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PubMed1995

[Clinical, radiographic and axiographic control after traction-screw osteosynthesis of fractures of the mandibular condyle region].

Clinical, radiographic and electronic axiographic follow-up examinations were performed in 45 patients with a luxation or highly displaced fractures treated with traction screw fixation from 1984 to 1989. Axiographic findings gave an excellent objective evaluation of joint function. The excellent results achieved with traction screw fixation suggest that this method can be recommended for condyleal fractures of the mandible.

Adolescent↗
PubMed1994

Traction apophysitis of the medial malleolus.

We report the cases of three children with chronic injuries of the medial tibial malleolus caused by traction injuries during sport. All three had the triad of swelling of the medial malleolus, tenderness over its anterior part, and pain on forced valgus movement of the foot. Radiographs showed bilateral accessory ossification centres and MRI demonstrated partial avulsion or avulsion fracture of the apophyseal cartilage and fragmentation of the accessory centres. A review of 134 young basketball players showed that 25% had tenderness of the anterior medial malleolus. This high rate indicates that traction apophysitis of the medial malleolus is not uncommon in children as a sports-related disorder.

Basketball↗
PubMed1996

Ultrastructural studies on myofibrillogenesis and neogenesis of skeletal muscles after prolonged traction in rabbits.

Little is known about the morphological response of muscle after long term traction. The purpose of this study was to investigate the morphological changes of skeletal muscle during limb lengthening. After application of mini-extraskeletal fixator, the hindlimb of New Zealand white rabbit was osteotomized and then slowly lengthened at the rate of 1 mm/day up to a 20 mm gain in length. The muscles of hindlimbs were perfused and dissected. Morphological studies were performed at electron microscopic level. Transmission electron microscopy revealed foci of microtrauma at the myotendinous junction. The distance between the muscle fibers and tendon parenchyma increased, with numerous primitive mesenchyme-like cells interposed within this gap. The cytoplasmic space of these cells was devoid of myofibril formation at the ends of stretched fibers. Within the satellite near the myotendinous junction myofilament production was observed in various gradations of maturation. It is concluded that myofibrillogenesis with traction neogenesis of skeletal muscle during limb lengthening does exist and occurs mainly near the myotendinous junction. The myotendinous junction in mature skeletal muscle actively participated in the process of limb lengthening.

Animals↗
PubMed1997

Tractional force generation by porcine Müller cells: stimulation by growth factors in human vitreous.

PURPOSE: To examine the levels of Müller cell contraction-stimulating activity in human vitreous, correlate these levels with clinical presentation, and identify, the causative growth factors. METHODS: Human vitreous was collected from patients undergoing pars plana vitrectomy (n = 84). Müller cells were isolated from porcine retina and maintained in tissue culture. Tractional forces generated by cells incubated on three-dimensional collagen gels were measured as changes in gel thickness. Contraction-stimulating activity in vitreous (VA) was calculated from the close-response profiles of gel contraction to vitreous protein. The contributions of individual growth factors to vitreous activity (n = 10) were assessed by inhibition with specific neutralizing antibodies. RESULTS: The mean VA of patients with retinal detachment (3.65) and proliferative vitreoretinopathy stages A, B, and C (2.06) were elevated above that of patients without retinal pathology (vitreous activity = 0.23) or retinal defects alone (0.57). Mean activities in patients with epimacular proliferation (1.22) and vitreous hemorrhage (1.40) were also significantly elevated. The percentage of this activity attributable to insulin-like growth factor 1 (IGF-1) varied from 9.2% to 84.5% with a mean of 61.3%. Similarly, the percent contribution of platelet-derived growth factor (PDGF) ranged from 6.8% to 49.0% with a mean of 26.5%. CONCLUSIONS: The vitreous of patients with retinal detachment, proliferative retinal disease, and vitreous hemorrhage contain varying amounts of growth factors that stimulate tractional force generation by Müller cells. The majority of the activity can be attributed to IGF-1 and a smaller proportion to PDGF.

Animals↗
PubMed1998

Tangential vitreous traction observed in optic disc pit maculopathy without apparent serous detachment.

