ORTHOSIS
 An
orthosis (sometimes called
an orthesis) is a device that
is applied externally to a
part of the body to correct
deformity, improve function,
or relieve symptoms of a
disease by supporting or
assisting the neuromusculoskeletal system
PROSTHESIS
a
prosthesis (plural
prostheses) is an artificial
extension that replaces a
missing body part
 Prostheses are typically used
to replace parts lost by injury
(traumatic) or missing from
birth (congenital) or to
supplement defective body
parts.
CARE OF CLIENTS IN A CAST
 Definition:
CAST
 PLASTER CAST/ FIBER GLASS CAST
 A temporary immobilization device which
is made up of gypsum sulfate anhydrous
which calcifies when mixed with water
and forms into hard cement.
 Description: are use to immobilize bones
and joints into correct alignment after a
fracture or injury
FUNCTIONS
TO IMMOBILIZE
• PROTECT FROM FURTHER INJURY
• PREVENT MALUNION
TO PREVENT OR CORRECT
DEFORMITY
• FASCILITATE HEALING OF BONES
• REALIGN BONE DEFORMITY/ SUPPORT/MAINTAIN
TO PROMOTE HEALING AND EARLY
WEIGHT BEARING
• HASTEN THE HEALING PROCESS
• PREVENT MALALIGNMENT WHEN HEALING
OCCURS
CASTING MATERIALS
1.
PLASTER OF PARIS
2. SYNTHETHIC
MATERIALS
3.POLYESTER/FIBERGLASS/
THERMOPLAST
POLYESTER/FIBERGLASS
PRINCIPLES IN APPLYING
A PLASTER CAST
 Provide
for maximal comfort and alleviation
of complications
 Application of padding is the first step in the
procedure.

Padding materials:
A. Wadding sheet
 B. Roll of cotton
 C. Stockinet
 D. Felt

 Maintain
a desired position through out cast
application
 Provide the patient for cast application by
providing appropriate education
 Use caution in handling of the cast until it has
set or becomes hard.
 Apply it to include the joint above and joint
below the injured area
 Apply it in a circular motion and mould it as
you do the procedure by the palmar
hypothenar
CAST APPLICATION
Slip one layer of stockinet over
the affected body part
Gloves must be worn
Additional padding may be used for greater
protection of pressure points and bony
prominences.
Open only one roll of
Hygia Castplus at a
time
Immerse the roll in room
temperature water. Three firm
squeeze of the roll while
immersed will give a set time
of approximately 3~3.5
minutes. To lengthen the set
time, immerse the roll and
remove it immediately without
squeezing. This will give you a
set time of around 4 minutes.
Warmer water shortens the set
time while cooler water
lengthens it
Wrap spirally,
taking care to
avoid excessive
tightness.
COMPLICATIONS OF CAST
NEUROVASCULAR COMPROMISE
• INCORRECT FRACTURE ALIGNMENT
SUPERIOR MESENTERIC ARTERY
SYNDROME
• SIGNS & Sx: ABDOMINAL PAIN/
NAUSEA/VOMITING/BLOODY STOOLS
MESENTERIC ARTERIES
COMPARTMENT SYNDROME
INCREASED PRESSURE
W/IN A LIMITTED SPACE
COMPROMISE
CIRCULATION AND
FUNCTION
DECREASE BLOOD FLOW,
TISSUE ISCHEMIA,
NEUROVASCULAR
IMPAIREMENT
COMPARTMENT
SYNDROME
ASSESSMENT
Unrelieved or increased pain in the limb
Distal tissue becomes pale, dusky and
edematous
Pulselessness and Paresthesia/ joint
dysfunction
CONTRAINDICATIONS IN
PLASTER CAST APPLICATION
PREGNANCY
SKIN DISEASE
CARE OF PATIENT WITH A CAST

KEEP THE CAST AND EXTREMITIES
ELEVATED

ALLOW A WET CAST 24 TO 72 HOURS TO DRY
(SYNTHETIC CAST DRY IN 20 MINUTES)

