TRACTION

I. MANUAL TRACTION
- A pulling force applied by the hands of the operator

II. SKELETAL TRACTION

- A pulling force applied directly to the bones using wires, pins, tongs

Hardware/Traction
1.Crutchfield tong
2. Vinke’s skull caliper
3. Kirschner’s wire
4. Steinmann’s pin
5. Halo-pelvic traction
6. Halo-Femoral traction
7. Balance Skeletal Traction
8. Overhead Traction
9. 90o-90o Traction
Indication
 Inserted at the parietal area; for affection of the upper dorsal cervical
spine
 Inserted at the temporo-parietal area; for affection of the cervical
spine
 Thinner than steinmann’s pin; for affection of the radius, ulna
 Affection of the humerus, femur, tibia, fibula
 For C-type scoliosis
 For S-type scoliosis
 For affection of the hips and or femur
 For supracondylar fracture of the humerus
 Subtrochanteric fracture of proximal 3 rd of femur

III. SKIN TRACTION

- Pulling force is applied to the skin, transmitted to the muscle, then to the bones

A. Adhesive – use of adhesives, elastic bandage, spreader

1.Buck’s Extension Traction  Affection of the hip and femur

2. Bryant Traction  Affection of hip and femur for children below three (3) years of age
3. Dunlop Traction  Affection of supracondylar of the humerus
o
4. 0 Traction  For affection of surgical neck of humerus
B. Non Adhesives – use of canvass, slings, leathers, straps with buckles and laces

1.Hammock suspension  Affection of the pelvis (malgaigned)

2. Head halter
3. Pelvic-girdle Traction
4. Cotrel Traction
5. Anklet Traction
6.Stove-in Traction
7. Boot Cast Traction
 Cervical spine affection
 Lumbo-sacral spine affection & Herniated Nucleus Pulposus (HNP)
 Combination of head halter traction and pelvic traction for scoliosis
 Affection of lumbar spine; hip and femur
 For massive rib fracture
 For post polio with residual hip & knee contracture
 CAST
A temporary immobilization device made of gypsum sulphate rendered anhydrous which when mixed
with water, swells and form into hard cement.

FUNCTIONS OF CAST

1. For immobilization
2. To correct or prevent a deformity
3. To support, maintain, and protect realigned bone
4. To promote healing and early weight – bearing
5. To obtain a mold of a limb to serve as a model in making an artificial limb

PRINCIPLES IN APPLICATION OF CAST

1. Apply padding first before applying cast

2. Apply cast by including the joint above and the joint below the affectation
3. Apply cast in circular motion and smoothen with the palm
4. Support with the palm

CONTRAINDICATIONS

1. Pregnancy
2. Skin Disease

MATERIALS / INSTRUMENTS IN CAST APPLICATION

1.Stockinette  Directly in contact with the skin

2.Wadding sheet and gauge bandage  Serve as padding
3.Plaster of Paris/fiber glass  Casting material
4.Trimming knife  Smoothen the edges of cast
5.Cast Spreader  To widen a bivalve cast
6.Stryker cast cutter  Used in windowing

CAST TECHNIQUES

1.Windowing  Putting a hole on a cast on the site of an open wound of the

casted extremity for the purpose of visualization, inspection,
dressing, as well as application of medications
2. Bi-valving  Cutting the cast into two halves from the upper portion to
the bottom part for the purpose of relieving possible cast
tightness, X-ray and inspection of the casted extremity
3.Reinforcing  Reapplication of Plaster of Paris for the purpose of regaining
its strength in case of wetting the cast which resulted o its
instability
I. CAST IN THE TRUNK AREA

1.Collar cast o Affection of the cervical spine

2.Minerva cast o Affection of upper thoracic & cervical spine
3.Rizzer’s jacket cast o Affection of thoraco-lumbar spine
4.Body cast o Affection of lower thoracic and upper lumbar spine

II. CAST IN THE UPPER EXTREMITY

1.Short arm circular cast o Affection of wrist and fingers

2.Long arm circular cast
3.Munster’s/Fuenster’s cast
4.Hanging cast
5.Functional cast
6.Shoulder Spica cast
7.Abduction Splint/Airplane
cast
8.Sugar tong
9.Airplane Cast
o Affection of radius and ulna
o Affection of radius & ulna with callus formation
o Affection of shaft of the humerus & the shoulder joint
o Affection of the shaft of the humerus & the shoulder joint
which allows flexion and extension of the humerus with
callus formation
o Affection of the upper portion of the humerus and shoulder
joint
o Affection of the neck of the humerus
o Affection of the upper portion of the humerus and shoulder
joint with swelling or infection
o For recurrent shoulder dislocation

III. CAST IN THE LOWER EXTREMITY

1.Short leg circular cast o Affection of ankle and toes

2.Long leg circular cast o Affection of tibia-fibula
3.Walking cast o Affection of ankle and toes with callus formation
4.Cylinder cast o Affection of the patella
5. Pantalon cast o Affection of the pelvis
6. Patellar Tendon Bearing o Affection of tibia-fibula with callus formation
cast
7. Delvit cast o Affection of distal 3rd of tibia with callus formation
8.Quadrilateral cast / Ischial o Affection of shaft of femur with callus formation
weight – bearing cast
9.Cast Brace o Affection of distal 3rd of femur & proximal 3rd of tibia
which allows flexion and extension of lower extremity
10. Basket cast o For massive bone injury, to facilitate dressing of wound
11. Frog cast o For congenital hip dislocation
12. Night splint o For post-polio with contracture of hip and knee; applied
at HS
13. Internal Rotator Splint o For post hip surgery, to maintain knee abduction
14. Single hip spica o Affection of hip and one femur
15. 1 ½ hip spica o Affection of both hips and one femur
 16. double hip spica o Affection of both hips and two femur

