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At least 343 records · Page 19Linked to original sources
PubMed2006

Effect of cervical traction on cardiovascular and selected ECG variables of cervical spondylosis patients using various weights.

BACKGROUND: There is currently no consensus among the clinicians regarding the tractive force to be employed during cervical traction (CT) that will correlate precisely with the percentage body weight of the patient and reduce the side effects associated with CT therapy. OBJECTIVE: This study therefore aimed to investigate the response of cervical spondylosis (CS) patients to different CT weights and to establish the effect of CT on the cardiovascular system of patients with cervical spondylosis (CS). METHODS: Sixty out of 78 subjects participated in the study. They were randomly assigned into three experimental groups A, B and C. Their systolic and diastolic blood pressures (SBP and DBP) and heart rates (HR) were measured. Rate pressure product (RPP) was calculated using standard equation18 and ECG recorded using the KENZ, 201 machine. Subjects' cardiovascular and ECG responses were monitored in a supine resting position (baseline) and under three experimental conditions using the subjects' 7.5% kg total body weights (TBW), 10% kg TBW and 15% TBW at different time intervals (5, 10 and 15 minutes respectively). RESULTS: Compared with the baseline values, there was a drop in SBP, DBP and RPP for all subjects in the three groups. The SBP, DBP and RPP alteration were not significant for the 7.5% TBW CT, but significant (p <0.05) for the 10% and 15% TBW tractions. The HR and ECG variables revealed no significant difference in all the groups, these results signified that the cardiac muscles were not adversely affected by any of the traction weights during application. Twenty subjects had side-effects including 5 subjects that terminated the treatment due to pain during the CT application. CONCLUSIONS: Cardiovascular alterations do occur during the application of cervical traction weights resulting in untoward patient's reactions. Efforts should be made to monitor the cardiovascular variables during and immediately after CT especially in "high risk" patients, that is, elderly patients and patients with unstable cardiovascular systems.

Adult↗
PubMed1991

The influence of skeletal traction on intraarticular pressure of the hip.

Patients with a femoral neck fracture often undergo skeletal traction until surgery. These patients may develop hip joint tamponade that can lead to necrosis of the femoral head. We have measured the pressure variations in 20 cadaveric hips using a semiflexion frame and various loads of skeletal traction. We found a significant decrease in pressure with loads of 5 kg or more of skeletal traction. Skeletal traction does not increase the risk of femoral head necrosis.

Aged↗
PubMed1989

Natchev's auto-traction for lumbago-sciatica: effectiveness in lumbar disc herniation.

In Lind's auto-traction (LAT) for lumbago-sciatica, the patient provides traction force by pulling with the arms on a specially designed table, which also allows painless mobilization of the lumbar spine and passive traction. Two studies reported that one to 15 one-hour sessions on successive days might be sufficient to relieve pain in 25% to 90% of cases with verified lumbar disc herniation. Unfortunately, the technique imposes tiring manual efforts on the therapist and requires that the patient be transported by ambulance and confined to bed for a long time. These inconveniences were removed in a new version of the treatment proposed by Natchev. The effectiveness of Natchev's auto-traction (NAT) was evaluated in an open prospective trial on 77 patient with chronic lumbago-sciatica refractory to previous therapies, and herniation of one or more lumbar discs verified by computed tomography (CT) or myelography. Thirty-six of the 77 patients (47%) responded to the treatment in three to ten (median = 5) half-hour sessions. Pain intensity dropped to 27% (median) of the pretreatment intensity. Six months after treatment, 28 of the 36 responders were stable; only four had undergone surgery. By contrast, 20 of the 41 nonresponders had been operated on. The severity of either the radiologic or the neurologic picture was not predictive of the outcome. NAT was as effective as LAT: thus, due to its greater convenience it appears to be suitable as a routine approach in lumbar disc herniation and as a screening technique before surgery.

Adult↗
PubMed1983

Use of spinal traction in the treatment of neck and back conditions.

Spinal traction is a time-honored method for the treatment of disc protrusion, degenerative disc disease, and joint dysfunction. Effective treatment is not as easy or as simple to administer as it may appear. Many variations of technique exist, some of questionable value. It must be emphasized that spinal traction is only a part of the total management-treatment regimen, which includes other forms of physical therapy. Without a total management program, spinal traction, like many other empiric methods, has little chance of long-range benefit. Consequently, physicians prescribing spinal traction must be prepared to apply proved diagnostic methods and other treatment methods.

Humans↗
PubMed1984

Traction-induced hypertension in children.

