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[Clinical and electroneuromyographical correlations in patients with lumbosacral pain syndrome in the complex therapy by the method of vertical underwater traction].

The authors have analyzed the efficiency of a complex treatment containing vertical underwater traction (VUT) method for patients with lumbosacral pain syndromes. The use of VUT in a complex treatment of patients with lumbosacral pain syndromes was determined to be effective by clinical data and positive indices of electroneuromyography.

Adult↗

Rush pin fixation versus traction and casting for femoral fracture in children older than seven years.

BACKGROUND: The optimal treatment for femoral fractures in children is controversial. The purpose of this study was to compare the results of Rush pin fixation with those of conservative treatment, and to evaluate the sequels of growth plate injury by internal fixation. METHODS: Eighteen femoral shaft fractures in 17 children who had concomitant head injury or multiple traumas were treated surgically. The mean age at operation was 9 years 3 months (range, 7 years 5 months to 11 years 1 month). One Rush pin was inserted from the tip of the greater trochanter, without reaming, to fix the fracture. Another 20 age-matched children treated by traction and casting were the control subjects. RESULTS: All the fractures united without consequences. In addition to a decrease in hospital stay with the use of the Rush pin (10 days vs. 27 days, p<0.05), fewer leg length discrepancies (4.2 mm vs. 7.1 mm, p<0.05) were also noted, compared with conservative treatment. The growth of the proximal femur after Rush pin fixation was evaluated after an average of 59 months. No femur shortening, coxa valgus, or hip dysplasia was noted. CONCLUSIONS: Intramedullary Rush pin fixation for femoral shaft fracture in children older than 7 years is a simple and reliable alternative. One narrow and non-reaming pin inserted from greater trochanter did not demonstrate femoral growth inhibition.

Casts, Surgical↗

Dynamic traction and passive mobilization for the rehabilitation of zone II flexor tendon injuries: a modified regime.

This retrospective study aims to evaluate the effectiveness of the modified regime for rehabilitation of Zone II flexor tendon injuries in Sibu Hospital. From January to December 2003, 8 patients with 15 injured digits were treated by using the combined method of dynamic traction and passive mobilization. According to Strickland's criteria, 14 (93.3%) digits achieved good to excellent outcomes and only 1 (6.7%) was rated as poor. No occurrence of tendon rupture was noted. The overall grip strength of the injured hand was 50.1% of the uninjured hand at 3 months after the repair. Our results compare favorably with the other published studies. We believed that this modified regime is as effective as other established regimes and suitable to be adopted in our setting. Further study with larger sample group will be required to consolidate our findings.

Adult↗

Conservative management of third trimester cervical spinal cord injury using Gardner-Wells tongs traction.

Spinal cord injury, though an important cause of morbidity appears to be uncommon in pregnant women or perhaps, has not been accurately documented among them. Superimposed on the many impairments resulting from spinal cord injury is the presence of the foetus in the womb which in itself normally brings about intense physiological alterations in the patient. Despite the complexities, neither the pregnancy nor the spinal cord injury needs jeopardize the optimal care of the other as long as the standard protocols are followed. In the past 10 years, the University college Hospital, Ibadan, Nigeria treated approximately 900 spinal cord injury patients, and only 3 of these were pregnant-an incident of 0.30 per 90 patients per year, or 0.33%. We report here, the conservative management of one of these pregnant patients using the Gardner-Wells' tongs traction, resulting in normal parturition and full neurological recovery.

Accidents, Traffic↗

Tibial condylar fractures treated with traction and early mobilisation (report on study of 75 cases).

Seventy-five cases of tibial condylar fractures irrespective of type of fractures were treated on a purely conservative line of management, consisting of traction and early mobilisation. The follow-up ranged from 6 months to 10 years; 67 cases had satisfactory results. Causes of unsatisfactory results were stiff knee, flexion deformity, osteo-arthritis and ligamentous instability.

Adult↗

[The bionator with extraoral traction--the Wurzburg concept. 1].

In this publication the bionator with extraoral anterior traction is presented. The preparation of the bionator and the headgear fit is demonstrated. The indication for the use of the appliance combination is outlined. The results of a cephalometric study concerning the therapeutic effects are presented. The following changes are especially noteworthy: There is a reduction of the SNA-angle, a significant retrusion of the upper incisors occurs. The mesial drift of the upper 6-year molars is inhibited, a slight posterior rotation of the maxilla is observed. In patients who wore their appliances well, a protrusion of the lower incisors could not be observed.

Activator Appliances↗

Physiatric therapeutics. 3. Traction, manipulation, and massage.

This self-directed learning module highlights advances in this topic area. It is part of the chapter on physiatric therapeutics for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. This section discusses physiologic effects of, and indications and contraindications for, traction, manipulation, and massage. Advances covered in this section include hypotheses of pain relief in manipulation.

Humans↗

[Retained canine. Surgical exposure and guided traction].