HANDLE A WET CAST WITH THE PALMS OF
THE HANDS UNTIL DRY

TURN THE EXTREMITY EVERY 1 TO 2
HOURS, TO ALLOW AIR CIRCULATION AND
DRYING OF CAST

TO HASTEN DRYING OF THE CAST
SEVERAL WAYS CAN BE USE:
EXPOSURE TO OPEN AIR
 ELECTRIC FAN
 EXPOSURE TO A HEAT LAMP
 PLACE IN A WARM ROOM
 HAIR DRYER IN A COOL
SETTING

DURATION OF KEEPING THE BODY PART
IN A CAST IS ATLEAST ONE MONTH.
VARIES AMONG PATIENTS. FACTORS
THAT INFLUENCE DURATION ARE:
AGE OF
THE
PATIENT
THE
DEGREE
OF INJURY
PART OF
OR
THE BODY
AFFECTED AFFECTION
OF THE
PART
NEUROVASCULAR
CHECKS
PRESERVATION OF
THE EFFICIENCY
OF THE CAST
MAINTENANCE
AND PROMOTION
OF THE INTEGRITY
OF THE SYSTEM OF
THE BODY
MAINTENANCE OF
THE CLEANLINESS
OF THE CAST
DURING THE ENTIRE PERIOD
THAT THE PATIENT IS IN A CAST
THE RESPONSIBILITIES OF THE
NURSES ARE:
NERVE FUNCTION
TEST:
NERVE
ACTION TO TEST
SENSORY
FUNCTION
RADIAL
PRICK WEB SPACE
BETWEEN THUMB
AND INDEX FINGER
HYPER EXTEND
THUMB OR WRIST
MEDIAN
PRICK THE DISTAL
SURFACE OF INDEX
FINGER
OPPOSE THUMB AND
LITTLE FINGER, FLEX
WRIST
PRICK DISTAL END OF
SMALL FINGER
ABDUCT ALL FINGERS
ULNAR
PERONEAL
TIBIAL
PRICK LATERAL
SURFACE OF GREAT
TOES & MEDIAL
SURFACE OF SECOND
TOE
PRICK MEDIAL AND
LATERAL SURFACES
SOLE OF FOOT
ACTION TO TEST
MOTOR FUNCTION
DORSIFLEX ANKLE
EXTEND TOES
PLANTAR FLEX ANKLE
AND FLEX TOES

MONITOR THE EXTREMITY FOR CIRCULATORY
IMPAIREMENT SUCH AS PAIN, SWELLING
DISCOLORATION, TINGLING, NUMBNESS,
COOLNESS OR DIMINISHED PULSE.

NOTIFY THE PHYSICIAN IMMEDIATELY IF
CIRCULATORY COMPROMISE OCCURS

PREPARE FOR BIVALVING OR CUTTING THE
CAST IF CIRCULATORY IMPAIREMENT OCCURS

PETAL THE CAST; MAINTAIN SMOOTH EDGES
AROUND THE CAST TO PREVENT CRUMBLING OF
THE CAST MATERIAL

MONITOR FOR SIGNS OF INFECTION SUCH AS
TEMPERATURE, HOT SPOTS ON THE CAST,
FOUL ODOR, OR CHANGES IN PAIN.

IF AN OPEN DRAINING AREA EXIST ON THE
AFFECTED EXTREMITY, THE PHYSICIAN WILL
MAKE A CUT OUT PORTION OF THE CAST OR
A WINDOW