Fifty-seven patients under treatment by traction were monitored for elevation of blood pressure. Hypertension developed in 39 of these patients (68%). Three patients required antihypertensive therapy to control the elevated blood pressure. The blood pressure returned to normal after discontinuation of traction. Sixty patients hospitalized for nonorthopedic problems who were not being treated by traction constituted the control group; seven of these patients (12%) had elevated blood pressure. Recognition of traction-induced hypertension is important to avoid not only its consequences but unnecessary diagnostic procedures as well.

Antihypertensive Agents↗
PubMed1982

Ambulatory dynamic patellar traction for patellar reconstruction.

When severe adjacent soft tissue injury precludes early operative repair of the patellar tendon, proximal migration of the patella and secondary quadriceps contracture may occur. Ambulatory dynamic patellar traction employs a cast brace assembly that prevents or corrects early proximal migration of the patella. The cast brace assembly incorporates a transverse threaded Steinmann pin through the patella, wire loops on the leg section of a cast brace, rubber band traction between the Steinmann pin and the wire loops, and drop lock knee hinges. The use of drop lock hinges allows passive knee motion when the lock is released and ambulation with a stable knee when the hinge is locked. Application of the dynamic ambulatory traction method is employed in the case of a 21-year-old man who sustained a severe electrical burn to the knee with loss of anterior soft tissue, including the patellar tendon. The prescribed traction method corrected early proximal migration of the patella prior to infrapatellar tendon reconstruction.

Adult↗
PubMed1994

Home traction in the management of femoral fractures in children.

Fracture of the femur in children is a common problem which can be managed in a variety of ways. We treated such fractures in children up to the age of 13 by immobilization in a Thomas splint, after reduction, if necessary, and traction in hospital. After a short period, traction was continued at home using a mobile frame with the Thomas splint. The results of such home traction were assessed in terms of both healing of the fracture and any complications and of the parental attitudes to treatment at home. It was found that traction at home was an acceptable method for the management of such fractures. Results were comparable to other methods of treatment and parental satisfaction was very high, providing there was adequate surveillance by the district nurse and immediate access to advice. The cost-savings of such a treatment are significant.

Adolescent↗
PubMed1993

One-stage correction of neglected congenital dislocation of the hip without preoperative traction.

The value of preoperative traction of a neglected congenital dislocation of the hip (CDH) is a controversial issue. A retrospective study was performed to evaluate the effects of one-stage, total correction without traction used in neglected CDH. From April 1984 to November 1988, 64 patients (74 untreated dislocated hips) were operated upon with one-stage total correction without preoperative traction. Their ages ranged from 1 year 2 months to 8 years 6 months. Forty-five patients (53 hips) underwent open reduction and a Salter's osteotomy. Ten patients (11 hips) had additional femoral shortening. Nine patients (10 hips) underwent open reduction and a triple osteotomy with femoral shortening. With a minimum of two years of follow-up, all of the hips were well contained, except for two hips with subluxation and one hip with redislocation (reduced after a secondary operation). Avascular necrosis of the femoral head was evident in three hips (one in each group). All of the patients without complications functioned well without significant leg length discrepancy. The other patients also performed well after their complications were treated. In conclusion, neglected CDH in patients up to nine years of age can be safely and effectively treated by one-stage, total correction without preoperative traction.

Child↗
PubMedDate not supplied

Home traction of femoral shaft fractures in younger children.

The study describes a home traction program of femoral shaft fractures in preschool children using the 90-90 traction technique. A special bed stretcher was designed for the program and adapted for use in ordinary ambulances and in all types of homes. Twenty-four patients, 2.2-5.9 years of age, were followed. The average hospital stay was 7.0 days, and the average home traction period was 22.1 days. One patient had a superficial pin tract infection. The treatment was uneventful in all other cases. All fractures healed with a shortening of < or = 1 cm. The angulation was < or = 10 degrees in all cases but one, which healed with a valgus angulation of 15 degrees but without functional disability. Interviews showed that the parents were very satisfied with the treatment program. The cost savings are obvious compared to traction treatment in the hospital.

Beds↗
PubMedDate not supplied

Femoral-shaft fractures in children: a comparison of immediate casting and traction.

Two hundred fifty-three femoral-shaft fractures in 246 pediatric patients treated between 1976 and 1986 were retrospectively reviewed, and 186 fractures in 181 patients were available for demographic review. Fifty-nine patients underwent spica casting within 48 h of injury, whereas 127 were placed in traction and underwent delayed casting (>48 h from injury). Fifty-five patients in the traction group and 33 in the immediate-casting group were locatable for long-term follow-up of 8.9 years average (range, 4-20 years). There was no clinically significant difference in limb-length inequalities, or rotational or angular deformities between the two groups at initial casting or at final follow-up. Hospital stay averaged 17.3 days in the traction group and 2.2 days in the immediate-casting group (p < 0.001). Total estimated charges, at current rates, demonstrated an 83% greater patient charge in the traction group than in the immediate-casting group.

