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At least 595 records · Page 33Linked to original sources
PubMed1986

Blood pressure response to inversion traction.

The purpose of this study was to determine blood pressure response to two minutes of inversion traction. Sixty female volunteers aged 20 to 30 years were assigned randomly to an Experimental or Control Group. After resting blood pressure was measured in the standing position, the Experimental Group was inverted for two minutes. Blood pressure was measured before the subjects dismounted. The Control Group remained standing for two minutes, after which blood pressure was measured again. The results of a Hotelling's T2 analysis and subsequent post hoc tests revealed a significant difference between the mean gain scores of the Experimental and Control Groups (p less than .05). Both systolic and diastolic blood pressures increased significantly. This increase with inversion indicates a need for caution when using inversion traction as a treatment technique for low back pain. Hypertensive individuals may need to avoid its use.

Adult↗
PubMed1996

Bone transport using intramedullary fixation and a single flexible traction cable.

The transfixing wires used in the limb-lengthening and bone-transport procedures described by Ilizarov are the primary source of complications, including infection, restricted joint motion, and pain. In an attempt to eliminate the need for external fixation, a traction cable device was devised to perform a 3-cm bone transport in the canine femur using an interlocking intramedullary rod for fixation. Twelve dogs were divided into 2 groups. Transport began 7 days after osteotomy and continued at either 1 mm per day (n = 6) or 2 mm per day (n = 6). The in vivo peak force, resting force, and stiffness of the transport segment increased throughout distraction to a mean of 150 Newtons, 58 N, and 58 N per millimeter, respectively, at the time of docking. The regenerate and docking sites united in 10 of 12 dogs. Failure of the regenerate associated with deep infection around the rod occurred in 2 animals (17%). Modifications of this technique to reduce the risk of infection are discussed. This study confirms that intramedullary fixation is compatible with distraction osteogenesis and shows that a single traction cable can provide the force necessary for bone transport without transfixing wires in this setting.

Animals↗
PubMedDate not supplied

Femoral head resection for painful hip subluxation in cerebral palsy: Is valgus osteotomy in conjunction with femoral head resection preferable to proximal femoral head resection and traction?

Patients with severe cerebral palsy who underwent either a femoral head resection with traction or a McHale procedure (femoral head resection and valgus osteotomy) were studied retrospectively and then contacted by telephone to assess whether removing the femoral head or proximal femur as a salvage procedure improved sitting tolerance, relieved pain, or improved hygiene. Twenty-seven patients (36 involved hips) were available for a retrospective chart and x-ray review, and over half (56%) of these patients or caretakers were able to complete a telephone questionnaire. Of the study cohort, 16 patients underwent femoral head resection with traction and 11 patients had a McHale procedure. The average age at surgery was 19 years and average follow-up was 3.4 years. For those in the McHale group, the length of stay in the hospital was shorter, the postoperative superior migration of the femoral head was less pronounced, and the surgical and medical complications were lower. The telephone survey showed that both groups had increased sitting tolerance and decreased pain, and both showed overall satisfaction with the surgical outcome.

Adolescent↗
PubMed1995

Intramedullary nailing of acute femoral shaft fractures using manual traction without a fracture table.

Intramedullary (IM) nails were prospectively placed in 32 consecutive femoral shaft fractures without the use of a fracture table. All fractures were reduced using manual traction. Pathologic and nonacute fractures and those requiring a reconstruction nail were excluded. The results are compared with results of two prior study groups from this institution that underwent IM nailing with or without a fracture table using a femoral distractor. Ten patients had unstable spine or pelvis fractures. Four nailings followed exploratory laparotomy. Twelve patients underwent two or more procedures on the lower extremities under the same preparation and drape. Six fractures were open. Sixty-seven percent of results were anatomic, 27% had < 5 mm lengthening/shortening or < 5 degree varus/valgus, and 7% had > 5 mm lengthening/shortening or > 5 degree varus/valgus. Average operative time was 95 min. No complications occurred that were attributable to the technique. Compared with the prior study groups, no statistical difference in the fracture types or results was found. However, operative time was significantly less in the manual traction group (p < .05). We feel that this technique is a safe, simple, and effective alternative to using a fracture table. The technique is especially useful in the polytrauma patient, significantly decreasing anesthetic time.

Adolescent↗
PubMedDate not supplied

Reduction of posterior hip dislocations in the lateral position using traction-countertraction: safer for the surgeon?