The authors describe a rare case of a patient with an optic pit that was accompanied by a cyst-like change in the macula without serous retinal detachment. A 38-year-old woman with a 10-year history of visual impairment in her right eye was referred to the authors' clinic. The best-corrected visual acuity was 20/200 in the right eye, and ophthalmoscopy showed a cyst-like change in the macula with tangential traction by the surrounding vitreous. The patient was treated with vitrectomy and the posterior vitreous was separated from the retina during the procedure. After the surgery, the cyst-like region disappeared and the corrected visual acuity improved to 20/40. The authors suggest that tangential vitreous traction played an important role in the pathogenesis of the optic pit maculopathy.

Adult↗
PubMed1996

Scar traction appliance for a patient with microstomia: a clinical report.

This clinical report illustrates how an active traction appliance was made for a patient with severe microstomia by attaching custom-made lip retractors to an orthodontic headgear. A steady, light tensile force was imparted to the lips with the elastic bands between the retractors and the headgear.

Child, Preschool↗
PubMed1994

[The place of traction and the anterior approach in the surgical treatment of kyphosis and kyphoscoliosis in children using C.D. instrumentation].

The surgical treatment of kyphosis and kyphoscoliosis in children or adolescents using the Cotrel-Dubousset (C. D.) instrument through a posterior approach may often need a further anterior procedure either before or after. We have reviewed 20 adolescents who were operated on at l'Hôpital Saint Vincent de Paul since 1983. Our choice of management was determined by consideration of the aetiology, the age, the degree of angulation and the suppleness of the kyphotic spine in hyperextension on the operating table. The use of preoperative traction for a mean of 25 days gained an improvement of 14% of the final correction. It was used in the curves which were most pronounced, usually high thoracic curves which lacked suppleness in the lumbar spine and which were stiff on the table. The anterior approach was not indicated in long double dorso-lumbar curves, usually of idiopathic origin, which had already reached an advanced stage of development. It was necessary in severe angular kyphoses which were unstable or had marked anterior stiffness. It was sometimes used in younger patients with kyphoscoliosis in which it was difficult to assess the state of maturity. After operation the kyphosis was corrected by up to 73% in simply kyphoses, 66% in kyphoscoliosis and 59% in scolio-kyphosis. After operation we were usually able to mobilise patients without a corset.

Adolescent↗
PubMed1994

Treatment of subtrochanteric fractures of the femur: reduction on the traction table and fixation with dynamic condylar screw.

In the subtrochanteric region of the femur high tensile forces are active in the lateral cortex and even higher compressive forces in the medial cortex. Subtrochanteric fractures are often comminuted. The implant of choice for osteosynthesis of subtrochanteric femoral fractures is the condylar plate. Usually the various fragments are dissected intraoperatively and the medial cortex is reconstructed anatomically for improved abutment. This devitalizing of fragments leads to disturbed healing, so that failure are frequent despite cancellous bone grafting. The osteosynthesis technique introduced by Mast and Ganz of indirect reduction by distractor without dissection of the fragments and the medial cortex allowed the complication rate to be reduced to 0%. We have modified this technique in that we performed closed reduction on the traction table rather than using the distractor to achieve axial and rotational alignment, after which the fracture is stabilized with dynamic condylar screw (DCS) under image intensifier control. The proximal femur is dissected only laterally and only in so far as in necessary to place the DCS. We never use cancellous bone grafting. From 1988 to 1990 this technique was used in 12 patients. All fractures had healed uneventfully after 4 months.

Adult↗
PubMed1995

An abduction-traction frame for the treatment of intertrochanteric fracture of femur.

We present a detailed outline of treatment of intertrochanteric fractures of femur with a new technique on the basis of principles of combined traditional chinese and western medicine. We use pins and an outer fixation frame, which keeps the injured limb in abduction and under traction and at the same time allows for functional exercise of all the joints in the extremity. The procedure is discussed and compared with other different techniques.

Fracture Fixation↗
PubMed2003

Traction spica cast for femoral-shaft fractures in children.

We treated 20 children for an isolated femoral shaft fracture using distal tibial traction incorporated into a spica cast with the knee in full extension. Patients were discharged from the hospital at a mean of 5.1 days following injury. All fractures healed, and there were four minor complications. At a mean follow-up of 35 (13-72) months, all patients were asymptomatic with normal function. All but one fracture healed in acceptable alignment, and there was no clinically significant leg-length discrepancy. The method is relatively simple to employ and may be advantageous in a setting of limited resources.

Casts, Surgical↗
PubMed2006

Prediction of acetabular development after closed reduction by overhead traction in developmental dysplasia of the hip.

