Traction function and application: Buck's traction - pelvic traction.
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Curriculum↗
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An evaluation of extraoral combined high-pull traction and cervical traction to the maxilla.
The effects of extraoral combined high-pull traction and cervical traction of known duration (mean, 122 days) and magnitude (2.5 to 3 pounds total per side) were studied by means of serial lateral cephalometric head films of thirty patients. The lateral cephalometric head films used were taken at three different times: before the extraoral force was applied, after the prescribed period of continuous headgear wear, and as long as possible after the extraoral force was discontinued. Changes in the dentition and associated structures were described both for the period of continuous headgear wear and for an average of 3.2 years later. The following conclusions are based on statistical analysis of the observed changes: 1. The position of the maxilla and the palatal plane was not significantly affected by relatively short periods of extraoral combined high-pull traction and cervical traction to the maxillary first molars as used for this investigation. 2. The maxillary first molars can be moved distally and bodily with this appliance without extrusion. 3. On the average, the mandibular first molars uprighted distally in response to the extraoral force to the maxilla. 4. The maxillary and mandibular first molars demonstrated a strong tendency to recover to their original positions and inclinations relative to their respective bases during the posttreatment period. 5. The amount and direction of growth in the posttreatment period may be important in determining how the Class I relationship is maintained.
Cephalometry↗
Intracranial aneurysm and hemorrhage following skull caliper traction. Review of skull traction complications.
Serious complications of caliper skull traction for fracture-dislocations of the cervical spine are so rare that they are not discussed in most standard textbooks. A fusiform intracranial aneurysm which followed the placement of skull tongs is reported. Subsequent aneurysmal rupture produced an intracerbral hematoma requiring drainage. The literature recording the complications of skull caliper traction is reviewed and the indications for skull traction and the need for scrupulous surgical technique are emphasized.
Cerebral Hemorrhage↗
[Theory of traction. Determination of the optimal arrangement of metal in the dorsal traction of an olecranon fracture].
This is the analysis of external forces acting on the elbow joint and their influence on the appearance of bending forces, shearing forces and tensions along the ulna and their alterations with fractures of the olecranon. The influence of flexor muscles on the fracture site is being evaluated too. The fracture of the olecranon is being defined by means of statics. All disadvantages of a dorsal tension band i.e. uncertainty to neutralize all forces acting at the fracture site adequately, irregular interfragmentary compression, creation of unwanted stearing forces and moments, rest on its excentric localisation. The optimal distribution of hard ware is being evaluated.
Biomechanical Phenomena↗
[Samples of traction harnesses for therapeutic spinal traction].
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Humans↗
[Treatment of idiopathic evolutional scoliosis with night-time vertebral traction and dynamic traction].
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Adolescent↗
Sharing: cervical traction, skeletal traction.
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Fractures, Bone↗
[Traction and kinesitherapy in the management of painful syndromes of the cervical spine].
Painful cervical spine syndromes caused by discopathy become ever more frequent. Conservative treatment of cervical discopathy includes mainly traction, kinesitherapy, thermotherapy, massage and electrotherapy. Traction treatment and kinesitherapy are particularly important. The author carried out investigations in 90 cases of cervical discopathy divided into 3 groups of 30 cases in each. In each group cervical traction was applied using Glisson's loop at different traction force and duration of traction. It was observed that three factors were of decisive importance for the end-result of traction: a) a proper position of the patient during the procedure and a proper direction of traction force, b) a proper duration of traction, c) a properly selected weight. Electromyography demonstrated bioelectric activity in the trapezius muscle and deltoid muscle on the affected side before treatment. After application of traction the bioelectric activity of these muscles was significantly reduced at rest. It is concluded that cervical traction and kinesitherapy are effective methods in treatment of cerival spinal painful syndromes.
Cervical Vertebrae↗
Tissue engineering science: consequences of cell traction force.