The Authors, after making a distinction between retained and included canine, examine the local and general causes of retention; moreover they illustrate clinical and radiological methods to reach the correct diagnosis; finally they highlight the importance of parodontal tissues during surgical treatment and particularly they describe a clinical case of surgical exposure and subsequent "under mucosal traction" on an intermediate retained canine.

Cuspid↗

[The evolution of cervical traction].

The authors in this note passed in review the literature data concerning cervical traction emphasizing its increasing importance since Cellier and Fox (1802) in our time.

Adolescent↗

[Application of isolation traction of aortic arch and upper part of the thoracic aorta in operation on cancer of the esophagus].

Isolation traction of aortic arch and upper part of thoracic aorta was performed by pulling and rotating them rightwards during operation on cancer located in the mid-segment of esophagus with serious adhesions. In 35 patients operated on, 33 cancers were resected with resection rate of 94%, including 21 by radical resection (60%) and 12 by palliative operation (34%). The method was to isolate the aortic arch and the upper part of thoracic aorta sufficiently and ligate the severed intercostal arteries and veins securely. While isolating the aorta, we pulled and rotated it with a strip of bandage and exerted strength evenly and gently as long as the operation field was exposed clearly. Otherwise, the heart function may be compromised. When isolating the aorta, a slight drop of blood pressure could be observed in some cases. It could recover immediately as we stop pulling and replaced the aorta in situ. According to our clinical experience, its advantages were: 1. It can prevent and treat the bleeding of hemiazygos vein. None of the 33 patients with adhesion and infiltration between the tumor and hemiazygos vein bled during the operation, even with the hemiazygos vein torn and bleeding. Bleeding could be stopped with ease because of good exposure; 2. It can extend the limit of resection and raise the resection rate; 3. It can broaden the space between the aorta and esophagus which is convenient for esophagogastrostomy on the esophagus bed, and 4. It can secure ligation of thoracic duct to prevent chylothorax.

Adult↗

Airport induced "cervical traction" radiculopathy: the OJ syndrome.

The escalation of airline travel compounded by federal deregulation, fostering crowded airports, delayed flights, and inconvenient gate scheduling, has forced the frequent flyer to run from one gate to another, carrying heavy under-the-seat bags. Eleven busy executive, nine men and two women, developed cervical radicular pain complaints associated with weakness and painful dysesthesias in the involved extremity. Four had right C6 root symptoms and seven had left C7 complaints. All had evidence, by x-ray, of cervical degenerative disc disease and three had abnormal electromyograms. Treatment, consisting of intermittent cervical traction after moist heat, as well as a modification of their travel habits including the use of a folding wheeled cart, in every instance resolved these complaints.

Adult↗

Subdural abscess associated with halo-pin traction.

Osteomyelitis and intracranial abscess are among the most serious complications that have been reported in association with the use of the halo device. The cases of five patients who had formation of an intracranial abscess related to the use of a halo cervical immobilizer are described. All of the infections resolved after drainage of the abscess, débridement, and parenteral administration of antibiotics. Meticulous care of the pin sites is essential to avoid this serious complication. Additionally, since all of the infections were associated with prolonged halo-skeletal traction, this technique should be used with caution and with an awareness of the possible increased risks of pin-site infection and of formation of a subdural abscess.

Adolescent↗

[Changes in the peripheral nerves in traction injuries].

The functional and structural changes in a nerve with various degree of stretching were studied by complex examination of 126 animals by means of neurophysiological and neurohistological methods. The character of changes in a nerve in traction trauma was found to be dependent on the degree of its stretching and the individual features of its external and intertruncal structure. A correlation between the type of changes and the size of nerve distraction was encountered.

Animals↗

The effect of a device for transverse traction on vertebral rotation in surgery for scoliosis as studied by X-ray stereophotogrammetry.

The effect of a device for transverse traction (DTT) on vertebral rotation in surgery for scoliosis has been analysed with an X ray stereophotogrammetric method in 17 patients. Six of them underwent conventional Harrington rod instrumentation and eleven patients received additional treatment with the DTT. The DTT exerted a positive effect on vertical rotation at the apex, and derotation average 10 degrees as compared with 5 degrees in the group in whom the device was not used.

Adolescent↗

Proximal tibial transfixion for skeletal traction. An anatomic study of neurovascular structures.

Pin placement in the proximal tibia is commonly performed by passing the pins percutaneously, without visualization of the underlying neurovascular and anatomic structures. Neurovascular injuries are uncommon. Complications are avoidable through a thorough familiarity with the location of the neurovascular structures. Six cadaveric legs were dissected and the three-dimensional anatomy of the peroneal nerve in the proximal one-third of the leg defined, with the use of profile radiography. The nerve is situated predominantly posterior to the tibia. The pin should be passed through the middle of the tibia (in cross section) strictly in the coronal plane to avoid neural damage. Skeletal traction or external fixation pins may, therefore, safely be placed in the proximal tibia.

Bone Nails↗