Overview
Skeletal traction is widely used in fixing bone fractures among patients. Usually it is used in the femoral part of the leg as well as the thighbone. However, it can also be used in other parts of the body such as the bones in the neck part, forearm, and arms. The orthopaedic surgeon (bone surgeon specialist) place several mechanisms which include a pin, screw or wire. This is surgically placed inside the bone. A weight must be in place to pull and force the bone in an
ortho bed.
Purpose and Type of Tractions
There are several uses of traction for a patient. First of all, it can prevent patient's discomfort such as pain and muscle spasms while waiting for a surgery. It can also p rev ent deformities and complications by correcting muscle contracture. It also help promotes bone alignment.
There are two classes or type of traction. The first one is skin traction. In this mechanism, the site of placement is external only. There are also weights being placed and there is also a pulling force being applied in line with the patient's body, usually up to 3.5 kilos which .
The other type is a skeletal traction. The main difference is that there is a penetration and use of wires, screws and pins. There is also a greater force being applied. The bone can also stand a heavier force or weight which is up to 12 kilos.
Nursing Care for Patients with Skeletal Traction
Nurses placed in the medical-surgical or orthopaedic unit must be aware of the various nursing care plan for their ortho patients. The nurse must always assess the vital sign of the patient especially the old ones with bone fractures since they are more predisposed to fat embolism which is life threatening. Before placement of skeletal traction, the nurse must prepare the patient for the operative procedure. After or post procedure, pain relief or pain management is one of the priority. Thus, the staff must provide pain relievers as necessary per doctor's order or comment. They also make sure or check that the position of the traction is well aligned and the weights are freely hanging. Once the fracture is already aligned, it will be removed again. The nurse must provide or share health teachings in taking care of their newly-healed bone such protecting it from further trauma, checking the site for sign of infection and consuming food rich in calcium.
Conclusion
The care for a patient with skeletal traction involves a lot of patience from close to admission to discharge for home by car. However, a lot of nursing skills can be applied to these types of medical condition.
Contact NicoleConsultancy.com at 62215262 for Nursing Care for Skeletal Traction in Singapore now!
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Definition TYPES:
Traction is applied to:
- Decrease muscle spasms
- Reduce, align, and immobilize fractures (e.g. femur fractures that cannot be immobilized in a cast).
- Correct or prevent deformity
- Increase space between joint surfaces
- Monitor skin integrity of the affected part before and after traction placement.
- Assess the skin, especially bony prominences for breakdown.
- Assess neurovascular status.
- Monitor respiratory status, including rate and patter, breath and lung sounds, ability to cough and breathe deeply.
- Evaluate muscle strength and tone and mobility in affected and unaffected areas.
- Assess mental status, noting level of orientation, effectiveness of coping and behavior.
- Regularly check the condition of the traction equipment: ropes, pulleys, and weights.
- For the client in skeletal traction, assess the pin site for signs and symptoms of infection.
- Deficient knowledge related to the treatment regimen
- Anxiety related to health status and the traction device
- Acute pain related to musculoskeletal disorder
- Self-care deficit: feeding, bathing/hygiene and/or toileting related to traction
- Impaired physical mobility related to musculoskeletal disorder and traction
- Impaired skin integrity related to traction
- Promote measures to prevent complication of immobility.
- Place a bedboard under the client’s mattress to ensure extra firm support. Turn and reposition the client regularly within the limitation of traction.
- Prevent constipation by increasing the client’s fluid intake to 2,000 to 2,500ml and provide a balanced diet high in fiber.
- Promote skin integrity.
- Use a special mattress to preserve skin integrity.
- Keep bed linen free of wrinkles to prevent skin breakdown.
- Provide frequent skin care to areas of potential pressures
- Inspect the skin traction for signs of skin breakdown. Assess areas over traction tape for tenderness or skin irritation. Always apply weights after the client is in the traction apparatus, and remove the weights before removing the traction apparatus.
- Inspect the skeletal traction sites for signs of irritation or infection. Assess pin entrance and exit sites and areas surrounding pin sites at least twice each day. Clean pin sites as prescribed; never remove weights.
- Provide client teaching
- Encourage active exercises for unaffected body parts.
- Encourage the use of a trapeze, if indicated.
- Promote deep-breathing exercises hourly
- Promote self-care within traction limitations.