Blood and tissue cells mechanically interact with soft tissues and tissue-equivalent reconstituted collagen gels in a variety of situations relevant to biomedicine and biotechnology. A key phenomenon in these interactions is the exertion of traction force by cells on local collagen fibers which typically constitute the solid network of these tissues and gels and impart gross mechanical integrity. Two important consequences of cells exerting traction on such collagen networks are first, when the cells co-ordinate their traction, resulting in cell migration, and second, when their traction is sufficient to deform the network. Such cell-collagen network interactions are coupled in a number of ways. Network deformation, for example, can result in net alignment of collagen fibers, eliciting contact guidance, wherein cells move with bidirectional bias along an axis of fiber alignment, potentially leading to a nonuniform cell distribution. This may govern cell accumulation in wounds and be exploited to control cell infiltration of bioartificial tissues and organs. Another consequence of cell traction is the resultant stress and strain in the network which modulate cell protein and DNA synthesis and differentiation. We summarize, here, relevant mathematical theories which we have used to describe the inherent coupling of cell dynamics and tissue mechanics in cell-populated collagen gels via traction. The development of appropriate models based on these theories, in an effort to understand how events in wound healing govern the rate and extent of wound contraction, and to measure cell traction forces in vitro, are described. Relevant observations and speculation from cell biology and medicine that motivate or serve to critique the assumptions made in the theories and models are also summarized.
Biomechanical Phenomena↗
Preoperative skeletal traction in scoliosis.
To determine the role of preoperative traction in the treatment of spinal curves, ten patients with curves averaging 81 degrees by the Cobb measurement were studied. Each patient was treated in traction by means of a halo or skull tongs and femoral pins for two to three weeks prior to the surgical correction of the scoliosis with instrumentation. Weights were added to the traction apparatus, 1.8 kilograms a day, to a maximum of 18.1 kilograms. Pretraction supine roentgenograms were compared with supine roentgenograms made at three-day intervals throughout the traction period. Preoperative traction resulted in an average improvement of the curves of 34 degrees, or 41 per cent of the initial curve. Most of the correction was obtained within the first week of traction. Further correction during surgery with Harrington instrumentation yielded 13.5 degrees on the average (16 per cent) so that combined correction averaged 47 degrees, or 57 per cent.
Adolescent↗
Pain and cervical traction variation during manual turning [proceedings].
An experiment using a dummy with a cervical traction recorder was used in place of a patient. Nurses and orderlies from the Spinal Unit carried out manual lifting and turning techniques, used in the conservative treatment of spinal injury. Variation in manual traction continues throughout a turn. Traction force may be quadrupled or quartered. Inco-ordination between the individuals lifting, causes bending forces in the neck. This, together with sharp variation in traction, elicits pain. Manual traction, lifting, and turning, should be totally avoided, by employing kinetic nursing, provided by the use of the Roto Rest Spinal Bed.
Cervical Vertebrae↗
The value of traction during roentgenography of the wrist and metacarpophalangeal joints.
Traction on wrist and metacarpophalangeal joints during radiography produces 'vacuum phenomenon' due to the release of intra-articular gas. The resultant pneumoarthrogram clearly portrays the articular cartilage. Manual traction radiography of the wrist and the metacarpophalangeal joints has the following potential uses. 1. Detection of joint effusion; increased interosseous space during traction without release of intraarticular gas is indicative of joint disease with effusion. 2. Separation of the carpal bones; the traction separates the carpal bones and allows evaluation. 3. Differentiation of arthralgia from arthritis. 4. Evaluation of midcarpal, radiocarpal compartments, and the metacarpophalangeal joints can be performed before the secondary ossification centers are ossified. 5. Evaluation of the integrity of the joint cartilage.
Adolescent↗
Cervical traction. Review of literature and treatment guidelines.
This article is a review of the literature on cervical traction. The various mechanical factors most relevant to cervical traction are organized and discussed. The factors presented are 1) neck position, 2) traction force, 3) duration of traction, 4) angle of pull, and 5) position of the patient. Treatment guidelines are suggested based on interpretation of the literature.
