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At least 451 records · Page 25Linked to original sources
PubMed2002

Closed reduction of colles fractures: comparison of manual manipulation and finger-trap traction: a prospective, randomized study.

BACKGROUND: An optimal outcome of closed treatment of a Colles fracture may depend on accurate reduction and adequate immobilization. It has been suggested that the use of finger-trap traction results in a better reduction and a lower rate of redisplacement than manual manipulation does, but to our knowledge these concepts have never been evaluated scientifically. We compared these two methods in a prospective, randomized controlled trial. METHODS: Two hundred and twenty-three patients with 225 displaced Colles-type fractures were randomized to treatment with closed reduction with either finger-trap traction (112 patients) or manual manipulation (111 patients). The fractures were assessed radiographically by measurement of the radial angle, dorsal tilt, and radial shortening before reduction, immediately after reduction, and at one and five weeks after reduction. RESULTS: The groups were comparable with regard to age, sex, side of injury, fracture grade, and amount of displacement at presentation. No significant differences were found between the alignment of the fractures in the two treatment groups at any time. With dorsal tilt of <10 degrees and radial shortening of <5 mm considered acceptable, the two techniques both produced an 87% rate of satisfactory reductions. However, the percentages of fractures in an acceptable alignment were only 57% and 50% at one week after finger-trap traction and manual manipulation, respectively, and only 27% and 32% at five weeks. The failure rates did not differ significantly between the two groups. CONCLUSIONS: The two methods of fracture reduction did not differ with regard to the eventual position of the fracture or the rate of failure. Although closed reduction was successful for the majority of fractures, most redisplaced substantially during the period of cast immobilization.

Adult↗
PubMed2005

Manual physical therapy, cervical traction, and strengthening exercises in patients with cervical radiculopathy: a case series.

STUDY DESIGN: A case series of consecutive patients with cervical radiculopathy. BACKGROUND: A multitude of physical therapy interventions have been proposed to be effective in the management of cervical radiculopathy. However, outcome studies using consistent treatment approaches on a well-defined sample of patients are lacking. The purpose of this case series is to describe the outcomes of a consecutive series of patients presenting to physical therapy with cervical radiculopathy and managed with the use of manual physical therapy, cervical traction, and strengthening exercises. CASE DESCRIPTION: Eleven consecutive patients (mean age, 51.7 years; SD, 8.2) who presented with cervical radiculopathy on the initial examination were treated with a standardized approach, including manual physical therapy, cervical traction, and strengthening exercises of the deep neck flexors and scapulothoracic muscles. At the initial evaluation all patients completed self-report measures of pain and function, including a numeric pain rating scale (NPRS), the Neck Disability Index (NDI), and the Patient-Specific Functional Scale (PSFS). All patients again completed the outcome measures, in addition to the global rating of change (GROC), at the time of discharge from therapy and at a 6-month follow-up session OUTCOMES: Ten of the 11 patients (91%) demonstrated a clinically meaningful improvement in pain and function following a mean of 7.1 (SD, 1.5) physical therapy visits and at the 6-month follow-up. DISCUSSION: Ninety-one percent (10 of 11) of patients with cervical radiculopathy in this case series improved, as defined by the patients classifying their level of improvement as at least "quite a bit better" on the GROC. However, because a cause-and-effect relationship cannot be inferred from a case series, follow-up randomized clinical trials should be performed to further investigate the effectiveness of manual physical therapy, cervical traction, and strengthening exercises in a homogeneous group of patients with cervical radiculopathy.

Female↗
PubMedDate not supplied

Understanding the principles of traction.

As the use of traction has declined in recent years, nurses' skills in this area have consequently decreased. Standards of care for patients in traction might now be called into question. This article attempts to redress this imbalance by describing the principles behind safe and effective traction.

Humans↗
PubMed1998

[Experimental study on the efficacy of methyl prednisolone in the treatment of traction injury of spinal cord in rabbits].