BACKGROUND: The prediction of acetabular development after reduction of developmental dysplasia of the hip (DDH) is important to ensure optimal timing of acetabuloplasty and to avoid unnecessary surgery. The objective of this study was to find early and reliable predictors of future acetabular dysplasia in the hips reduced by overhead traction (OHT). METHODS: We retrospectively reviewed 45 hips in 40 patients treated by OHT for DDH without additional procedures. The average age at the time of closed reduction was 9.3 months, and the average age at the latest examination was 17.3 years. Residual hip dysplasia at skeletal maturity was defined according to Severin's classification. The following variables were evaluated as possible predictors of the final outcome: age at reduction, severity of the dislocation, serial measurements of acetabular index (AI), center-edge angle of Wiberg (CE), and the center-head discrepancy distance (CHDD). RESULTS: Sixty-two percent of the hips had satisfactory results in Severin I/II and 38% had unsatisfactory results in Severin III. Bilateral DDH showed significantly poorer outcome than unilateral DDH. The average AI of the unsatisfactory group was significantly greater than that of the satisfactory group at 4 years or more after reduction. Similarly, the average CE of the satisfactory group was greater than that of the unsatisfactory group at 5 years or more after reduction. In unilateral cases, the AI and the CE of the uninvolved hip at 1 year after reduction also correlated with the final outcome of the involved hip. CONCLUSIONS: The AI of 4 years and the CE of 5 years after reduction were the earliest predictors of the final outcome. Careful consideration for the need of acetabuloplasty would be given at 4 or 5 years after reduction by OHT. Bilateral DDH and poor acetabular coverage of the uninvolved hip in unilateral DDH were the prognostic factors of unfavorable acetabular development of the dislocated hip.

Acetabulum↗
PubMed1979

The activated face-bow: simple, safe, extraoral traction.

A simple and safe extraoral traction model is described. This consists of a face-bow with activated outer arms and a neck strap or headgear without any elastic force, such as rubber bands, elastic ribbons, coil springs, etc. The appliance cannot be withdrawn from the mouth by acident; therefore, the patient is protected from possible injuries.

Activator Appliances↗
PubMed1982

The initial effects of orthopedic forces: a study of alterations in the craniofacial complex of a macerated human skull owing to high-pull headgear traction.

The initial reaction of components of the craniofacial skeleton of a macerated human skull was studied after high-pull headgear traction. The applied forces were increased step by step from 0.5 N to 3.25 N per side (1N = 100 grams). Laser holography was used for measuring displacements in three dimensions in seventeen indicator points on the skull. These points were located near sutures or on the outer surface of individual bones. The skull was observed from the right frontal and from the left lateral side. Results indicate that displacements range from 0 micrometer to 17.0 micrometers, depending on force magnitude and on the location of the observed point. Individual components of the craniofacial skeleton were mostly displaced in a horizontal backward direction when the skull was viewed from the frontal aspect. Various compression and shearing patterns were observed in the craniofacial sutures, apparently depending on their spatial locations and intersutural surface morphology.

Cranial Sutures↗
PubMed1985

Holographic and cephalometric study of the relationship between craniofacial morphology and the initial reactions to high-pull headgear traction.

Eight macerated human child skulls with a dental age of approximately 9.5 years (mixed dentition) were consecutively subjected to an experimental standardized high-pull headgear traction system attached to the maxilla at the first permanent molar area via an immovable acrylic resin splint covering all teeth. This system produced tensile forces from 0.5 to 3.5 N (1 N = 0.10 kg) per side. Laser holography was used to measure displacements in a three-dimensional coordinate system. Displacements varied in direction. In addition, conventional cephalometric analysis of standardized lateral roentgen cephalograms was performed. Displacements and cephalometric data were then compared. Results indicate that the direction of initial displacements of bones of the facial skeleton bears a definite relationship to the morphology of the individual skull. In skulls with high divergency values (large angles, sella-nasion-occlusal plane, sella-nasion-mandibular plane), displacements are in a backward and posterior downward direction; in skulls with a small sella-nasion-occlusal plane angle, backward displacements occur in a direction almost parallel to the occlusal plane.

Cephalometry↗
PubMed1986

Initial displacements and variations of eight human child skulls owing to high-pull headgear traction determined with laser holography.