Closed reduction of a hip dislocation is a physically demanding task for the orthopaedic surgeon. The most commonly used methods for reduction of the hip involve vigorous axial traction on the lower extremity with the patient in the supine position, using an assistant who attempts to hold the pelvis down. The surgeon generally stands over the patient to pull up on the bent knee, which puts the surgeon at risk for a low back injury and, if done while the patient remains on a stretcher, can put the surgeon at risk for a fall from a height. Reduction in the prone position is advocated by some, but caring for the sedated patient in the prone position can be difficult and the patient's pelvis tends to roll off the edge of the stretcher, preventing the achievement of hip flexion, which is desirable in achieving reduction. We describe a traction-countertraction technique that appears to be significantly less dangerous for the surgeon. In this technique the hip is reduced with the patient remaining on the stretcher in the lateral position. In addition, fluoroscopy can be carried out during the reduction maneuver, and the images can be quite helpful in adjusting the direction of manipulative forces.

Hip Dislocation↗
PubMed2004

Heterotopic ossification of the quadriceps following distal femoral traction: a report of three cases and a review of the literature.

SUMMARY: We present the previously unreported complication of symptomatic heterotopic ossification of the quadriceps following placement of a large-diameter Steinmann pin for the purpose of temporary skeletal traction. Following the development of distal quadriceps heterotopic bone formation in three patients, we conducted a comprehensive search of the literature using the Medline database from 1966 to the present. A variety of publications, including review articles, case reports, and randomized prospective studies, were used for the literature review. This potential complication should be considered when using a large-diameter Steinmann pin in the distal femur for skeletal traction.

Adult↗
PubMed1984

Halo-clavicle traction.

A case is presented employing a modification of the halo traction technique using clavicle and scapular based pins attached through Hoffmann spacing bars to a standard halo frame. Other techniques that have been employed for fractures and dislocations of the cervical spine are reviewed. The principle advantages are the satisfactory stability it affords and the access the technique provides to the torso. The major problem anticipated of loosening of pins or instability of the apparatus because of the mobile clavicle and scapula did not occur in this patient. The halo-clavicle traction is a needed alternative to more conventional methods of stabilizing the spine.

Bone Screws↗
PubMedDate not supplied

Traction basics: Part I.

Traction is a treatment modality used for the reduction or immobilization of fractures or dislocations. It is used to maintain alignment, decrease muscle spasms, relieve pain, correct, lessen or prevent deformities, expand joint spaces prior to surgery, promote rest to diseased or injured body parts and to promote exercise. Nurses need a working knowledge of the various types of traction along with its rationale, correct setup, and maintenance. They must become familiar with potential complications and use nursing diagnoses to work with patients to strive to achieve expected patient outcomes.

Humans↗
PubMedDate not supplied

Traction at home for infants with developmental dysplasia of the hip.

Early treatment of developmental dysplasia of the hip in infants is essential for optimal development of the hip joint. Orthopaedists commonly use a period of preliminary traction before hip reduction to stretch the soft tissues and reduce the risk of avascular necrosis. A program developed at the University of Michigan Medical Center allows the infant to receive traction at home instead of the traditional admission to the hospital. This program has been found to be clinically effective as well as cost effective, and less of an inconvenience to the infant and family than the traditional admission. Intensive involvement by the clinical nurse specialist in teaching and follow-up of each patient is essential for success.

Hip Dislocation, Congenital↗
PubMed1997

Traction-induced rupture of an extracranial vertebral artery aneurysm associated with neurofibromatosis. A case report.

STUDY DESIGN: This report describes presumed traction-induced rupture of a vertebral artery aneurysm in a patient with neurofibromatosis Type I. OBJECTIVE: To draw attention to the need for preoperative arteriography in the surgical management of severe cervical kyphosis in neurofibromatosis. SUMMARY OF BACKGROUND DATA: Aneurysmal dilatation is a rare but well-documented manifestation of neurofibromatosis. The complication of rupture of a vertebral artery lesion has not been described previously. METHODS: The clinical features of the reported complication in a 56-year-old woman are detailed. RESULTS: A successful outcome was achieved by embolization and later anterior and posterior spinal fusions. CONCLUSIONS: Vertebral arteriography should be part of the preoperative assessment of neurofibromatotic cervical kyphosis. Skull traction may produce aneurysmal rupture.

Aneurysm, Ruptured↗
PubMed1998

Results after preoperative traction and pinning in slipped capital femoral epiphysis: K wires versus cannulated screws.

We have retrospectively reviewed 53 cases (62 hips) with a diagnosis of slipped capital wedge epiphysis. After admission to our Hospital, a skin longitudinal traction was applied for 2 weeks, All patients were treated afterward with pinning in situ without manipulation in the operating room. Group A (31 hips) consisted of patients treated with smooth K wires and group B (31 hips) of patients treated with cannulated screws. We found a high incidence of pin penetration in group A (27 hips), whereas there was just one case in group B. Physical closure was considered when 75% of proximal growth plate disappeared in the frog lateral view and both groups showed similar values (7 months). Chondrolysis was observed in just three cases in group A, and one case had an avascular necrosis. Few complications were observed compared with the high rate of pin penetration, and we suggest that preoperative traction may be a relevant factor contributing to the low incidence of avascular necrosis (1.6%).

