1. Femur traction
2. Cervical spine
Skin versus Skeletal Traction
traction The skin can only take about 5kg traction in an adult. If more than this
3. Dunlop Traction force is required to obtain on maintain a reduction Skeletal traction
4. Femur fractures must be used. Avoid skeletal traction in children - growth plates can
5. Site map easily be damaged by skeletal pins.
Indications for Skin Traction
• Children
• Temporary traction - only a few days e.g. Preoperative
• Small force required to maintain reduction <5 kg
Counter Traction
Any force needs an opposing force. If traction pulls a limb distally the
patient will slide downwards towards the pulley, and the traction will
not be effective. Provide an opposing force by raising the foot of the
bed on blocks. By sloping the bed in the other direction the tendency to
slide will be opposed. In Cervical traction thefront end of the bed needs
raising, and with Dunlop traction the side of the bed near the injury
needs elevation.
Gallows Traction
This is used in infants and children with femoral
fractures.
Indications Gallows Traction
• Child must weigh less than 12 kg
• Femoral fractures
• Skin must be intact
Both the fractured and the well femur
are placed in skin traction and the
infant is suspended by these from a
special frame. Vascular compromise is
the biggest danger. Check the
circulation twice daily. The buttocks
should be just off the bed.
1. Traction principles
2. Femur traction
3. Dunlop Traction
Halter Traction
4. Femur fractures Halter traction is used for short term cervical traction. Uses include
5. Site map minor neck injuries without obvious fractures e.g. Whiplash injury,
neck muscle spasm, conservative treatment of cervical disk lesions.
Children with cervical fractures can also be treated without skeletal pins
as their skull is too fragile to withstand pins.
Problems with
Halter Traction
• Uncomfortable
• Tempero-
mandibular pain
• Contraindicated in mandible fractures
• Difficult to control flexion - extension
Flexion Extension cervical X-rays
If a patient has normal cervical X-rays, but has neck muscle
spasm Flexion Extension views may be needed to exclude serious
instability of the cervical spine. Halter traction is a good way to relieve
the spasm before these X Rays can be done. The patient is admitted and
placed in Halter traction until the neck is free of muscular spasm. Under
direct supervision of the attending doctor the flexion extension views
are taken in the X ray department. The patient must have no pain when
the neck is flexed and extended. If neurological symptoms such as
parasthesia develop the X rays are abandoned.
Skull Traction
In more serious cervical injuries skull tongs such as Cones calipers are
indicated. Indications include the conservative treatment of cervical
fractures and dislocations.
Application of Cones Calipers
• Shave the hair above the ear region
• Local anaesthetic
• Avoid masseter
• Avoid Temporal artery
• Small incision above ear in line with auditory meatus
• Screw in pin until it just perforates outer table skull
• Tie on rope
• Attach weights
Direction and Weights
• Force - 2.5 kg for head and
1/2 kg for each vertebra* Crutchfield tongs:
Allow the patient to be
• Direction Neutral In line with easily turned, as the
caliper sits high on the
Auditory meatus skull. Consider these in
• Position to apply the Cone's Caliper Flexion needed - raise pulley a paralized patient.
pins - in line with auditory meatus
• Extension needed - use double mattress
ending @ shoulders
*(Each uninvolved vertebra cephalad)
Complications of Cervical Traction
• Bleeding - temporal artery
• Pressure sore on skull - avoid downwards vector to rope
• Sepsis - from skin to subdural abscess
• Worsening neurological status
• Squint from 6th cranial nerve fallout
1. Traction principles
2. Femur traction
3. Cervical Traction
Dunlop Traction
4. Femur fractures The main use of Dunlop's traction is in the maintenance of reduction in
5. Site map supracondyar fractures of the humerus in children.
Dunlop Traction
• Supracondyar fractures in children
• Allows swollen elbow to settle
• Contraindicated in open fractures and skin defects
Skin traction is placed on the forearm and A special frame used on the side
of the bed.
Traction is placed along the axis of the forearm as well as at right angles to
the humerus by means of a broad sling placed around the upper arm. Bed
blocks are required on the lateral side (fracture side up) of the bed.
