Skin Traction vs. Skeletal Traction Quiz

Traction

• Prevents or reduces muscle spasm
• Immobilizes and reduces fractures or dislocations
• Treats joint or part of the body with pathologic condition

Skin Traction

• An adhesive strap is applied on the skin and traction is applied
• Used for short-term treatment until skeletal traction or surgery is possible

Skeletal Traction

• Provides long-term pull that keeps injured bones and joints aligned

Immobilization of Fractures

• After reduction, bone fragments must be immobilized until union occurs
• Methods of external fixation include bandages, casts, splints, traction, and external fixators
• Metal implants used for internal fixation serve as internal splints to immobilize the fracture
• Strapping: fractured part is strapped to an adjacent part of the body (e.g., finger fractures)
• Sling: used for fractures of the upper extremity to relieve pain where rigid immobilization is not necessary

Reduction of Fractures

• Closed reduction: non-surgical, manual realignment of bone fragments to their previous anatomic position
• Open reduction: correction of bone alignment through a surgical procedure, includes internal fixation of the fracture

Internal Fixation

• Screws: used for fixing small fragments onto the main bone
• Wires: applied percutaneously without exposing the fracture, used for fractures that heal quickly
• Plates: used for treating metaphyseal fractures of long bones
• Intramedullary nail: suitable for fractures of long bones and rotational fractures
• Tension bands: created by wires and cables, used to compress bone fragments together

External Fixation

• The bone is transfixed above and below the fracture with screws or pins connected to each other by a frame or rigid bars outside the skin
• Used for severe fractures or when internal fixation is difficult to apply or has failed

Immobilization of Fractures

• POP/Scotch Cast: made of natural (plaster of Paris), synthetic (acrylic), latex-free polymer, or a hybrid of materials
• Splints and braces: used for immobilizing fractures, either temporary during transportation

Complications of Fractures

• General: hemorrhage, hypovolemic shock, fat embolism, cardiopulmonary failure
• Local: visceral injury, vascular injury, nerve injury, compartment syndrome, hematoma, infection, gangrene, fracture blisters, and pressure sores
• Late complications: delayed union, malunion, non-union, avascular necrosis, muscle contracture, joint instability, and osteoarthritis

Assessment of Fractures

• Mechanism of injury
• Location, character, and intensity of pain
• Neurovascular status: ask patient to describe sensations in injured extremity
• Functional mobility: observe patient's ability to change position
• Physical examination: examine skin for lacerations, abrasions, ecchymosis, edema, and temperature