position and the amount of vertebral separation produced by intermittent lumbar traction. Ten subjects received intermittent lumbar traction at a force of 31.8 kg (70 lb) for 15 minutes in each of three positions of hip flexion (supine): 0 degrees, 45 degrees, and 90 degrees. Vertebral separation was measured on lateral roentgenograms by outlining and marking the vertebral bodies and measuring interspaces with fine-point calipers. Except for the T12-L1 interspace, traction produced greater posterior interspace separation as the angle of hip flexion increased from 0 to 90 degrees. These differences were statistically significant at interspaces L4-5 and L5-S1. We found no systematic changes in anterior interspace distance. To produce maximal posterior vertebral interspace separation, pelvic traction should be applied with the hip flexed 90 degrees.

Adult↗
PubMed1994

Pinless calcaneus traction: a preliminary report.

Calcaneus traction with a Steinmann-pin or K-wire inserted into the dorsal aspect of the calcaneus is a common temporary procedure in fractures of the lower leg when internal fixation has to be delayed. Infection due to this simple manoeuvre is rare, but is a very serious complication. In 1991, a so-called pinless external fixator was introduced in clinical trials, based on the idea of external fixation without transosseus pins, thus preserving local blood supply and lowering the risk of pin track infection. This pinless clamp also represents a handy tool for calcaneus traction. We have used this pinless clamp for calcaneus traction in 39 patients without any major problems or complications. Of these, 29 patients were scheduled for delayed internal fixation, and in 10 patients this clamp was used intraoperatively in closed tibial nailing for traction on the fracture table. Tips and tricks for the use of this pinless clamp, and its advantages and disadvantages are discussed.

Adolescent↗
PubMed2001

Efficacy of preoperative skin traction in hip fracture patients: a prospective, randomized study.

OBJECTIVE: To compare the analgesic benefit of preoperative skin traction with the placement of a pillow under the injured extremity in patients with hip fractures. DESIGN: Prospective, randomized clinical study. SETTING: University-affiliated teaching institution. PATIENTS AND PARTICIPANTS: One hundred consecutive patients with hip fractures admitted to the authors' institution who met inclusion criteria were enrolled. Fifty-five patients had femoral neck fractures, and forty-five patients had intertrochanteric fractures. The average patient age was seventy-eight years. INTERVENTION: All patients were preoperatively randomized into two intervention groups. One group underwent placement of five pounds of skin traction on the injured extremity, whereas the second underwent placement of a pillow under the injured extremity. Fifty patients were enrolled in each intervention group. RESULTS: With respect to immediate postintervention pain levels, patients treated with a pillow showed a trend toward better pain relief, as compared with patients treated with skin traction; however, this was not statistically significant. On the morning after admission, patients treated with a pillow had a statistically significant greater reduction in pain (p = 0.04). These patients also requested a statistically significant lower amount of pain medication (p < 0.01). CONCLUSIONS: The authors think that preoperative skin traction in patients with hip fractures does not provide significant pain relief, as compared with pillow placement under the injured extremity, and thus should not be routinely performed in this patient population for analgesia.

Aged↗
PubMed2002

Massive perineal wound slough after treatment of complex pelvic and acetabular fractures using a traction table.

An operating table with the capacity for skeletal traction against a pudendal post is a helpful and commonly used piece of equipment for certain pelvic and acetabular fracture patterns. Perineal soft tissue trauma and urogenital injuries are associated with some pelvic and acetabular fractures. The perineal region is vulnerable to compromise after such injuries. There is little documentation available in the literature that addresses intraoperative complications of the perineum after the use of a traction table for pelvic fractures. We present here a case in which prolonged traction against a pudendal post during operative fixation of complex pelvic and acetabular fractures resulted in massive perineal wound slough. This case should heighten surgeons' awareness of the vulnerability of the perineum to injury with the use of a traction table and should prompt measures to prevent complications.

Acetabulum↗
PubMed2005

Successful reduction for a pediatric chronic atlantoaxial rotatory fixation (Grisel syndrome) with long-term halter traction: case report.

STUDY DESIGN: Clinical case report of atlantoaxial rotatory fixation (AARF) in a girl presenting with torticollis and neck pain. OBJECTIVE: To report this rare case that was successfully treated with long-term traction and a brace. SUMMARY OF BACKGROUND DATA: AARF is a rare kind of subluxation that is a pathologic fixation of the atlas on the axis. It is most common in pediatric patients and is usually reduced easily with conservative treatments only in the acute stage. However, previously reported chronic AARFs have usually been treated with operative reductions. Although high success rates have been achieved with operative reduction in chronic cases of AARF, even successful operative reduction may result in significant neck motion limitation. METHODS: A 9-year-old girl had torticollis of more than 3 months duration develop as a result of an upper respiratory infection. Dynamic computerized tomography showed consistent fixation of the atlantoaxial joint consistent with type 1 AARF according to the classification of Li and Pang. The patient was treated with halter traction of 5-lb weight for 6 weeks, and with a brace for 4 months and collar for 2 months. RESULTS: We successfully treated this patient with chronic AARF only with cervical traction. She had full recovery of neck motion and normal atlantoaxial angle on follow-up computerized tomography after 6 months. CONCLUSION: From this case, we suggest that long-term traction could be another treatment method for chronic AARF, especially in children.

Atlanto-Axial Joint↗
PubMed2001

Outcome of polyester cuff retention following traction removal of tunneled central venous catheters.

PURPOSE: To elucidate the factors that contribute to cuff retention during traction removal of tunneled catheters, as well as to determine the risk of complication associated with polyester cuff retention. MATERIALS AND METHODS: A total of 428 tunneled, cuffed catheters were removed with traction and local anesthesia. Polyester cuff retention was recorded when it occurred, and the effects of cuff retention were determined at a mean follow-up of 250 days. Statistical analysis was performed to determine the variables influencing cuff retention. RESULTS: Traction removal was successful in 428 (100%) patients. Of 428 catheters removed, 41 (10%) cuffs were retained. Silicone 10-F double-lumen and 9.6-F single-lumen catheters had a higher rate of cuff retention (27 [32%] of 84 and nine [39%] of 23, respectively) than did the split-tip polyurethane hemodialysis catheter (two [1%] of 196; P <.001). Cuff retention rates among other catheter types compared with that of the polyurethane catheter were not significantly different. Duration of catheter dwell did not significantly influence cuff retention. Of 41 retained cuffs, three required removal with cutdown for cuff migration to the exit site, which inhibited healing (n = 1); for suspected infection (n = 1); or for cosmetic purposes as requested by the patient (n = 1). The remaining patients had no complications associated with cuff retention. CONCLUSION: Traction removal of smaller-bore silicone catheters is more likely to result in cuff retention than removal of larger silicone and polyurethane catheters, and cuff retention is usually inconsequential.

Catheterization, Central Venous↗