In order to study the prophylactic and therapeutic effect of methyl-prednisolone (MP) on traction injury of spinal cord, 48 rabbits were divided into four groups randomly. According to decreasing amount of the amplitude of P1-wave, 50% reduction lasted for 5 min and 10 min with MP as experimental group, and 50% 5 min and 10 min with NS as control, the changes of amplitudes were monitored by, and the function of the spinal cord was assessed. The amounts of MDA and SOD of the spinal cord tissue were determined and the pathomorphological changes of the spinal cord were observed. The results showed that in the experimental groups, the recovery of P1-wave was quicker, the Tarlov and Molt value were decreased, the density of gray matter of the anterior horn and the myelinated nerve fiber of white matter of 100 microns diameter were higher, the SOD and MDA was decreased and the degenerative and necrotic degree of neuron and nerve fiber were milder. Where in the control groups all the above items were just on the opposite. The conclusions list as follows: the application of MP before operation of spinal deformity might prevent traction injury of the spinal cord during operative correction of spinal deformity, and could also minimized the secondary damage to spinal cord from traction injury if MP was used in time. The action to MP were summarized as improving the microcirculation, inhibiting the hyperoxidation of lipid and accelerating the recovery of SCEP.

Animals↗
PubMedDate not supplied

Manual cervical traction reduces alpha-motoneuron excitability in normal subjects.

The excitability of the Flexor Carpi Radialis alpha-motoneuron pool following manual cervical traction was assessed in twenty asymptomatic subjects, and compared to a hands only intervention. The excitability of the alpha-motoneuron pool was measured indirectly using the Hoffmann (H) reflex. H-reflex recruitment curves were taken to assess the number of alpha-motoneurons (alpha-motoneurons) firing in response to a given incremental increase in stimulation intensity. The rate of rise of the slope of the H-reflex recruitment curve (Hslp) was assessed using linear regression. Following manual cervical traction Hslp was significantly lower than pre-intervention trials. Manual cervical traction, therefore, reduced the excitability of the Flexor Carpi Radialis alpha-motoneuron pool. This effect was mediated by the central nervous system. There was no significant decrease in alpha-motoneuron excitability following the hands only intervention. Hslp was shown to be a more sensitive measure of changes in the H-reflex than the more traditional parameter of Hmax/Mmax ratio and should be used in future studies of this nature.

Adult↗
PubMed1992

Proximal tibial skeletal traction for femoral shaft fractures in children. Treatment to discard or retain.

A proximal tibial skeletal traction in the treatment of femoral shaft fractures in the growing child has been reported to result in complications such as knee pain, knee joint subluxation, and growth disturbance. For the last 15 years, the authors used a single screw (instead of the Kirschner wire) inserted in the tibia perpendicular to the surface and well below the tibial tubercle physis. With the traction applied to this screw and the leg in a 90-90 position or resting on a Braun splint, none of the previously described complications were observed. This modification of the proximal tibial skeletal traction is a simple, quick, and safe method in the treatment of femoral shaft fractures in children.

Adolescent↗
PubMed1992

Displaced supracondylar humeral fractures in children. A comparison of results and costs in patients treated by skeletal traction versus percutaneous pinning.

Clinical outcome and treatment cost were compared in 65 children treated by either percutaneous pinning or skeletal traction for displaced supracondylar humeral fractures. Clinical outcome was evaluated by loss of elbow motion and change in carrying angle. Results of treatment were basically equivalent in the two groups and were satisfactory in 90% or more. To determine treatment cost, the authors analyzed factors that vary according to the type of therapy. Cost of treatment was lowest in those who had percutaneous pinning and subsequent pin removal in the office. Compared to this group, the cost of treatment increased by 23% in those who had percutaneous pinning and removal of the pins as a surgical procedure, by 117% in those treated by traction with the olecranon pin inserted in the emergency room, and by 142% in those treated by traction with the olecranon pin inserted in the operating room.

Bone Nails↗
PubMed1992

Three traction knots for the orthopaedic surgeon.