Biomechanical Phenomena↗
Effect of pelvic-femoral position on vertebral separation produced by lumbar traction.
The purpose of this study was to determine the relationship between hip position and the amount of vertebral separation produced by intermittent lumbar traction. Ten subjects received intermittent lumbar traction at a force of 31.8 kg (70 lb) for 15 minutes in each of three positions of hip flexion (supine): 0 degrees, 45 degrees, and 90 degrees. Vertebral separation was measured on lateral roentgenograms by outlining and marking the vertebral bodies and measuring interspaces with fine-point calipers. Except for the T12-L1 interspace, traction produced greater posterior interspace separation as the angle of hip flexion increased from 0 to 90 degrees. These differences were statistically significant at interspaces L4-5 and L5-S1. We found no systematic changes in anterior interspace distance. To produce maximal posterior vertebral interspace separation, pelvic traction should be applied with the hip flexed 90 degrees.
Adult↗
Traction intolerance syndrome: a psychiatric complication of femoral fractures.
Traction Intolerance Syndrome is defined as a behavioral and/or emotional reaction related to skeletal traction severe enough to require psychiatric consultation and/or the use of major psychiatric medication for prolonged periods in the absence of pre-existing major psychiatric illness. Patients often attribute these reactions to the predicament of traction. This syndrome was present in five of nine patients between the ages of sixteen and forty-five who underwent traction for more than three weeks admitted to the UCLA Orthopedic Service during calendar year 1975. Moreover, all the patients were between sixteen and twenty-six years of age, and all the patients in that age range developed the syndrome. The multiple contributions to the pathogenesis of these reactions are described, and the interventions of the liaison psychiatrist in intervention at the biological, psychological, family and hospital staff levels are discussed.
Adaptation, Psychological↗
Traction sutures in a tracheostomy using a ligature passer.
1. A history of tracheostomy is reported, indicating the relatively recent use of traction sutures. 2. The indications for a tracheostomy are listed. 3. The complications of a tracheostomy are mentioned briefly with emphasis on tube displacement and how this provides the rationale for the use of traction sutures. 4. The technique of placement of the traction sutures with the use of a new instrument, the ligature passer, is described. 4. An illustrative case is reported to demonstrate the significance of traction sutures.
Aged↗
Traction--a surgical/orthodontic procedure.
Maxillary crowding may cause failure of eruption of the canine. The teeth so displaced are directed buccally or palatally. In both cases, surgical intervention is indicated after space has been made in the arch. Palatally displaced canines are treated by surgical excision of palatal mucosa to promote eruption. Wide excision is indicated to prevent the healing process from covering the exposed tooth crown. Because of the anatomy of the buccal mucosa, however, surgical excision of the crowns of buccally displaced canine frequently results in periodontal problems. An alternative technique is therefore presented; this involves the surgical exposure of the crowns of buccally displaced teeth to allow the attachment of a wire traction hook. The crown is then recovered. The traction hook provides a point of attachment, so that orthodontic forces may be applied to the unerupted tooth to guide its eruption. The preservation of the mucosal flap ensures a normal epithelial attachment develops on the buccal surface of the tooth, and the normal gingival anatomy of the buccal mucosa is maintained. The procedure may also be used in cases where upper incisors have been prevented from erupting because of the presence of supernumerary teeth. Even after surgical removal of the supernumerary teeth, the permanent incisors often fail to erupt. In such cases, the placement of traction hooks will enable the orthodontist to bring the unerupted teeth into their correct positions in the arch.
Adolescent↗
Stable temporary traction substitute with the Pinless external fixator.
The stable traction substitute with a JBPF seems a very promising indication for pinless clamps, offering good patient comfort and easy care. The implantation of a JBPF is possible under the same conditions as for conventional calcaneal traction. Although the stability provided is less than for conventional external fixators, it is sufficient for a temporary traction device. The JBPF does not affect secondary ORIF.
Adult↗