INSTRUCT THE CLIENT NOT TO STICK
OBJECT INSIDE THE CAST

KEEP THE CAST CLEAN AND DRY

ISOMETRIC EXERCISE TO PREVENT
MUSCLE ATROPHY
KINDS OF CAST, ITS INDICATIONS AND
WHAT TO OBSERVE
CAST FOR
UPPER
EXTREMITIES
SHORT ARM
CIRCULAR CAST
LONG ARM
CIRCULAR CAST
INDICATION
WHAT TO
OBSERVE
REMARKS
FRACTURE
DISLOCATIONS OF
THE WRIST OR
FINGERS. Applied
below the elbow to
the hand. Forearm
or wrist fractures
SIGNS OF
IMPAIRED
CIRCULATION:
1. CYANOSIS OF
THE SKIN
2. LOSS OF
FUNCTION
1. AVOID
INSERTION
OF FOREIGN
BODIES
INSIDE
2. AVOID
SOILING THE
CAST
Applied from the
upper arm to the
hand. Upper arm,
elbow, or forearm
fractures
3. COLDNESS OF
THE SKIN
4. NUMBNESS
PULSELESSNESS
3. REPORTS FOR
SIGNS OF
WEAKNESS OF
THECAST
CAST
INDICATIONS
WHAT TO
OBSERVE
REMARKS
HANGING CAST
FRACTURE OF THE
SHAFT OF THE
HUMERUS
5. SEVERE PAIN
6. MARKED
SWELLING
4. MAINTAIN
PROPER
ALIGNMENT OF
CASTED
EXTREMITIES
FUENSTER’S/
MUNSTER CAST
FRACTURES OF THE
RADIUS AND ULNA
WITH CALLUS
FORMATION
2. NERVE DAMAGE 5. PROPPER
DUE TO
SUPPORT OF
PRESSURE ON
CAST
THE NERVE AS IT
PASSES OVER THE
BONY
PROMINENCES
A. PERSISTENT,
INCREASING,
LOCALIZED
PAIN
B. ANESTHESIA
OR NUMBNESS
UPPER EXTREMITY CAST
SHORT ARM
POSTERIOR
MOLD
• AFFECTATIONS OF WRIST AND
FINGERS
• WITH INFECTIONS OR OPEN
WOUND
LONG ARM
POSTERIOR
MOLD
• AFFECTATIONS OF RADIUS AND
ULNA
• WITH INFECTION AND OPEN
WOUNDS
SUGAR
TONG
• AFFECTATIONS OF SHOULDER AND
UPPER PORTION OF THE HUMERUS
• WITH INFECTION AND OPEN
WOUNDS
AIRPLANE CAST/
ABDUCTION
SPLINT
• FRACTURE OF THE BACK OF THE
HUMERUS
SHOULDER SPICA • FRACTURE OF THE UPPER ARM AND
SHOULDER
CAST
WATCH OUT FOR
• UNPLEASANT ODOR OVER THE CAST
INFECTIONS
TISSUE NECROSIS • DRAINAGE FROM THE CAST OR WINDOW
• HOT SPOT FELT ON THE CAST/ RISE IN
D/T SKIN
BODY TEMPERATURE
BREAKDOWN
SHOULDER SPICA CAST
CAST OF THE LOWER EXTREMITIES
CAST
INDICATIONS
BOOT CAST OR
SHORT LEG
CIRCULAR CAST
AFFECTATIONS OF OBSERVE FOR
THE ANKLES AND IMPAIRED
TOES
CIRCULATION AS
MANIFESTED BY:
WALKING CAST
WHAT TO
OBSERVE
REMARKS
1. AVOID
INSERTION OF
FOREIGN BODIES
IN THE CASTS
AFFECTATIONS OF A. CYANOSIS OR
2. AVOID SOILING
ANKLE AND
BLUISH
OF THE CAST
METATARSALS
DISCOLORATIO
WITH CALLUS
N
FORMATION
B. COLDNESS OF
SENSATION
CAST
INDICATIONS
WHAT TO
OBSERVE
REMARKS
PATTELAR
TENDON
BEARING CAST
FRACTURE OF
SHAFT OF TIBIA
AND FIBULA
WITH CALLUS
FORMATION
C. LOSS OF
FUNCTION OF
AFFECTED
EXTREMITIES
3. REPORT FOR
SIGN AND
WEAKNESS OF
THE CAST
LONG LEG