Adolescent↗
PubMed1989

Interaction of retinal glial cells with collagen matrices: implications for pathogenesis of cell-mediated vitreous traction.

Traction retinal detachment results in severe visual loss in many proliferative vitreoretinal disorders. Retinal glial cells participate in nearly all of the proliferative diseases involving the retina. In order to better understand the mechanism of vitreous traction we used phase-contrast and scanning electron microscopy to study the interaction of human retinal glial cells and rabbit dermal fibroblasts with collagen gels. To modify this interaction, we placed a peptide containing the arginine-glycine-aspartic acid sequence that competes for the cellular binding site of fibronectin onto the collagen gels. We found that both glial cells and fibroblasts attached to collagen fibers and pulled them centripetally. The cells extended their processes toward adjacent cells in the gel creating "strands" and traction in a self-promoting fashion. Despite a dramatic effect on fibroblast-mediated traction, the peptide had little effect on glial cells even at 3 mg/ml.

Animals↗
PubMed2005

Transvaginal myomectomy with screw traction by colpotomy.

INTRODUCTION: The aim of this study is to evaluate the clinical effectiveness and safety of the enucleation of uterine leiomyomas by traction method via colpotomy. METHODS: Ten women with menorrhagia, pelvic pain, or secondary infertility associated with single uterine myomas underwent transvaginal myomectomy with screw traction by colpotomy. The feasibility of the procedure, operative complications, postoperative recovery, pregnancies, and relief of symptoms were the main outcome measures. RESULTS: Traction myomectomy was completed vaginally in all patients. The mean operating time was 71 min and average blood loss 385 ml. The mean size of a single myoma was 6.7 cm (range 5.6-8.0 cm) and weight 153 g. One patient developed a transient hematoma. All women reported relief of their symptoms after a mean follow-up of 24 months. Three patients had a term delivery postoperatively. CONCLUSIONS: Traction myomectomy by colpotomy is a feasible approach for selected patients wishing to preserve their ability to conceive. A single well-lined myoma of 5-8 cm diameter and possible to reach via colpotomy is a suitable subject for the procedure, which proved a viable surgical approach.

Adult↗
PubMed2003

Clinical variables and their relation to visual outcome after vitrectomy in eyes with diabetic retinal traction detachment.

BACKGROUND: To analyse vitrectomy results in diabetic eyes with retinal traction detachment and to investigate which variables are associated with a worse visual outcome. METHODS: Forty-four diabetic eyes (33 patients) with central retinal traction detachment were analyzed retrospectively. RESULTS: After a median follow-up of 10 months, median visual acuity significantly improved from 20/800 to 20/160 (P=0.02), despite the fact that the majority of patients had a long-standing macular traction detachment (median 120 days). Twenty-two eyes (50%) achieved a visual acuity of >20/200. The retina was finally reattached in 38 eyes (86.3%). Univariate analysis showed that patients with type 2 diabetes, age older than 50 years, preoperative visual acuity <20/200, iris neovascularisation and macular detachment of >30 days had a significantly worse final visual outcome. After multiple logistic regression analysis, age and iris neovascularisation were the strongest predictors of a worse visual outcome; if both were present, the chance of a obtaining a visual outcome of <20/200 was almost 90%. CONCLUSIONS: Age and iris neovascularisation were the strongest predictors for a low visual outcome. In a review of vitrectomy studies in eyes with severe diabetic traction detachment in the past 2 decades, we found a trend towards higher anatomic success rates, while visual outcome only slightly improved. The current study confirmed the importance of ophthalmic variables, but also indicates the importance of evaluating systemic variables in larger series in order to predict which eyes may truly benefit from vitrectomy.

Adult↗
PubMed1985

Treatment of diabetic traction retinal detachment with the pulsed neodymium-YAG laser.

Three patients with diabetic traction retinal detachment not involving the central macula were treated with the pulsed neodymium-YAG laser. In each case, with energy levels of 9 to 11 mJ, vitreous traction bands were sectioned and the traction retinal detachment diminished or disappeared. Other than a small choroidal hemorrhage in one instance, no adverse side effects occurred. The pulsed neodymium-YAG laser may provide a new therapeutic modality in a few selected cases of diabetic traction retinal detachment.

Adult↗
PubMed1995

Sternal traction after open heart operation: an effective alternative to delayed sternal closure.

