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PubMed1979

Supracondylar fractures of the humerus. A comparative study of Dunlop's traction versus percutaneous pinning.

A retrospective comparative study was done of two groups of patients with displaced supracondylar fractures of the humerus. The patients in the first group were treated with Dunlop's traction, while those in the second group were treated by percutaneous pin fixation. There were thirty-six patients in the group treated with Dunlop's traction, of whom twenty-seven were seen in follow-up with an average time of 2.7 years. Twenty-eight patients were in the group treated with pin fixation, of whom twenty were seen in follow-up with an average time of 2.9 years. In each case the chart and roentgenograms were reviewed and the patient was examined. The results showed a 33 per cent incidence of cubitus varus (so-called gunstock deformity) in the patients treated with Dunlop's traction as compared with 5 per cent in those pinned percutaneously. The range of elbow motion was also slightly better in the group treated with pin fixation. Furthermore, the costs and hospital stays were significantly less in those treated by pinning. Complications in both groups were few.

Child↗
PubMed1979

[Functional and morphological changes in the nerves following injury due to traction mechanism (experimental and morphological studies)].

In acute and chronic experiments on 52 animals (rabbits and dogs), carried out by means of neurophysiologic and neurohistologic methods, the authors have studied functional and histologic changes in the nerves following a one-step forced traction. Traction injuries have been found to cause early trophic disorders, persistent and long-lasting alterations of the nerve conductability and excitability. Some considerable retrograde changes in the nerves and related segments of the spinal cord have been noted together with the delay of the resorption of the decay products of the axons and the myelin sheath in the peripheral nerve fragment. The severity degree of the alterations depends on the degree of the traction.

Animals↗
PubMedDate not supplied

Cranial nerve injury from halo traction.

Six of the 70 patients treated with skeletal traction at the Alfred I. duPont Institute exhibited cranial nerve complications. The sixth cranial nerve was most commonly affected by distraction and resulted in weakness in lateral gaze. A combined lesion of the ninth, tenth and twelfth nerves was not an infrequent complication and presented as abnormalities in swallowing, quality of speech, and of tongue movement. It has not been singled out for its significance in the literature but it is potentially the most lethal of the complications. From our review it appears that patients who have had radiation treatment and who have presented with myelomeningocele experience a higher risk of complication in cranial skeletal traction. A definite clinical-pathological correlation could not be made. Frequent monitoring of the patients in skeletal traction is necessary, and prompt recognition of the clinical signs of these complications must be stressed. The complications in the patients of our series subsided upon release of the distraction force.

Abducens Nerve↗
PubMed1983

Traction radiography of the hip and fluid in the hip joint.

Applying traction to the hip joint normally creates a 'vacuum phenomenon' between the femoral head and the acetabulum. With the presence of fluid in the hip joint, this effect does not occur. Traction radiography thus gives the clinician and radiologist an easy and noninvasive method for detecting fluid in the hip joint. The subsequent article illustrates the potentialities of traction radiography in several hip diseases.

Adolescent↗
PubMed1982

Home traction in the management of congenital dislocation of the hip.

A form of axial fraction has been devised for the premanipulative management of a child with congenital dislocation of the hip. This set-up makes it possible to maintain a child in his own home while gently pulling the head of the femur down to the level of the acetabulum. Home traction has proven to be a simple, extremely safe method of management of congenital dislocation of the hip, with an exceptionally low incidence of avascular necrosis. It requires only that adequate instruction and supervision are available to the family. It helps to reduce the stress on the child inherent with hospitalization and on the parents with dividing their time and energy between the hospitalized child and their family at home. Home traction and is as effective as hospital traction and is far more acceptable to he parents and child.

Child, Preschool↗
PubMed1981

An effective method of skin traction in A-K guillotine amputation.

In modern orthopedic surgery, there are still indications for the guillotine amputation of the thigh. Immediate postoperative management by effective skin traction can promote rapid healing and eliminate the need for revision surgery. Revision surgery necessitates further shortening of the stump; skin grafting likewise can be avoided as a secondary procedure. Most skin tractions for above-the-knee amputations loosen within 24 hours. The suggested method of applying skin traction on A-K amputations, if applied properly, will be effective for periods ranging from five to seven days.

Amputation, Surgical↗
PubMed1980

Skeletal traction vs. femoral shortening in treatment of older children with congenital hip dislocation.

A review of skeletal traction compared with femoral shortening in treatment of older patients with congenital dislocation of the hip clearly favors femoral shortening. During the period 1952-74, 30 hips in 22 patients (average age, 6 6/12 years) were treated with skeletal traction, and during 1971-77, 17 hips in 12 patients (average age, 6 8/12 years) were treated with femoral shortening. In those treated with skeletal traction, avascular necrosis developed in 57%; redislocation or subluxation in 30%; an X-ray rating (Severin) of poor in 43%; and the incidence of pin and skin complications was 27%. The average follow-up was 11 1/2 years. In the group treated with femoral shortening, there were no cases of avascular necrosis and none with a poor rating on X-ray. The average follow-up was three years and seven months and it was never less than one year. Complications included one refracture at the osteotomy site six weeks after surgery, one late resubluxation, and two redislocations (early in the series prior to routine use of Steinmann pin fixation). The redislocations were easily reduced. Acceptable leg length inequality was present in all unilateral cases except in one 12-year-old patient who required a contralateral epiphysiodesis. One patient with late subluxation had open reduction and acetabuloplasty.