CIRCULAR CAST
FRACTURE OF
TIBIA AND
FIBULA
D. NUMBNESS
E. MARKED
SWELLING
4. MAINTAIN
PROPER
ALIGNMENT OF
CASTED
QUADRILATERAL
CAST/ ISCHIAL
WEIGHT
BEARING CAST
FRACTURE OF
THE SHAFT OF
FEMUR WITH
CALLUS
FORMATION
2. NERVE
5. PROPER
DAMAGE DUE TO SUPPORT OF
PRESSURE ON
CAST
THE NERVE AS IT
PASSES OVER
THE BONY
PROMINENCE
PATELLAR TENDON BEARING CAST
ISCHIAL WEIGHT BEARING CAST
LOWER EXTREMITY CAST
WHAT TO OBSERVE
CAST
INDICATION
CYLINDER CAST
FRACTURE OF PATELLA
SHORT LEG POSTERIOR
MOLD
FRACTURE OF ANKLE
AND TOES WITH
INFECTIONS AND OPEN
WOUNDS
LONG LEG POSTERIOR
MOLD
FRACTURE OF TIBIA
AND FIBULA WITH
INFECTIONS AND OPEN
WOUND
A. INCREASING
PERSISTENT
LOCALIZE PAIN
B. NUMBNESS IN THE
EXTREMITIES
C. FEELING OF DEEP
PRESSURE
D. PARESTHESIA
E. MOTOR WEAKNESS OR
PARALYSIS
3. INFECTIONS, TISSUE
NECROSIS DUE TO SKIN
BREAKDOWN
CAST OF THE TRUNK
WHAT TO OBSERVE
CAST
COLLAR CAST
MINERVA CAST
RIZZERS JACKET
INDICATIONS
FRACTURE OF THE
CERVICAL SPINE
1. SIGNS OF
RESPIRATORY
DISTRESS
AFFECTATIONS OF
THE UPPER DORSAL
CERVICAL SPINE
(TRAUMA,
SCOLIOSIS,POTT’S
DSE.)
SIGNS OF CAST
SYNDROME
1. PROLONGED
NAUSEA
2. REPEATED
VOMITING
SCOLIOSIS
3. ABDOMINAL
DISTENTION
4. VAGUE
5.ABDOMINAL PAIN
ABSENCE BOWEL
SOUND
WHAT TO OBSERVE
CAST
INDICATIONS
BODY CAST
AFFECTATIONS OF THE
LOWER DORSO LUMBAR
SPINE
3. PRESSURE ON THE
SKIN, JAW, EARS, FACE ,
AXILLAE, CLAVICULAR
AREA, ANTERIOR
SUPERIOR ILIAC CREST,
GROIN, BUTTOCKS
ABOVE KNEE
SINGLE HIP SPICA CAST
AFFECTATIONS OF THE
HIP AND FEMUR
4. URINARY BOWEL
DISTURBANCE
1-1 ½ HIP SPICA CAST
AFFECTATIONS OF THE
HIP AND FEMUR
5. SIGNS OF PLASTERCAST
A. ITCHINESS AND
BURNING
CAST
INDICATIONS
WHAT TO OBSERVE
DOUBLE HIP SPICA
AFFECTATIONS OF HIP
AND FEMUR
B. SEVERE PAIN
C. RISE IN BODY
TEMPERATURE
FROG CAST
CONGENITAL HIP
DISLOCATION
D. DISTURB SLEEP
E. NIGHT CRIES AMONG
BABIES
G. RESTLESSNESS
PANTALON CAST
FRACTURE OF THE
PELVIC BONES
6. SIGNS OF INFECTIONS
AND TISSUE NECROSIS
CARE OF PATIENT IN A
TRACTION
TRACTION IS
THE AS ACT
OF PULLING
OR DRAWING
WHICH IS
ASSOCIATED
WITH
COUNTER
TRACTION
IT MEANS
THAT A
WHILE A
PULLING
COUNTER
FORCE IS
TRACTION
APPLIED TO PULLS IN THE
A PART OF
OPPOSITE
THE BODY
DIRECTION
OR AN
EXTREMITY
PINS AND WIRES
COUNTERTRACTION SUPPLIED BY
THE CLIENTS BODY WITH BED IN THIS
POSITION:
FLAT
TILTED AWAY
FROM THE
TRACTION PULL
ELEVATING THE
HEAD/KNEE
GATCH
BASIC TYPE
OF
TRACTION
SKIN
TRACTION
MANUAL
TRACTION
SKELETAL
TRACTION
MECHANICAL
TRACTION
SKIN TRACTION

