Immobilization used in Musculoskeletal injuries

Useful to know the different Immobilization & splints especially used in treatment of fractures. Details are given along with appropriate pictures, that will b easier for students to understand.

1. IMMOBILIZATION, SUPPORT & BANDAGING

2. INTRODUCTION It can be done with – Splints Traction

3. SPLINTS It can be used in – Immobilization of fracture Support in other orthopedic conditions

4. Commonly used Splints Cramer-wire splint Ladder splint Light weighted Temporary splintage of fractures made up of two thick parallel wires with interlacing wires Made up of steel wire with PVC coating

5. Commonly used Splints Thomas knee-bed splint ( Thomas splint) Commonly used splint Initially for immobilization for TB of the knee. It is now commonly used for the immobilization of hip and thigh injuries – femur fracture

6. Commonly used Splints Bohler -Braun splint BB splint Used for immobilization of lower limb fractures

7. Commonly used Splints Dennis Brown splint Used for CTEV

8. Commonly used Splints Cock-up splint Used in radial nerve palsy

9. Commonly used Splints Knuckle–bender splint Used in ulnar nerve palsy

10. Commonly used Splints Toe-raising splint For foot drop AFO

11. Commonly used Splints Volkmann's splint For volkman’s contracture (VIC)

12. Commonly used Splints Four-post collar For neck immobilization

13. Commonly used Splints Aeroplane splint For brachial plexus injuries

14. Commonly used Splints SOMI Brace Sternal Occipital Mandibular Immobilizer For cervical spine injuries

15. Commonly used Splints ASHE Brace Anterior spinal hyper extension brace For thoracic & lumbar spine injuries

16. Commonly used Splints Taylor's brace For thoracic & lumbar spine injuries

17. Commonly used Splints Milwaukee brace For correction of scoliosis

18. Commonly used Splints Boston brace For correction of scoliosis

19. CARE OF THE PATIENT IN A SPLINT Properly applied Well padded Proper bandaging Encourage exercise with splint Avoid pain & compression of vessels & nerves Regular X - ray

20. TRACTION Objectives – Reduction of fractures and dislocations For immobilizing a painful, inflamed joint For the prevention of deformity For the correction of soft tissue contractures by stretching them out.

21. TYPES OF TRACTION Depending upon the counter traction – Fixed traction Sliding traction

22. TYPES OF TRACTION Fixed traction – In this type, counter-traction is provided by a part of the body e.g., in Thomas splint fixed traction, the ring of the splint comes to lie against the ischial tuberosity and provides counter-traction

23. TYPES OF TRACTION Sliding traction – In this type, the weight of the body acts as counter-traction e.g., traction given for a pelvic fracture, where the weight of the body acts as counter-traction; made effective by elevating the foot-end of the bed

24. Skin traction Skeletal traction

25. METHODS OF APPLYING TRACTION Skin traction An adhesive strap is applied on the skin and traction applied. The traction force is transmitted from the skin through the deep fascia, muscles & the bone. Skeletal traction The traction is applied directly on the bone by inserting a K-wire or Steinmann pin through the bone.

26. COMMONLY USED TRACTION Gallow's traction Used in Fracture shaft of the femur in children Skin  traction  is applied to both legs and the child is suspended from a beam so that the buttocks are just clear of the bed

27. COMMONLY USED TRACTION Bryant's traction Used in young children who have fractures of femur & in CDH. Both the patient's limbs are suspended in the air vertically at a 90 ° from the hips and knees slightly flexed.

28. COMMONLY USED TRACTION Russell's traction Used in trochanteric fractures of femur. The lower leg is supported in a sling just below the knee and pulling forces are exerted upwards and longitudinally by means of pulleys and weights.

29. COMMONLY USED TRACTION Buck's traction Buck's traction is a type of skin traction that pulls the femur so that the femur can remain in its proper place after a fracture.

30. COMMONLY USED TRACTION Perkin's traction Used for Fracture shaft of femur in adults

31. COMMONLY USED TRACTION 90 90 traction Used for Fracture shaft of femur in children

32. COMMONLY USED TRACTION Agnes-Hunt traction Used for correction of deformity of hip

33. COMMONLY USED TRACTION W ell leg traction Used for correction of abduction deformity of hip The traction is applied to the normal limb while the deformed hip is stabilized by splint

34. COMMONLY USED TRACTION Dunlop traction 90 – 90 position of arm

35. COMMONLY USED TRACTION Smith’s traction 90 – 90 position of arm Used for supracondylar fracture of humerus

36. COMMONLY USED TRACTION Calcaneal traction For fracture of ankle or leg Pin is inserted inferior & posterior to medial malleolus Attached with pulley system

37. COMMONLY USED TRACTION Calcaneal traction For fracture of forearm Pins are inserted into radius & ulna through the base of 2 nd & 3 rd Metacarpal

38. COMMONLY USED TRACTION Head - Halter traction For cervical spine injuries

39. COMMONLY USED TRACTION Head - Halter traction For cervical spine injuries

40. COMMONLY USED TRACTION Head - Halter traction For correction of scoliosis

41. DAILY CARE OF A PATIENT IN TRACTION Comfortable Effective Assess the distal part of limb for skin integrity & sensory function Check for swelling at distal part Check of infection Regular x – ray Physiotherapy Avoid complications due to prolonged bed rest Diversion therapy