Fracture reduction

Fracture reduction

  • Closed reduction
    • Nonsurgical, manual realignment of bone fragments
    • Traction and countertraction applied
    • Under local or general anesthesia
    • Immobilization afterwards
  • Open reduction
    • Surgical incision
    • Internal fixation
    • Risk for infection
    • Early ROM of joint to prevent adhesions
    • Facilitates early ambulation

Traction

  • Purpose
    • Prevent or decrease pain and muscle spasm
    • Immobilize joint or part of body
    • Reduce fracture or dislocation
    • Treat a pathologic joint condition
  • Pulling force to attain realignment – countertraction pulls in opposite direction
  • Two most common types of traction
    • Skin traction
    • Skeletal traction
  • Skin traction
    • Short-term (48-72 hours)
    • Tape, boots, or splints applied directly to skin
    • Traction weights 5 to 10 pounds
    • Skin assessment and prevention of breakdown imperative
  • Skeletal traction
    • Long-term pull to maintain alignment
    • Pin or wire inserted into bone
    • Weights 5 to 45 lbs.
    • Risk for infection
    • Complications of immobility
    • Maintain countertraction, typically the patient’s own body weight
      • Elevate end of bed
    • Maintain continuous traction
    • Keep weights off the floor

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