The application of pulling force to the skin from
where it is transmitted to the muscles and then to
the bones by the use of:

ADHESIVE TYPE OF MATERIAL
EXAMPLE:
A. BRYANT TRACTION
B. DUNLOP TRACTION
C. BUCK’S EXTENSION
NON-ADHESIVE TYPE MATERIALS:
(CANVAS, SLINGS, LEATHERS AND STRAPS WITH
BUCKLES AND LACES)

EXAMPLES:
A. HEAD HALTER TRACTION
B. HAMMOCK SUSPENSION TRACTION
C. PELVIC TRACTION
D. ANKLE TRACTION
SKELETAL TRACTION

THE PULLING FORCE IS APPLIED DIRECTLY TO THE
BONE USING WIRES SUCH AS KIRSHNER’S
WIRE, STEINMAN’S PIN, VINKI’S SKULL
RETRACTOR AND CRUTCH FIELD TONGS.
MANUAL TRACTION
THE PULLING FORCE IS APPLIED BY THE
HANDS OF THE OPERATOR
 TEMPORARY MEASURE SOMETIMES
EMPLOYED IN HANDLING NECK INJURY
WHEN A CERVICAL SPINE IS FRACTURED
 USE TO APPLY A NECESSARY PULL TO AN
EXTREMITY WHEN CAST IS BEING APPLIED

MECHANICAL TRACTION
TRACTION IS OFTEN USED IN THE
TREATMENT OF FRACTURED
EXTREMITIES
TO LESSEN MUSCLE
SPASM
TO REDUCE FRACTURE
PROVIDE
IMMOBILIZATION/MAINTAIN
ALIGNMENT
USE TO CORRECT OR LESSEN OR PREVENT
DEFORMITIES AS IN THE CASE OF:
ARTHRITIS
PATIENT WITH
FLEXION
CONTRACTURES
A CHILD WITH
SCOLIOSIS BEFORE
SURGERY
PRIOR TO TOTAL HIP
REPLACEMENT
STRETCH MUSCLES AND
LESSEN MUSCLE SPASM
IN BACK PAIN
REST A DISEASE JOINT
AS IN BONE
TUBERCULOSIS
PRINCIPLES OF TRACTION

A.
B.
C.
D.
E.
TRACTION MUST :
HAVE AN OPPOSITE PULL OR
COUNTERTRACTION
BE FREE FROM ANY FRICTION
FOLLOW AND ESTABLISHED LINE OF PULL
THAT IS THE LINE OF PULL MUST BE IN LINE
WITH THE DEFORMITY
BE CONTINOUS TRACTION
BE APPLIED TO A PATIENT IN A SUPINE
POSITION
F. ENSURE THAT THE WEIGHTS HANG FREELY AND DO
NOT TOUCH THE FLOOR
G. MAINTAIN PROPER BODY ALIGNMENT
H. DO NOT REMOVE OR LIFT THE WEIGHT WITHOUT
THE PHYSICIANS ORDER
I. ENSURE THAT PULLEYS ARE NOT OBSTRUCTED AND
THAT ROPES IN THE PULLEYS MOVE FREELY.
J. PLACE KNOTS IN THE ROPES TO PREVENT SLIPPING
K. CHECK THE ROPE FOR FRAYING
PROVIDE CARE FOR SPECFIC TYPE OF
TRACTION
A.
BRYANT TRACTION

APPLIED FOR FRACTURES OF THE FEMUR,
INJURIES TO THE HIP AMONG CHILDREN
BELOW 3 YEARS OLD
CARE:
Both legs are suspended vertically, hips flexes at
right angle buttocks not resting against mattress.

