To reduce the healing time of hip fractures (and not only), skeletal traction is used. This is a long-known treatment method, the purpose of which is to accurately match the ends of the damaged bone. Despite the high degree of effectiveness, the method has several disadvantages and contraindications. All possible restrictions are taken into account by the doctor based on the results of the examination and diagnosis.
The essence of the method
In case of a hip fracture, traction (in the photo below is a schematic illustration of the structure) is necessary. Using this method, high-quality and complete fixation of broken bones is provided.
Initially, the doctor determines the area of the damaged area. Then a Kirschner needle is drawn through it. This is a medical device made of metal. Immediately before the implementation of this manipulation, anesthesia of the limb is performed. Then a load is suspended at one end of the broken bone, the mass of which is calculated individually. Then the bone structures are compared. As a result, all conditions are created for the successful formation of bone marrow.
Indications
With a hip fracture, a skeletal hood is prescribed very often. Depending on the location of the damage to the bone structures, the technique is slightly different. Indications for this type of treatment are the following types of fractures:
- Spit. In this case, the load is suspended by a spoke held through the condyles of the thigh or the tuberosity of the tibia.
- Cervical. With a femoral neck fracture, skeletal traction is rarely prescribed. If the doctor decides that this method of treatment is most effective and appropriate, the load is suspended through the condyles of the femur.
- Fracture of the diaphysis. In such situations, the method can be considered as the main or auxiliary. Suspension of the cargo is carried out through the tuberosity of the tibia. The position of the lower limb during the hood directly depends on the location of the fracture (the upper third is the abduction, the middle - the leg should be straight, the lower - the limb is bent at the knee at a right angle and lay the roller).
- In the condyle zone. Skeletal traction during a hip fracture in this area is prescribed only in isolated cases. The main way to treat this injury is surgery.
In order to assess the feasibility of prescribing traction for a hip fracture, a doctor must consider several factors. These include: the patient’s age, general health, fracture site, the presence of complications (including infection of the wound with open injury).
Contraindications
Like any other treatment method, skeletal traction during hip fracture has several limitations. It is not prescribed for children under 5 years of age. In addition, the presence of an inflammatory process at the fracture site is a contraindication.
In some cases, it is more advisable to prescribe alternative methods of treatment. For example, young people with uncomplicated fractures without displacement are recommended to apply a plaster cast. As for the elderly, for them the most effective is endoprosthetics or osteosynthesis.
Benefits
This treatment method has been used in practice for many years. Every year, his technique is improved, which minimizes pain during the suspension of the load, and after the procedure.
The undeniable advantages of skeletal traction during hip fracture in children over 5 years old and in adults:
- The patient is almost constantly around the clock under the supervision of doctors and medical personnel. The victim can call for help at any time, for example, if severe pain occurs.
- The method completely eliminates the repeated displacement of damaged bone sections. Contrary to popular belief, the design is extremely reliable.
- Skeletal extraction is a minimally invasive treatment. Due to this, the risk of developing complications is much lower than after surgery.
- Using this method, it becomes possible to significantly reduce the healing time of bone structures.
Separately, it is worth noting that after stretching, the recovery period is minimal. Shortly after removing the load and removing the knitting needle, the patient can begin to carry out his daily activities.
disadvantages
Skeletal traction during a hip fracture is associated with a number of uncomfortable sensations. The first days, patients complain of severe aching in the muscle tissue.
The method has several more disadvantages:
- The procedure carries a risk of infection and the subsequent formation of purulent exudate. It is worth noting that in medical institutions only a sterile set of tools is used. In addition, the installation of knitting needles and suspension of cargo is carried out exclusively in compliance with all sanitary standards. Every day, the doctor examines the area in which the metal instrument is located. Antiseptic treatment is also carried out regularly. In this regard, the risk of infection is rather a drawback not of the method itself, but of a medical institution in which such complications are recorded.
- Long bed rest. In the supine position, the patient must stay long enough. This is associated with a risk of pressure sores and muscle contracture. In the supine position, it is necessary to be until until bone splices merge. Only after the formation of bone marrow, the needle is removed.
- The presence of contraindications. In case of a hip fracture, skeletal traction cannot be prescribed for small children and the elderly.
Despite a number of disadvantages, the method is actively used at present.
Cargo weight
When the patient enters the hospital, the doctor decides on the advisability of prescribing skeletal traction. At the same time, the initial weight of the cargo is calculated. For this patient is weighed and sent for x-ray examination. Stretching for a fracture of the hip (neck and other sections) requires the installation of devices, the mass of which is approximately 15% of the patient’s total body weight.
In order for the muscle tissue to be relaxed, the leg is fixed on a special tire. Due to this, the intensity of painful sensations gradually decreases, and fragments of bone tissue coalesce faster.
Terms of traction
The length of hospital stay depends on the severity of the injury and the presence of various complications. With a hip fracture, the extension period is about 2 months.
Bone monitoring is carried out regularly. The doctor assesses the dynamics using x-ray examination. After the formation of bone marrow, the needle is removed. First, it is shortened on both sides so that its ends are as close as possible to the skin. Then the limb is treated with an antiseptic solution. The next step is to extract the spokes. The resulting wounds are treated with medicines, then a sterile dressing is applied to them.
After that, the patient is transferred to the fixation method of treatment.
Finally
In hip fractures, skeletal traction is often the only possible treatment. This method involves installing a spoke, on which the load is subsequently suspended. Due to this, fragments of structures evenly coalesce. The extraction of the spokes is carried out after the formation of bone marrow. The average duration of treatment is 2 months. Monitoring the condition of the patient is carried out using x-ray examination. The method is highly effective, but has a number of contraindications. Traction is not assigned to the elderly and children under 5 years old. In such situations, surgery is preferred.