Indications and methods of traction after fracture

Many fractures are treated with fracture traction, which is helpful for promoting the reduction of the fracture ends, preventing and correcting deformities, and is also more conducive to the observation and treatment of open wounds. What symptoms are fracture traction mainly suitable for?

1. Indications for traction

1. Adults with unstable fractures of lower limbs.

2. Complete rupture and displacement of the pelvic ring (mainly the posterior ring).

3. School-age children with unstable femoral fractures.

4. Children with elbow fractures (condylar) that cannot be reduced immediately and require observation, swelling reduction and position maintenance under traction.

5. Fractures of short tubular bones where skin traction cannot be performed, such as metacarpals and phalanges.

6. Patients with severe central dislocation or dislocation of the acetabulum.

7. Others who need traction treatment but are not suitable for skin traction.

2. Pulling Method

1. Bone traction: Children are prone to epiphyseal damage and should be used with caution.

How to do it:

1) Position the patient properly, mark the area, perform routine disinfection, and apply sterile drapes.

2) The surgeon uses local infiltration anesthesia at the entry and exit of the guide needle, from the skin to the periosteum, and the assistant fixes the affected limb and gently pulls the skin proximally.

3) The surgeon uses a bone drill to insert the guide needle directly into the skin and drill perpendicular to the bone shaft according to the entry and exit positions.

4) Protect the needle inlet and outlet with alcohol gauze.

5) Install the traction bow and traction frame, and traction according to the required weight. Raise the bed legs.

2. Skin traction

(1) Clean the skin first, apply tincture of benzoic acid to the incision area and apply adhesive tape before the solution dries.

(2) The tape to be applied to the limb should be prepared in advance and should be flat and wrinkle-free. The end of the tape should be divided into 2 to 3 pieces so that the pulling force is evenly distributed on the affected limb.

(3) Protect the bony prominence with gauze or cotton pads. Use long strips of tape to connect the two sides in a large spiral, but avoid wrapping the tape around the limb.

(4) Wrap the bandage again with a second layer, but leave 1 cm of the proximal end exposed to facilitate observation later to see if the bandage has fallen off.

(5) Use an expansion board of appropriate width at the towing end.

(6) Place the traction frame and add appropriate weight. When performing lower limb traction, raise the foot of the bed.