This article reviews the technique of tying three knots that are used by orthopaedic surgeons when treating a patient in skeletal traction--the traction knot, the bowline, and the cow hitch. The advantages of the bowline and the cow hitch over the traction knot are also discussed.

Humans↗
PubMed2006

[A case of further significant anastomotic rupture after gentle traction of urethral catheter for minimal anastomotic leakage after radical retropubic prostatectomy].

A 76-year-old man with clinical stage T1c adenocarcinoma of the prostate underwent radical retropubic prostatectomy. After a cystography on postoperative day 7 demonstrated minimal contrast extravasation, gentle catheter traction was performed. However, a cystography on postoperative day 21 showed a displacement of the catheter out of the bladder due to more significant anastomotic rupture. The catheter was preserved without catheter traction for two months. A cystography revealed complete healing of anastomosis without extravasation. This case suggests that catheter traction for anastomotic leakage should be performed carefully because of a potential risk of further anastomotic leakage.

Adenocarcinoma↗
PubMed2006

[The effectivenes of traction influence in a complex treatment of the spine's thoracocervical osteochondrosis].

The efficacy of implementation of isolated autogravitational extension as well as in complex with rehabilitation-recovery measures on neurological manifestations thoracocervical osteochondrosis of spine were investigated in this work. Investigation of traction influence conducted on the 57 patients with thoracocervical osteochondrosis of spine in the acute stage has shown distinct therapeutic effectiveness of autogravitational extension in the presence of reflex manifestations of thoracocervical osteochondrosis, it's normalizing effect on the muscular-tonic changes, vertebral disorders including pain syndrome. Efficacy is achieved by applying autogravitational extension with gymnastic exercises and massage. Therapeutic effect when lying on the traction couch achieved due to equal traction effort in all section of spine. At the compression manifestations of thoracocervical osteochondrosis in the acute stage with pain syndrome efficacy of autogravitational extension is lower then at the reflex that basically is connected with impossibility of initial full relax.

Cervical Vertebrae↗
PubMedDate not supplied

[Correction of a dental and basal Class II with accentuated overjet using traction].

Correction of a dental and basal 2nd class with accentuated overjet using extraoral traction and programmed extractions of 17-27, 38-48 according to Armstrong's technique. The paper reports a case of dental and basal 2nd class with accentuated overjet treated using the extraction of 17-27, 38-48 and extraoral traction only, according to Armstrong's technique. Results obtained after 117 days of combined extraoral traction are reported in order to illustrate the reasons behind the choice of this apparatus and to demonstrate its evident efficacy in this case of 2nd class, 1st subdivision.

Cephalometry↗
PubMed1990

The value of preliminary traction in the treatment of congenital dislocation of the hip.

In forty-one children who had forty-seven congenitally dislocated hips, the results of attempted closed reduction with general anesthesia, but without preliminary traction, were studied. Twenty (43 per cent) of the hips could not be reduced closed, and an open reduction was needed. After the reduction, all of the involved hips were immobilized in the so-called human position (marked flexion and slight abduction). At a minimum follow-up of two years, osteonecrosis of the femoral head had developed in only two hips (4 per cent). Patients who were more than one year old when the hip was reduced had a higher incidence of osteonecrosis of the femoral head and were more likely to need reconstructive procedures later. Patients who were more than eighteen months old at the time of the attempted closed reduction were more likely to need an open reduction of the hip. Treatment of congenital dislocation of the hip in young children remains an extremely complex problem. It has not been clearly established that the use of preliminary traction decreases the incidence of osteonecrosis of the femoral head or improves the outcome of treatment. In our experience, uncomplicated (non-teratological, postnatal) congenital dislocation of the hip has been safely treated with either open or closed reduction without preliminary traction in patients who were younger than two years old, provided that the reduction could be obtained without excessive force.

Female↗
PubMed1990

Closed reduction by two-phase skin traction and functional splinting in mitigated abduction for treatment of congenital dislocation of the hip.