a.
CARE FOR SKIN TRACTION
CHECK FOR
THE
PRESENCE OF
• PIMPLES AND
BLISTERS
• PURULENT
DISCHARGES
CHECK FOR
SIGNS OF
• IMPAIRED
CIRCULATION
• IMPAIRED
FUNCTION
SKIN
TRACTION
MUST BE
• SNUG AND IN PLACE
• PROPER
APPLICATION OF
DIAPER
BUCK’S EXTENSION
TRACTION
SKIN TRACTION
• ALLEVIATE MUSCLE
SPASM
• IMMOBILIZE A
LOWER LIMB BY
MAINTAINING A
STRAIGHT PULL ON
THE LIMB WITH THE
USE OF WEIGHTS
INDICATIONS
• AFFECTATION
S OF FEMUR
AND HIP
• MUSCLE
SPASM
BUCK’S EXTENSION TRACTION
A BOOT
APPLIANCE IS
APPLIED TO
ATTACH TO THE
TRACTION
WEIGHTS ARE
ATTACHED TO A
PULLEY
ALLOW WEIGHTS
TO HANG FREELY
OVER THE EDGE
OF THE BED
NOT MORE THAN
8 TO 10 LB OF
WEIGHT SHOULD
BE APPLIED
ELEVATE THE FOOT OF
BED TO PROVIDE THE
TRACTION
RUSSEL’S TRACTION
SKIN TRACTION
• STABILIZED A
FRACTURED
FEMUR
BEFORE
SURGERY
SIMILAR TO
BUCKS TRACTION
BUT PROVIDES A
DOUBLE PULL
USING A KNEE
SLING THAT
PULLS AT KNEE
AND FOOT
OBSERVATIONS
PILLOWS
SUPPORT THE
LEGS WITH
THE HIP IN 20
ANGLE FROM
THE BED
SIGNS OF
IRRITATION OR
DISCHARGES
CHECK FOR
ON THE
SIGNS OF
ISCHIAL
IMPAIRED
TUBEROSITY,
CIRCULATION
POPLITEAL
OF TOES
REGION,
MALLEOLI AND
HEEL
CERVICAL SKIN TRACTION/ HEAD
HALTER TRACTION
RELIEVES MUSCLE SPASMS AND
COMPRESSION IN THE UPPER EXTREMITIES
AND NECK
A. CERVICAL SKIN TRACTION USES A HEAD
HALTER AND CHIN PAD TO ATTCH THE
TRACTION
B. USE POWDER TO PROTECT THE EARS FROM
FRICTION RUB
C. POSITION THE CLIENT WITH THE HEAD OF THE
BED ELEVATED 30 TO 40 DEGREES, AND ATTACH
THE WEIGHTS TO A PULLEY SYSTEM OVER THE
HEAD OF THE BED.

CERVICAL SKIN TRACTION
PELVIC SKIN TRACTION
USE TO RELIEVE LOW BACK, HIP OR
LEG PAIN OR TO REDUCE MUSCLE
SPASM
AFFECTATIONS OF THE LUMBAR SPINE SUCH AS
HERNIATED NUCLEUS PULPOSUS
APPLY TRACTION SNUGLY OVER THE PELVIS AND ILIAC
CREST AND ATTACH TO WEIGHTS/ PREVENT THE CLIENT
FROM SLIPPING DOWN THE BED
PELVIC SKIN TRACTION
DUNLOP TRACTION
• HORIZONTAL TRACTION USE TO ALIGN FRACTURES OF
THE HUMERUS
• SUPRACONDYLAR FRACTURE OF THE HUMERUS
• VERICAL TRACTION MAINTAINS THE FOREARM IN
PROPER ALIGNMENT
• CHECK RADIAL PULSE OF THE FINGER AND SIGNS OF
IMPAIRED CIRCULATION
DUNLOP TRACTION
90 DEGREES-90 DEGREES
TRACTION

UPPER AND LOWER EXTREMETIES FRACTURE

THE LOWER LEG IS SUPPORTED BY A BOOT
CAST OR A CALF SLING

A SKELETAL STEINMANN PIN OR KIRSHNER
WIRE IN THE DISTAL FRGAMENTOF THE
FEMUR ALOWING 90 DEGREE FLRXION AT
BOTH THE HIP AND KNEE
90 °- 90º TRACTION
HALO FEMORAL TRACTION
CRUTCHFIELD TONG AND HALO
TRACTION
BALANCED SKELETAL TRACTION
( IN A THOMAS SPLINT AND PEARSON
ATTACHMENT)
BALANCED SUSPENSION TRACTION
USE WITH SKIN OR SKELETAL
TRACTION
USE TO APPROXIMATE
FRACTURES OF THE FEMUR,
TIBIA OR FIBULA
BALANCED SUSPENSION
TRACTION IS PRODUCED BY A
COUNTERFORCE OTHER THAN
CLIENT
EQUIPMENTS FOR SKELETAL BALANCE
TRACTION OF LOWER EXTREMITIES
1. THOMAS SPLINT
 2. PEARSON ATTACHMENT
 3. REST SPLINT
 4. SASH CORD
 Thigh rope – shortest
a. Traction rope – long
b. Suspension rope – longest
 5. SLINGS of different sizes
 6. SAFETY PINS OR PAPER CLIPS
 7. WEIGHT BAG AND SUSPENSION WEIGHT
BAG

