indication and contra-indication cast & traction

for nurse student , nurse, medical students

1. TRACTION Group 5

2. INTRODUCTION Traction is application of a pulling force to an injured body part or extremity while counter-traction pulls in the opposite direction. In the medical field, traction refers to the practice of slowly and gently pulling on a fractured or dislocated body part.

3. Traction serves several purposes Used to reduce, align and immobilize fractures It minimizes muscle spasm. It reduces deformities It helps relieve pain. It increases space between opposing surfaces .

4. Types of Traction Skin traction (Buck’s Extension traction) Skeletal traction (including cervical)

5. SKIN TRACTION Application of a pulling force directly to the skin through the use of strips, boots or foam splints Used to control pain, muscle spasms and immobilize an area before surgery. Amount of weight cannot exceed 1/10 of body weight in Kg Buck's skin traction is widely used in the lower limb for femoral fractures, lower backache, acetabular and hip fractures. Skin traction rarely reduces a fracture, but reduces pain and maintains length in fractures

6. Indication of skin traction Immobilization before surgery Muscle spasm Sprain damage To maintain the reduction To reduce the fracture or dislocation

7. Contra-indication of skin traction Unstable spine Congenital malformation Osteoporosis Peripheral vascular diseases Wound or lesion on the site Paralysis on affect site

8. Materials of skin traction con’t … Ropes Pulley Bandage Splints Adhesive plaster Traction weight bag Sleek Special bed

9. SKELETAL TRACTION Is accomplished by surgically inserting metal wires or pins through distal bones to the site or by anchoring metal tongs in the skull. A traction bow is attached to wire or pin and traction force is applied . Used to reduce unstable fractures of long bones.

10. INDICATIONS Muscle spasm Certain degenerative disc disease Herniated or protrude disc Nerve root compression Facet joint pathology Osteoarthritis

11. CONTRAINDICATIONS Traction is contraindicated in patients with  structural disease secondary to tumor or infection , rheumatoid arthritis, severe vascular compromise, and any condition for which movement is contraindicated . Vertebrate fracture Spinal cord compression Extruded disc fragmentation Unstable spine Osteoporosis

12. MATERIALS Ropes Adhesive plaster Traction weight bag Sleek Pulley Bandage Splints Pins drill driver

13. material in skeletal traction con’t ……

14. Skeletal traction con’t ….

15. Skeletal traction con’t …..

16. TECHNIQUES

17. Check the four P's of traction maintenance Pounds: Inspect traction setup. Is the correct weight in place Pull: Is the direction of aligned with the long axis of affected bone Pulleys: Is the rope gliding smoothly over the body surface area. Pressure: Are clamps and connections tight ?

18. Pin Site Care With gloves remove gauze dressings from around pins Inspect sites for drainage or inflammation. Prepare supplies and apply new gloves. Clean each pin site with NaCl by placing sterile applicator close to the pin and cleaning away from the insertion site .

19. Pin Site Care con’t ….. Dispose of applicator. Continue process for each pin site. Using a sterile applicator, apply a small amount of topical antibiotic ointment as ordered Provide pin site care according to hospital policy Cover with a sterile gauze dressing

20. COMPLICATIONS bed sores Constipation reduced respiratory function urinary & and circulatory problems kidney/gallstones stiff joint deep vein thrombosis nerve damage

21. CAST

22. INTRODUCTION An orthopedic cast , or simply cast, is a shell, frequently made from plaster or fiberglass, that encases a limb (or, in some cases, large portions of the body) to stabilize and hold anatomical structures—most often a broken bone (or bones), in place until healing is confirmed . Casts are orthopedic devices that are used to protect and support fractured or injured bones and joints. They help to immobilize the injured limb to keep the bone in place until it fully heals. Casts are often made from fiberglass or plaster .

23. INDICATION Fractures. Severe sprains. Dislocations. Protection of post-operative repairs. Gradual correction of a deformity with serial casting.

24. CONTRAINDICATION Acute infection. Tracking wound, ulcer depth greater than width. Excessively draining wound. Fragile skin. Excessive swelling.

25. Various types of casts Short arm cast: Extends from below the elbow to the palmar crease, secured around the base of the thumb. If the thumb is included, it is known as a thumb spica or gauntlet cast.

26. Various types of casts con’t ….. Long arm cast: Extends from the upper level of the axillary fold to the proximal palmar crease. The elbow usually is immobilized at a right angle.

27. Various types of casts con’t ….. Short leg cast: Extends from below the knee to the base of the toes. The foot is flexed at a right angle in a neutral position .

28. Various types of casts con’t ….. Long leg cast: Extends from the junction of the upper and middle third of the thigh to the base of the toes. The knee may be slightly flexed.

29. Various types of casts con’t ….. Walking cast: A short or long leg cast reinforced for strength

30. Body cast: Encircles the trunk Encircles the trunk

31. Shoulder spica cast: A body jacket that encloses the trunk and the shoulder and elbow. Hip spica cast: Encloses the trunk and a lower extremity. A double hip spica cast includes both legs.

32. Materials Plaster :- such as aluminum, zinc, magnesium, and sometimes copper alloys. The most common plaster cast material is aluminum. Fiberglass: Most casts are made of fiberglass. Fiberglass is a kind of plastic that is moldable and dries hard. Some fiberglass casts are waterproof. Less often, casts are made of plaster of paris .

33. TECHNIQUES Choose an appropriate-width bandage, then apply the casting material evenly, overlapping each preceding turn by half the width of the bandage. ... Smooth the cast edges. ... Support the cast on a firm, smooth, soft surface as it hardens. ... To help the cast dry, leave it uncovered and exposed to the air.

34. COMPLICATION Numbness or tingling in the affected limb. Cold or pale skin or skin with a bluish tinge. Burning or stinging. Increased pain or swelling.

35. REFERENCE https ://www.google.com/search?q=MATERIALS+NEEDED+FOR+TRACTION&ei=B28eYtKHHpDgkwWf-oqwDg&ved=0ahUKEwiSp7CNzqX2AhUQ8KQKHR-9AuYQ4dUDCA4&uact https://www.google.com/search?q=step++for+aplying+cast&ei=IGseYqWvM5q5sAfEmLpo&ved=0ahUKEwilv5exyqX2AhWaHOwKHUSMDg0Q4dUDCA4&uact=5&oq=step++for+aplying