BACKGROUND: Routine closure of the sternum after cardiovascular surgical procedures sometimes causes severe cardiac depression because of a tamponade-like reduction in ventricular filling, leading to cardiogenic shock. Leaving the sternal halves apart, sealing the mediastinum by simply approximating the skin or using a prosthetic patch, and then performing delayed sternal closure in several days is a widely practiced life-saving maneuver. METHODS: Described herein is an experience with 5 patients with severe cardiac output depression of the type usually treated by delayed sternal closure. Instead, upward (outward) traction was applied to the anterior chest while the sternum was primarily closed. Traction was maintained with full-thickness chest wall sutures. RESULTS: The traction sutures were removed successfully in the intensive care unit between 1 and 4 days postoperatively, after appropriate vigorous treatment of postbypass myocardial enlargement and pulmonary distention and edema. CONCLUSIONS: This method of sternal traction allows physiologic improvement equivalent to delayed sternal closure in some patients and obviates the need for returning to the operating room to close the sternum in the early postoperative period.

Cardiac Surgical Procedures↗
PubMed1987

Birth progression and traction forces developed under vacuum extraction after slow or rapid application of suction.

A vacuum extraction recorder was used to provide an objective measure of the traction forces developed on the fetal head during 120 vacuum extractions. In half of the deliveries the vacuum was gradually and stepwise increased to -0.8 kg/cm2 before traction. In the others, a rapid application of vacuum to the same level was chosen. No significant difference could be recorded in the traction forces developed by the different methods. In fact, once an adequate level of vacuum had been achieved, high degrees of traction could be applied to the suction cup, regardless of the rate at which the vacuum was developed. Furthermore, the number and nature of neonatal complications were not influenced by the method chosen.

Birth Injuries↗
PubMed2005

Tomographic features and surgical outcomes of vitreomacular traction syndrome.

PURPOSE: To study the relation between preoperative macular changes and surgical outcomes in vitreomacular traction syndrome. DESIGN: Prospective study. METHODS: We prospectively examined 14 eyes of 13 patients (aged 48 to 82 years; mean 66.1) with vitreomacular traction syndrome using optical coherence tomography (OCT) before and after vitreous surgery. RESULTS: OCT demonstrated two types of partial posterior vitreous detachment: incomplete V-shaped detachment in 10 eyes (group 1) and partial detachment temporal to the fovea but attached nasally in 4 eyes (group 2). Preoperative OCT showed foveal retinal detachment in all eyes in group 1; the detached retina was intact in 2 eyes and edematous with (6 eyes) or without (2 eyes) cystic changes. After surgery, these 10 eyes had a normal foveal configuration accompanied by visual improvement. In group 2, 3 of the 4 eyes had prominent cystoid macular edema (CME) without foveal retinal detachment before surgery. After surgery, 2 eyes developed a full-thickness macular hole, 1 had persistent CME, and 1 developed macular atrophy. The visual acuity decreased in 2 eyes and remained the same in 2 eyes. CONCLUSIONS: Two types of vitreous traction develop in vitreomacular traction syndrome: an incomplete V-shaped posterior vitreous detachment that leads to foveal retinal detachment, the surgical outcome of which is favorable, and partial posterior vitreous detachment temporal to the fovea in which prominent CME developed, which may result in a macular hole or macular atrophy postoperatively.

Aged↗
PubMed2005

Epiretinal pathology of diffuse diabetic macular edema associated with vitreomacular traction.

PURPOSE: To investigate the ultrastructure of the vitreomacular interface in patients with diffuse diabetic macular edema (DDME) associated with vitreomacular traction. DESIGN: Laboratory investigation. METHODS: Fifty-five consecutive patients with DDME underwent vitrectomy with en-bloc removal of the inner limiting membrane (ILM) and epimacular tissue. Six patients were operated on both eyes. Sixty-one specimens harvested during vitrectomy were analyzed by electron microscopy. RESULTS: Preoperatively, a thickened premacular cortical vitreous was present in 47 eyes. Native vitreous collagen with single cells interspersed within the collagenous layer or a cellular monolayer were the ultrastructural features in these eyes. Twenty-three eyes showed an epimacular membrane. In eyes with obvious signs of tangential vitreomacular traction, multilayered membranes situated on a layer of native vitreous collagen were found. Fibroblasts and fibrous astrocytes were the predominant cell types; myofibroblasts and macrophages were also present. Sixty of 61 specimens showed native vitreous collagen covering the ILM. Macular edema resolved in 58 eyes and persisted in 3 eyes. No recurrent fibrocellular proliferation was observed during the follow-up period of 18 months (mean, 3 to 56 months). CONCLUSIONS: The vitreomacular interface in eyes with DDME is characterized by a layer of native vitreous collagen and a varying cellular component. Tangential vitreomacular traction is associated with multilayered membranes situated on a layer of vitreous collagen. Resolution of macular edema does not depend on the presence and removal of contractile membranes. In eyes without tangential traction, complete removal of epimacular tissue also leads to fluid resorption.

Adult↗