Continuous fixed traction is provided by –
Correct Answer: Thomas splint
Description: Ans. is 'a' i.e., Thomas splint * In Classical thomas splint, tration is applied to the limb distal to the fracture, and pull is exerted against a fixed point. This is thus an example of continuos fixed traction.Continuous traction* Traction is applied to the limb distal to the fracture, so as to exert a continuous pull in the long axis of the bone, with a counterforce in the opposite direction (to prevent the patient being merely dragged along the bed). This is particularly useful for shaft fractures that are oblique or spiral and easily displaced by muscle contraction. Traction cannot hold a fracture still; it can pull a long bone straight and hold it out to length but to maintain accurate reduction is sometimes difficult. Meanwhile the patient can move the joints and exercise the muscles.* Traction is safe enough, provided it is not excessive and care is taken when inserting the traction pin. The problem is speed : not because the fracture unites slowly (it does not) but because lower limb traction keeps the patient in hospital.* Consequently, as soon as the fracture is 'sticky' (deformable but not displaceable), traction should be replaced by bracing, if this method is feasible.Traction includes:a) Traction by gravity - This applies only to upper limb injuries. Thus, with a wrist sling the weight of the arm provides continuous traction to the humerus. For comfort and stability, especially with a transverse fracture, a U-slab of plaster may be bandaged on or, better, a removable plastic sleeve from the axilla to just above the elbow is held on with Velcro.b) Skin traction - Skin traction will sustain a pull of no more than 4 or 5 kg. Holland strapping or onewaystretch. Elastoplast is stuck to the shaved skin and held on with a bandage. The malleoli are protected by Gamgee tissue, and cords or tapes are used for traction.c) Skeletal traction - A stiff wire or pin is inserted - usually behind the tibial tubercle for hip, thigh and knee injuries, or through the calcaneum for tibial fractures - and cords tied to them for applying traction. Whether by skin or skeletal traction, the fracture is reduced and held in one of three ways: fixed traction, balanced traction or a combination of the two.d) Fixed traction - The pull is exerted against a fixed point. The usual method is to tie the traction cords to the distal end of a Thomas' splint and pull the leg down until the proximal, padded ring of the splint abuts firmly against the pelvis, eg: Classical Thomas splinte) Balanced traction - Here the traction cords are guided over pulleys at the foot of the bed and loaded with weights; countertraction is provided by the weight of the body when the foot of the bed is raised. Eg: Hamilton russel, Gallows, Thomas splint with pearsons knee attachementf) Combined traction - If a Thomas' splint is used, the tapes are tied to the end of the splint and the entire splint is then suspended, as in balanced traction.
Category:
Orthopaedics
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