Halo femoral

Traction

Definition:

A technique of spinal distraction that provides

correction of spinal deformities by using a halo ring
in combination with pins placed in the distal
femoral diaphysis.

Indication:

For severe Scoliosis

NURSING INTERVENTIONS FOR TRACTION

A. MINIMIZING THE EFFECTS OF IMMOBILITY 1. Examine bony prominences frequently for evidence of
1. Encourage active exercise of uninvolved muscles and joints pressure or frictions irritation.
to maintain strength and functions. Dorsiflex feet hourly to
avoid development of foot drop and aid in venous return. 2. Observe for skin irritation around the traction bandage.

2. Encourage deep breathing hourly to facilitate expansion of
lungs and movement of respiratory secretions.
3. Auscultative lungs field twice a day.
4. Encourage fluid intake of 2,000 to 2,500 ml daily.
5. Provide balanced high- fiber diet rich in protein; avoid
excessive calcium intake.
6. Establish bowel routine through use of diet and/ or stool
softeners, laxatives, and enemas, as prescribed.
7. Prevent pressure the calf and evaluate periodically for the
development of thrombophlebitics.
3. Observe for pressure at traction-skin contact points.
4. Report compliant of burning sensation under traction
5. Relieve pressure without disrupting traction effectiveness.
a. Ensure that linens and clothing are wrinkle-free
b. Use lamb’s wool pads, heel/ elbow protection, and special
mattresses as needed.
6. Special care must be given to the back at regular intervals,
because the patient maintains a supine position.
a. Have patient use trapeze to pull self up and relieve back
pressure.
b. Provided backrubs.

8. Check traction apparatus at repeated intervals-the traction

must be continuous to be effective, unless prescribed as
intermittent, as with pelvic traction.
a. With running traction
⇒ The patient may not be turned without disturbing the lie of
pull
b. With balanced suspension traction.
⇒ The patient may be elevated, turn slightly, and moved as
desired.

B.MAINTAIN SKIN INTEGRITY

C. AVOIDING INFECTION AT PIN SITE.
1. Monitor vital signs for fever or tachycardia.
2. Watch for signs of infection, especially around the pin tract.
a. The pin should be immobile in the bone and the skin wound
should be
dry. Small amount of serous oozing from pin site may occur.
b. If an infection is suspected, per cuss gently over the tibia;
this may elicit
pain if infection is developing.
c. Assess for other signs of infection: heat, redness, fever.
3. If directed, clean the pin tract with sterile applications and
prescribed solution/ ointment- to clear drainage at the entrance
of tract and around the pin, because plugging at this site can
predispose to bacterial invasion of the tract and bone.
D.PROMOTING TISSUE PERFUSSION
1. Assess motor and sensory function of specific nerves that
might be comprised.
a. PERONEAL NERVE
⇒ Have patient point great toe toward nose; check sensation on
dorsum of foot; presence of foot drop.
b. RADIAL NERVE
⇒ Have patient extend thumb; check sensation in web between
thumb and index finger.
c. MEDIAN NERVE
⇒ Thumb- middle finger apposition; check sensation of index
finger.
2. Determine adequacy of circulation (ex. Color, temperature,
motion, capillary refill of peripheral fingers or toes).
a. With Buck’s traction, inspect the foot for circulatory
difficulties within a few minutes and then periodically after the
elastic bandage has been applied.
3. Report promptly if charge in neurovascular status is
identified.