In this study eight macerated, human child skulls (dental age approximately 9.5 years) were subjected to a standardized high-pull headgear traction system. Tensile forces from 0.5 to 3.5 N (1 N = 0.1 kgf) per side were produced to the maxillae. Displacements of skeletal components were determined at 22 indicator points per skull by means of laser holography. Coordinated displacements and variations in amount and direction were established in all skulls. The overall amount of displacements was primarily a characteristic of an individual skull, not of a particular displacement. On the average, the maxillae were displaced in a slightly downward and posterior direction almost parallel to the occlusal plane. No deformations of skeletal components were seen. Results indicated that initial displacements of the maxillae and other skeletal components are not in the same direction as the direction of applied forces.

Cephalometry↗
PubMed1983

Quantitative analysis of the orthodontic and orthopedic effects of maxillary traction.

This article analyzes differences in displacement of ANS and of the upper first molar when different vectors of force are delivered to the maxilla in non-full-banded Phase I mixed-dentition treatment of Class II malocclusion. The sample is identical to that for which we have previously reported differences in change in several key measures of mandibular and facial shape. It includes a cervical-traction group, a high-pull-to-upper-molar group, a modified-activator group, and an untreated Class II control group. Using newly developed computer-conducted procedures, which are described, we have been able to partition the orthodontic and orthopedic components of upper molar displacement and also to isolate treatment effects from those attributable to spontaneous growth and development. In the region of ANS, small but statistically significant and clinically meaningful differences were noted between treatments. When the intercurrent effects of growth and development had been factored out (Table III), orthopedic distal displacement of ANS was significantly greater in the high-pull and cervical groups than in the activator group. Orthopedic downward displacement of ANS was seen to be significantly greater in the cervical group than in the high-pull and activator groups. In the region of the first molar cusp, mean distal displacement of the tooth as an orthopedic effect was found to be almost identical in the cervical and high-pull groups (although variability was greater in the cervical group), but the mean orthodontic effect was significantly greater in the high-pull group than in the cervical group. In the cervical group, where relatively light forces were used for relatively long treatment periods on average, more of the total distal displacement of the upper molar was of an orthopedic character than of an orthodontic character. Conversely, in the high-pull group, in which relatively heavier forces tended to be used for briefer treatment periods, most of the distal displacement at the upper molar was of an orthodontic character. These observations are contrary to expectations from conventional orthodontic theory. In the activator-treated group, roughly equal components of the treatment-associated distal displacement of the upper molar were of the orthodontic and orthopedic types. As concerns changes in the vertical direction in the region of the molar cusp, significant intrusion of both the orthopedic and orthodontic types was seen in the high-pull sample as compared to each of the other groups examined.(ABSTRACT TRUNCATED AT 400 WORDS)

Activator Appliances↗
PubMed1977

'Straight lateral traction' in selected supracondylar fractures of the humerus in children.

A method of treating completely displaced supracondylar fractures of the humerus in children by 'straight lateral traction', as originally used by John Dunlop, is recommended. The results in 26 children, selected because manipulation had failed to achieve reduction, is examined, and indicates that this treatment is satisfactory for some problem fractures, leading usually to good results in terms of resolution of complications and return of function. It also avoids the ugly deformities of the elbow which follow reliance on a single form of treatment for all supracondylar fractures. Failure of anatomical reduction by the appliance is shown to be in the plane of elbow movement, where normal physiological mechanisms correct the bone by remodelling. Where there is epiphyseal damage, deformities may occur with any form of treatment.

Child↗
PubMed1981

Diagnosis of brachial plexus traction lesions by sensory nerve action potentials and somatosensory evoked potentials.

Forty-two patients with unilateral brachial plexus traction lesions were investigated by recording sensory nerve action potentials (SNAPs) from the lower arm and somatosensory evoked potentials (SEPs) from the clavicle, the cervical spine and the scalp overlying the contralateral somatosensory cortex, in response to electrical stimulation of peripheral nerves. The median and radial nerves were assumed to derive principally from the C6 and C7 roots, and the ulnar nerve from the C8 and T1 roots. Combination of SEP and SNAP findings suggested a location for the lesion (preganglionic, postganglionic or combining pre-and postganglionic elements) which was found to be accurate in 10 out of 16 operated cases, and substantially accurate in another 3. There was a poor correlation, however, between the presence of absence of SNAPs in the musculocutaneous nerve and the location of the lesion to the C5 root.

Action Potentials↗