traction(redirected from immobilization care)
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a method of treating patients with injuries (fractures, dislocations) and certain diseases of the supportive and locomotor apparatus (limbs and spinal column). Traction is used to restore the normal anatomical alignment of portions (segments) of the limbs in dislocations and of broken ends of bones in fractures, in sprains of persistently contracted muscles (contractures), and in the stretching of tissues surrounding a joint and to correct deformities of the joints and spinal column (by acting on the ligaments and muscles). Traction is also used in preparation for various surgical interventions and to hold the trunk and limbs in the correct position after a deformity has been surgically corrected.
Traction can be constant, that is, last for some time (three to four weeks or more) or be instantaneous (momentary). Constant traction, besides its corrective effect, has a pro-longed, gradual, relaxing effect on the muscles, ensures physiological rest by creating the best conditions for the circulation of blood and lymph, and permits functional treatment (graduated physical exercise, massage) to be started early. Traction can be applied to the limbs and spinal column in various ways, depending on the pathology involved and the treatment: in bed, on an inclined surface, on a special extension table, or under water. Patients with traumatic in-juries can be placed in traction by means of special splints using long needles or clamps attached to the bone (skeletal traction) or by means of soft braces secured to the limb with adhesive plaster or kleol (solution of rosin; adhesive-plaster traction) or cuffs with lacing. Spinal traction is secured by using special loops or clamps (attached to the head), soft straps, or a belt (attached to the pelvis). In traction the pull is created by suspending weights from strings drawn over pulleys. To create counterpull in traction of the lower limbs, the foot end of the bed is raised; in traction involving the head and using straps, the head end is raised.
Traction on extension tables is used for various diseases of the spinal column. It is exerted by the pull of a weight, spring rod, or rod of a special apparatus driven by electricity. Tensile force is increased by tilting the tabletop and by the mobility of the panels.
Instantaneous traction is exerted by the physician’s hands or by special apparatus (pulling apparatus) usually to align broken ends of bones in fractures or to reduce dislocations and is followed by fixation with a plaster cast or splints. In some spinal diseases and contractures of the lower limbs, use is made of traction in warm water to ensure better relaxation of the muscles. Traction is applied in a pool both in a vertical direction (the patient rests his head on a headrest and his arms on the elbowrest of a device immersed in the water; weights are suspended from the patient’s waist or lower leg) and in a horizontal direction (the patient’s trunk is held fast in a special bath by a soft belt around the chest while traction is exerted on the pelvis).
REFERENCESBogdanov, F. R., I. G. Gertsen, and N. N. Veselkov. Ortopedotravmatologicheskaia apparatura i instrumentarii. Sverdlovsk, 1949.
Novachenko, N. P., and F. E. El’iashberg. Postoiannoe vytiazhenie. Kiev, 1960.
Volkov, M. V., and A. F. Koptelin. Lechenie vytiazheniem v vode pri zabolevaniiakh pozvonochnika: (Metodicheskie ukazaniia). Moscow, 1966.
A. F. KOPTELIN