STEINMANS PIN AND HOLDER
 KIRSHNERS WIRE HOLDER
 OVERHEAD TRAPEZE/ FOOT SUPPORT
 BALKAN FRAME WITH FIRM MATRESS
FRACTURE BOARD AND DIFFERENT BARS

INTERVENTIONS FOR BALANCE
SKELETAL TRACTION
POSITION THE CLIENT IN A LOW FOWLER’S
POSITION ON EITHER THE SIDE OR THE BACK
 MAINTAIN A 20˚ ANGLE FROM THE THIGH TO
THE BED
 PROTECT THE SKIN FROM BREAKDOWN
 PROVIDE PIN CARE IF PINS ARE USED WITH
SKELETAL TRACTION
 CLEAN THE PIN SITES WITH NORMAL SALINE
AND HYDROGEN PEROXIDE OR POVIDONE
IODINE AS PRESCRIBED


CHECK FOR SIGNS OF IMPAIRED CIRCULATION ON
TOES, INFECTION ON PIN SITE, PRESSURE AROUND
THE ISCHIAL, POPLITEAL, ANKLE OR HEEL

CHECK FOR ANY PROBLEM IN ELIMINATION

PROTECT ENDS OF PINS WITH CORK OR EMPTY
VIALS

CHECK FOR THE EFFEICIENCY OF TRACTION

ENCOURAGE ISOMETRIC EXERCISE, ANKLE AND
TOE MOVEMENTS, DEEP BREATHING AND ROM
EXERCISES FOR THE UNAFFECTED EXTREMITIES.
PATIENT IS FREE FROM THE FOLLOWING:
 Impaired
circulation of the extremities
 Respiratory Distress
 Condition of the skin with emphasis on
the ischial, sacral, popliteal, achiles
tendon, dorsum of foot
 Deformity like footdrop and contracture
of joint
 Signs of infection
APPLICATION OF TRACTION
1.
2.
3.
4.
VERIFY DOCTOR’S ORDER
INFORM THE PATIENT ABOUT THE
USED AND PURPOSE OF THE
PROCEDURE
PREPARATION: ASSEMBLE ALL THE
NEEDED EQUIPMENTS AND THE
DIFFERENT PARTS OF THE
ORTHOPEDIC BED
MOUNT THE THOMAS AND PEARSON
ATTACHMENT ON THE REST SPLINT.
FIVE PRINCIPLES IN THE
APPLICATION OF SLINGS

1. NOT TOO TIGHT… NOT TO LOOSE
 2.
ONE INCH DISTANCE BETWEEN
THE SLINGS TO PROMOTE AERATION
AND VENTILATION
 3. POPLITEAL AND HEEL PORTION
SHOULD BE FREE FROM ANY SLING
 4. SMOOTH AND RIGHT SIDE
SHOULD COME IN CONTACT WITH THE
PATIENT’S SKIN
 5.TWO LONGER SLINGS FOR THE THIGH
PORTION AND THREE FOR LEG AREA
 5.
INSERTION OF THE APPARATUS
UNDER THE AFFECTED EXTREMITY
 6. APPLICATION OF THE TRACTION
WEIGHT (TRACTION WEIGHT:15% OF
THE BODY WEIGHT, SUSPENSION
WEIGHT:50% OF THE TRACTION
WEIGHT)
 7. APPLY SUSPENSION TRACTION
 8. REMOVE THE REST SPLINT
 9. APLLY FOR SUPPORT
PRINCIPLES OF TRACTION
SWING THE PATIENT TO AND FRO, SIDE TO
SIDE TO CHECK THE EFFEICIENCY OF TRACTION
 PATIENT SHOULD BE ON DORSAL RECUMBENT
POSITION
 LINE OF PULL SHOULD BE IN LINE WITH THE
THIGH; SECOND PULLEY SHOULD BE IN LINE WITH
THE FIRST AND THIRD PULLEY
 TRACTION SHOULD ALWAYS BE CONTINOUS
 AVOID FRICTION IN THE ROPE, SHOULD BE
RUNNING ALOG GROOVE OF PULLEY, KNOTS
SHOULD BE AWAY FROM THE PULLEY,
WEIGHT SHOULD BE HANGING FREELY
 PROVIDE COUNTERTRACTION