Bone Nails↗
PubMed1980

The treatment of fractures of the hip by Roger Anderson well-leg traction.

In recent years the treatment of fractures of the hip in elderly patients has been almost exclusive surgical. However, there are occasions when either because of medical conditions or other surgical problems it is not possible to operate on these patients. An alternative method of handling such patients is the use of Roger Anderson well-leg traction. This is a retrospective report on a total of 15 patients treated at the Indiana University Medical Center between 1969 and 1977. It was found that ten of these patients survived the period in traction apparatus. Of the ten who survived nine healed their fractures. Few complications arose from the use of this method. This group of patients was compared with 16 patients who were treated surgically for comminuted intertrochanteric fractures. Eleven of these 16 patients survived. Seven had complications during the time of hospitalization for a rate of more than 50%. Although we realize that both series were very small, we feel that this study points out that Roger Anderson well-leg traction is an effective method of treating elderly patients under certain conditions.

Adult↗
PubMed1992

[Use of supra-malleolar traction in treatment of closed fractures of the crural shafts].

The results of treatment of 36 closed fractures of the crural shafts reduced with supra-malleolar traction have been presented and evaluated with own scale. The best results were achieved with traction maintained for 5-6 weeks. Most of the failures were due to the disturbed union and restricted range of movement in the ankle. The authors conclude, that traction prevents secondary displacement and should be recommended for treatment of unstable fractures of the crural shafts.

Ankle Joint↗
PubMed1995

[Personal modification of skeletal traction].

Technical design and clinical assessment of skeletal traction kit is presented. The kit consists of 2 washers, 2 cylinders with blocking screws and a chain with hooks. The set is applied along with K-wire stretched in the buckle. The washers and blocking cylinders restrict longitudinal movements of the K-wire. Rotational ones are eliminated by resting the buckle (with no traction) on the extremity. The traction is executed by the chain attached to the K-wire near the buckle fastenings. Patients comfort and aseptic condition is improved. The modification proved valuable after observation of 38 patients treated by this method.

Arm↗
PubMed1994

The statics of cervical traction.

The statics of a sliding body was used to study the distribution of forces during the application of cervical traction in supine patients. This theoretical analysis was completed using a dynamometer to determine the static friction between bed surface and patient head. Therefore, we measured the head weight in 12 inpatients and the minimum force that causes impending motion of the head on the bed surface. The static friction coefficient was calculated from the ratio of the two quantities. The forces acting on the cervical spine were determined by inserting the former data into a specifically designed algorithm that forecasted a progressively increasing traction angle. The coefficient of static friction was 0.62, whereas the maximum available force acting on the cervical spine was obtained with a 35 degrees traction inclination. In contrast, the forces dissipated by the plane progressively decreased with larger angles.

Aged↗
PubMed1994

The efficacy of cervical extension-compression traction combined with diversified manipulation and drop table adjustments in the rehabilitation of cervical lordosis: a pilot study.

OBJECTIVE: To experimentally investigate the effect of cervical extension-compression traction combined with diversified chiropractic manipulation and drop table adjusting in establishing or increasing cervical lordosis. DESIGN: Blinded, before and after trial with pre- and postlateral cervical radiographic measurement. SETTING: Primary care private chiropractic clinic in Saugus, MA. SUBJECTS: A) Control group--convenience sample who had no health care for 10-14 wk, 30 persons. B) Treatment group 1, nonrandomized control trial, 35 persons, whose pre- and postlateral cervical radiographs were taken 10-14 wk apart and whose radiographs clearly depicted C1 through C7. C) Treatment group 2, nonrandomized control trial, 30 persons, whose pre- and postlateral cervical radiographs were taken 10-14 wk apart and whose radiographs clearly depicted C1 through C7. INTERVENTIONS: Treatment group 1: diversified spinal manipulation, drop table adjustments and cervical extension-compression traction five times per week for 10-14 wk (12 wk +/- 2). Treatment group 2: diversified spinal manipulation and drop table adjustments five times per week for 10-14 wk (12 wk +/- 2). MAIN OUTCOME MEASURES: Anterior head translation millimeters, C2 to C7 absolute rotation angle, angle of C1 to horizontal (atlas plane angle), five relative rotation angles (C2-3, C3-4, C4-5, C5-6, C6-7) and qualitative classification of lordotic configuration. RESULTS: No statistically significant changes existed between the pre- and posttests for the control group except in the C6-7 relative rotation angle. In the treatment group 1, statistically significant differences were found in all X-ray markings. Twenty-nine of 35 members have a lordosis after treatment compared to 11 of 35 before treatment. The C2 to C7 angle changed an average 13.2 degrees, C1 to horizontal changed an average 9.8 degrees, the anterior head translation reduced an average of 6.8 mm, the average relative rotation angle changed: C2-3: 3.1, C3-4: 5.5, C4-5: 4.80, C5-6: 2.7 and C6-7: 1.1. In the treatment group 2, no statistically significant changes existed between the pre- and posttests except atlas angulation to horizontal which increased an average of 3.0 degrees. CONCLUSIONS: A transformation to a lordotic configuration or increase in lordotic configuration occurred and was measured in the majority of treatment group 1 subjects, while no change in the control group and essentially no change in treatment group 2 was measured. Extension-compression traction combined with diversified chiropractic manipulation and drop table adjusting procedures may improve or partially reestablish the cervical lordosis in 10-14 wk of daily care.