A method of a two-phase closed reduction using longitudinal skin traction followed by abduction was employed by the authors for treatment of children with congenital dislocation of the hip (CDH). Longitudinal traction was used for two to four weeks, depending on the child's age and the degree of dislocation. Traction in abduction required two weeks. Splinting after reduction was used with an intermediate abduction device, which allowed immediate hip function and motion without the risk of redislocation. The results of 1178 treated hips, with follow-up examinations in 809 cases, demonstrate the efficacy of this method even for completely dislocated hips. The procedure is nonaggressive, results in a low incidence of femoral head osteonecrosis (3.4%), and is suitable for children with CDH aged six weeks to about 2.5 years.

Child, Preschool↗
PubMedDate not supplied

[Morphologic changes in the mandibular condyle under the action of extraoral traction].

The experiment was performed in 29 mongrel dogs in the periods from second dentition to final occlusion formation. The mandibular traction was applied for 3, 7, 15, 30, 60 and 90 days, the restitutional period lasted for 45 days. At early stages of the traction the active cartilage and osseous tissue structuration was noted in the condylus. The late period displayed the suppression of the cartilage growth and increased ossification of cartilage zone with prevalent secondary type, atypical of the condylar cartilage. This resulted in the cartilage ossification around the dilated blood vessels and delayed primary trabeculae formation at the ossification border. With the traction released, a tendency to normal cartilage osteogenesis was evident, though the width and structure of the cartilage zone of the condylus were not fully restored.

Animals↗
PubMed1989

The effect of skeletal traction on femoral neck fractures.

Patients with fracture of the femoral neck often undergo skeletal traction until surgery. We found that the fracture position worsened in 5 of 15 patients during the period with skeletal traction. Accordingly, skeletal traction does not prevent further vascular damage to the femoral head. We advocate operating as soon as the patient's condition is stable.

Aged↗
PubMed1989

[2 cases of brain abscess as a complication of direct cranial traction].

Two cases of brain abscess as a complication of direct cranial traction have been presented. In the first case traction was used in the treatment of aneurysmatic cyst of the cervical spine, in the second case for cervical spine trauma. In the first case development of abscess was related with local infection in the site of localization of traction, and in the second case, most probably, with direct contamination of the brain tissue in the site of dura mater perforation. In both cases abscess was treated surgically; in the first case, a female patient was discharged with severe neurological deficit and in the second case, the male patient recovered without neurological deficit.

Adult↗
PubMed1988

Reverse skeletal traction for instability following revision total hip arthroplasty. A report of two cases.

Dislocation is a recognized complication following total hip arthroplasty (THA). Immobilization of the hip has been used successfully to treat those cases due to soft-tissue laxity. In two patients who had severe instability of the hip following complex revision THA, skeletal traction through the tibia was applied in a cephalad direction for three weeks. This unique method of employing traction maintained a reduction and resulted in a stable hip at the six-month follow-up evaluation in both patients. Reverse skeletal traction is a valuable treatment option when more conventional methods of immobilization of the hip will not maintain a reduction due to soft-tissue compromise.

Female↗
PubMed1987

Skeletal traction for fractures of the femoral shaft in children. A long-term study.

Fifty-four children who had been treated with 90-90 skeletal traction for a fracture of the femoral shaft were examined after an average follow-up of 4.3 years. All of the patients were functioning normally and had a symmetrical range of motion of both hips and knees. A limb-length discrepancy of more than thirteen millimeters was found in three of thirty-nine children who were less than eleven years old and in eight of fifteen who were more than eleven years old. Traction pins that were placed obliquely were associated with a statistically significant (p less than 0.01) and predictable difference in the intercondylar angle (axis of the knee joint) as compared with pins that were placed horizontally. The study showed that pins for skeletal traction should be placed parallel to the axis of the knee joint and that fractures in children who are more than eleven years old should be reduced without overriding.

Adolescent↗