Adolescent↗
PubMedDate not supplied

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

A total of 14 patients with congenital dislocation of the hip have used our home traction frame and program over a 2-year period. The newly designed frame is made of polyvinyl chloride tubing and consists of two parts: a Bradford frame and a roller base. The frame is lightweight, portable, and inexpensive to make. Traction can be maintained for 3 weeks at home, with a significant cost savings of more than $5,000/child. In our patients, there have been no cases of avascular necrosis of the hip or neurovascular problems to the legs. There is decreased psychological stress to the child and family when the care can be provided at home.

Child, Preschool↗
PubMedDate not supplied

Preoperative Russell traction in Legg-Calvé-Perthes disease.

Divergent opinions about the pathophysiology and the optimal time and methods for the treatment of Legg-Calvé-Perthes (LCP) disease exist. Synovitis causing restriction of hip motions may be hazardous to the circulation to the femoral head. We studied 23 children (24 hips) in the initial phase of LCP disease. Seven to 14 days of Russell traction decreased the intraosseous pressure significantly (p less than 0.001) and increased the hip motion a mean of 33.6 degrees. As assessed by osteovenography, the venous congestion decreased in almost every hip during Russell traction.

Child↗
PubMed2006

Systematic literature review of spinal decompression via motorized traction for chronic discogenic low back pain.

OBJECTIVE: The objective of this study was to systematically review the literature to assess the efficacy of nonsurgical spinal decompression achieved with motorized traction for chronic discogenic lumbosacral back pain. DESIGN: Computer-aided systematic literature search of MEDLINE and the Cochrane collaboration for prospective clinical trials on adults with low back pain in the English literature from 1975 to October 2005. Methodologic quality for each study was assessed. Studies were included if the intervention group received motorized spinal decompression and the comparison group received sham or another type of nonsurgical treatment. RESULTS: Data from 10 studies were fully analyzed. Seven studies were randomized controlled trials using various apparatus types. Because of this low number, we also analyzed three nonrandomized case series studies of spinal decompression systems. As the overall quality of studies was low and the patient groups heterogeneous, a meta-analysis was not appropriate and a qualitative review was undertaken. Sample sizes averaged 121 patients (range 27-292), with six of the seven randomized studies reporting no difference with motorized spinal decompression and one study reporting reduced pain but not disability. The three unrandomized studies (no control group) of motorized spinal decompression found a 77% to 86% reduction in pain. CONCLUSIONS: These data suggest that the efficacy of spinal decompression achieved with motorized traction for chronic discogenic low back pain remains unproved. This may be, in part, due to heterogeneous patient groups and the difficulties involved in properly blinding patients to the mechanical pulling mechanism. Scientifically more rigorous studies with better randomization, control groups, and standardized outcome measures are needed to overcome the limitations of past studies.

Chronic Disease↗
PubMed2004

Novel development for intraoral distraction osteogenesis by individually fabricated traction prostheses.

Modified fixed or removable partial dentures are used for intraoral distraction osteogenesis. These traction prostheses rest on teeth or endosseous implants and direct distraction forces to an endosseous implant in the osteotomy segment. This article explains the fabrication and function of custom-made traction prostheses for 1-, 2- and 3-dimensional distraction osteogenesis.

Dental Abutments↗
PubMedDate not supplied

Use of traction during magnetic resonance imaging of caudal cervical spondylomyelopathy ("wobbler syndrome") in the dog.

Cervical spondylomyelopathy or "wobbler syndrome" is a well-defined disorder of large-breed dogs, characterized by a compressive lesion affecting the cervical spinal cord that in many dogs may have a dynamic component. Determination of whether this dynamic component is present is important in the decision-making process as regards therapeutic intervention. Despite a significant risk of neurologic deterioration following myelography in some large dogs affected by wobbler syndrome, myelography is considered an essential part of the assessment, primarily as it allows assessment of whether a dynamic compression exists. This same neurologic deterioration is not apparent following magnetic resonance (MR) imaging; however, the use of MR imaging in the investigation of wobbler syndrome has thus far been limited by the inability to perform the traction studies required to ascertain whether a dynamic component to the spinal cord compression exists. This paper presents a technique of applying traction during MR imaging of the cervical spine to reduce a dynamic wobbler syndrome lesion.

Animals↗