Adult↗
PubMed1994

Rapid traction for reduction of cervical spine dislocations.

There is still some controversy about the reduction of unilateral and bilateral facet dislocations in the cervical spine. We have reviewed the notes and radiographs of 210 such patients; reduction was attempted by manipulation under anaesthesia (MUA) in 91, and by rapid traction under sedation in 119, using weights up to 150 lb (68 kg). Our results suggest that early reduction in patients with neurological deficit gives the best chance of neurological recovery, that rapid traction is more often successful than MUA, and that traction is safer than MUA. We found that the use of heavy weights with close monitoring was safe and brought about reduction in an average time of 21 minutes. We recommend this technique for the reduction of all cervical facet dislocations.

Adolescent↗
PubMed1977

Reduction of neglected traumatic dislocation of the hip by heavy traction.

Heavy traction treatment was applied to seven patients with old isolated posterior dislocation of the hip. Traction of seven to eighteen kilograms applied under sedation for five to seventeen days allowed over-reduction of the dislocation. Then gradual reduction of the femoral head into the acetabulum was accomplished by reducing the traction and abducting the limb. The results were good to excellent. In six patients there was no evidence of avascular necrosis or osteoarthritis during a follow-up period of from six months to three years. The femoral heads became fully concentric. The method failed in one patient in whom the dislocation was of nine months' duration and in whome a comminuted fracture of the acetabulum and other fractures of the pelvis were also present.

Adult↗
PubMed1996

Compartment syndrome as complication of skin traction, in children with femoral fractures.

We report the history of two 3-year-old children with femoral shaft fractures, who developed severe compartment syndromes following skin traction. Both children were admitted in our department for treatment of their compartment syndromes. In both, important and permanent disability persisted. The causative role of the skin traction is proven by the fact that in one infant, the compartment syndrome developed in the non-fractured limb. Cautious application of skin traction, conscientious observation, immediate diagnosis, and aggressive treatment of threatening compartment syndromes will prevent these tragic complications.

Anterior Compartment Syndrome↗
PubMed1997

Height increase, neuromuscular function, and back pain during 6 degrees head-down tilt with traction.

BACKGROUND: Spinal lengthening and back pain are commonly experienced by astronauts exposed to microgravity. METHODS: To develop a ground-based simulation for spinal adaptation to microgravity, we investigated height increase, neuromuscular function and back pain in 6 subjects all of whom underwent two forms of bed rest for 3 d. One form consisted of 6 degrees of head-down tilt (HDT) with balanced traction, while the other was horizontal bed rest (HBR). Subjects had a 2-week recovery period in between the studies. RESULTS: Total body and spinal length increased significantly more and the subjects had significantly more back pain during HDT with balanced traction compared to HBR. The distance between the lower endplate of L4 and upper endplate of S1, as measured by ultrasonography, increased significantly in both treatments to the same degree. Intramuscular pressures in the erector spinae muscles and ankle torque measurements during plantarflexion and dorsiflexion did not change significantly during either treatment. CONCLUSION: Compared to HBR, HDT with balanced traction may be a better method to simulate changes of total body and spinal lengths, as well as back pain seen in microgravity.

Adaptation, Physiological↗
PubMedDate not supplied

A joint protocol for home skeletal traction.

Cost-effective delivery of quality patient care is a major focus of the orthopaedic advanced practice nurse's practice. Long-term skeletal traction therapy for select fractures of the pelvis remains a treatment option for certain patients. The purposes of this article are to describe the development of a joint proposal for home skeletal traction therapy and to analyze the cost savings involved by reviewing a case study of a home traction patient.

Adult↗
PubMedDate not supplied

[The types of traction in osteochondrosis of the lumbar spine].

The effects of low-intensive tractions were evaluated clinically and electrophysiologically in 148 patients with neurological symptoms of lumbar osteochondrosis. The above tractions were combined with vibration, peloid electrophoresis and sulphide baths. Indications and contraindications for tractions are outlined. The above complexes are recommended for use in the programs of rehabilitation of patients with osteochondrosis of the lumbar spine.

Combined Modality Therapy↗