If a supracondyar
fracture cannot be
reduced to over 90
degrees elbow flexion,
this method of traction
is an alternative to
invasive methods such
as a percutaneous K-
wires. It allows swelling to subside. Do
not rely on this method to reduce a supra
condylar fracture, a manipulation will still be required!
Pelvic traction for Backache
In sciatica and other backaches relief from pain can be obtained by means
of pelvic traction. Traction is applied to a pelvic harness with weights over
the end of the bed.
Acetabular Traction
In conservative treatment of acetabular fractures longitudinal traction in
the long axis of the limb is often used. In addition the head of the femur
can be disimpacted from the acetetabulum ( central fracture dislocations)
by means of manipulation under anesthesia. The reduction is maintained
by means of lateral traction from pins paced in intertrochanteric
region.
Lateral Traction for an acetabular fracture
<< Go Home
Cranial nerves are nerves that emerge directly from the brain, in contrast to spinal nerves which
emerge from segments of the spinal cord. In humans, there are 12 pairs of cranial nerves. Only
the first and the second pair emerge from the cerebrum, the remaining 10 pairs emerge from
the brainstem.
•
[edit]Cranial nerves in non-human vertebrates
Human cranial nerves are nerves evolutionarily homologous to those found in many
other vertebrates. Cranial nerves XI and XII evolved in the common ancestor to amniotes (non-
amphibian tetrapods) thus totaling twelve pairs. These characters are synapomorphies for their
respective clades. In some primitive cartilaginous fishes, such as the spiny dogfish or mud shark
(Squalus acanthias), there is a terminal nerve numbered zero (as it exits the brain before the
traditionally designated first cranial nerve).
Some of the major cranial nerves and their ganglia and fiber connections
[edit]Mnemonic devices
Main article: List of mnemonics for the cranial nerves
As the list is important to keep in mind during the examination of the nervous system, there are
many mnemonic devices in circulation to help remember the names and order of the cranial
nerves. Because the mind recalls rhymes well, the best mnemonics often use rhyming schemes.
Two of the best known examples are, "Oh, Oh, Oh To Take A Family Vacation! Go Vegas After
Hours!", or "On Old Olympus' Towering Top, A Finn And German Viewed A Hop". Others are more
explicit, for example: "On the Occasion Of Party The Attractive Faces Are Girl Visitors, Say Hello".
Its also "OOOPTAFAGV SH" A very useful way of remembering which nerve is motor and which is
sensory use, "Some Say Marry Money But My Brother Says Big Boobs Matter More". Although
many exist from many sources, for
example OLd OPi.e. OCcasionally TRies TRIGonometry AndFeels VEry GLOomy, VAGUe, And H
YPOactive.[6]
The importance of good nutrition for teens can't be emphasized enough. For an overweight
teen, weight loss can result in poor eating habits. They figure the fastest way to lose weight is
through eating as little as possible. Nothing could be farther from the truth.
In order to lose weight safely and keep it off once you're off the diet, it's important to eat
properly. Don't be fooled into thinking that following a "starvation" diet is the best way to lose
weight. It's not.
Losing weight isn't easy. In fact if you're overweight and have decided to lose weight, you
should be congratulated. But it's important to choose the right kind of diet. If you're dieting,
and feel tired and just plain awful, a teen weight loss program will be hard to maintain. That's
what happens on a starvation diet.
Better weight loss plans for teens include eating enough nourishing foods so that your body
gets the nutrients it needs to function.
Start off each day by eating breakfast. This is really the single most important thing you can
do to lose weight. Eating breakfast jumpstarts your metabolism and puts it to work burning
calories. The more calories you burn the more weight you lose.
Pack a lunch from home. That way you won't be tempted by high calorie cafeteria food. Don't
forget to include a couple of healthy snacks for when you get hungry between meals. Eat
dinner on a small plate. Even if you fill the plate to overflowing you'll eat less. Dinner should
include a protein and a couple of vegetables along with a salad. If you can't go without dessert
make it a small portion.
Be aware of the importance of good nutrition in a weight loss plans for teens because there is
never any substitute for healthy eating.
Cathy Johnson is the owner of Weight Loss Plans For Teens, a website which focuses
specifically on weight loss.
If your a teen or a parent of a teen who is concerned about their weight there are many
healthy and effective weight loss plans for teens that can be found
athttp://www.weightlossplansforteens.com