MOLD – used for splinting the affected part of the body wherein there is a n open wound, inflammation,
abrasion, swelling, or infection and is applied posteriorly
BRACE
A mechanical support for weakened muscles, joints, and bones in rehabilitation

I. FUNCTIONS

1. For immobilization
2. To control involuntary movements
3. For support
4. Permit patients to walk without fatigue
5. Prevent and correct deformity
6. Maintain body alignment

EXAMPLES

Braces Indication
1. Shantz collar  Cervical spine affectation
2. Philadelphia Collar  For cervical spine injury (but softer than shantz collar)
3. Forester brace  Cervico-thoraco-lumbar spine
4. Four-poster brace  Cervical spine affection
5. Milwaukee brace  For scoliosis
6. Knight Taylor brace  Upper thoracic affectation
7. Jewette brace  Lower thoracic affectation
8. Chair-back brace  Lumbar spine; lumbo-sacral spine & BNP
9. Cock-up splint  For wrist drop
10. Banjo splint  For peripheral nerve injury
11. Bilateral long leg brace  For post polio with residual
12. Short leg brace  For clubfoot, for post polio with residual paralysis
13. Dennis browne shoe  For congenital clubfoot (talipes equino-virus)
14. Open Heimer  For radial nerve injury
15. Yamamoto  For scoliosis
16. SOMI brace  Sterno-Occipito-Mandibular Immobilizer

SURGICAL ABBREVIATIONS AND THEIR MEANING

SSI - Segmental Spinal Instrumentation TAR - Tendon Achilles Repair

AEA - Above Elbow Amputation VDO - Varus Derotation Osteotomy
AKA - Above Knee Amputation PSR - Progressive Surgical Release
BKA - Below Knee Amputation CHSF - Compression Hip Screw Fixation
ADSF - Anterior Decompression Spinal Fusion ORSF - Open Reduction Screw Fixation
PSF - Posterior Spinal Fusion ORIF - Open Reduction Internal Fixation
CSTR - Complete Soft Tissue Release RCHSF- Richard Compression Hip Screw Fixation
PMR - Postero-Medial Release DCS - Dynamic Compression Screw
PSTR - Postero-Soft Tissue Release HRI - Harrington rod instrumentation
IMN - Intr-Medullary Nailing ROI - Removal of Implant
OR - Open Reduction STSG - Split Thickness Skin Grafting
RAEF - Roger Anderson External Fixation TRHP - Total Replacement Hip Prosthesis
TBW - Tension Band Wiring PRHP - Partial Replacement Hip Prosthesis
CW - Circlage Wiring RFS - Rush Frozen Section
BG - Bone Grafting

Orthopedic Hardware and Terms

Hardware Indication (s)

1. Roger Anderson External Fixator (RAEF)  For comminuted fracture of long bones
2. Delta Frame external Fixator  For fracture of proximal/distal tibia
3. Spanning External Fixator  For fracture of femur extended to tibia
4. Hoffman’s External Fixator  for pelvic affection/ hip dislocation
5. Hybrid External Fixator  For peri-articular fracture of the ankle or knee
joint
6. Compression Hip Screw Fixation (CHSF)  Intertrochanteric fracture of femur
7. Buttress plate/ T-plate  Proximal 3rd of tibia
8. X-Pinning/ Y-Pinning  For supracondylar fracture of the humerus
9. Harrington Rod Instrumentation (HRI)  For scoliosis
10. Luque Rod  For scoliosis
11. Total Hip Replacement Arthroplasty (THRA)  Replacement of femoral head, neck &
acetabulum
12. Partial Hip Replacement Arthroplasty (PHRA)  Replacement of femoral head and neck
13. Intra Medulla Nailing (IMN)  Fracture of middle 3rd femur/long bones
14. Intramedullary Nail Extractor  For removal of IM nail
15. Spacer Antibiotic  Replacement of infected hip prosthesis
16. Hemovac  For collection of drainage under negative
pressure
17. Gigli Saw  For ampulation
18. Antibiotic Beads  For osteomyelitis (Therapeutic effect)
 For plating, IMN, and all types of internal and
external fixators (Prophylactic effect)
19. Tower External Fixatory Interdental Wiring  For fracture of the mandible
20. Tension Band Wiring (TBW) with the use of  For fracture of the patella
Cerelage Wire
21. Total Knee Arthroplasty/ Prosthesis  For fracture of the patella, femoral and tibial
component (Osteoarthritis Bone)
22. Crutchfield Tong  For cervical spine affection
23. Steinmann’s Pins  For fracture of the femur and hips for BST
24. Mini RAEF  For fracture of the carpals, metacarpals
25. Osteolome (Chisel)  Use for obtaining bone chips for spinal fusion
 Used for scraping dead or necrotic bone
26. Ellizarov External Fixator  For comminuted fracture, non-union, mal-
union, bone lengthening
 CHARACTERISTIC SYMPTOM OF SOME ORTHOPEDIC CONDITIONS

1. Neck of femur, fracture in the elderly  limping gait

2. Malgaigned fracture  pelvic instability
3. Supracondylar fracture, humerus  pain and swelling elbow
4. Septic hip arthritis  pain and swelling hip
5. Herniated Nucleus Pulposus  low back pain
6. Pott’s Disease  gibbus formation
7. Clubfoot/Talipes equino varus  foot inversion/equines deformity
8. Congenital hip dislocation  extragluteal fold
9. Bilateral Congenital Hip Dislocation  wadding gait
10. Cervical Fracture, dislocation  quadriplegia
11. Legg Perthe’s Disease/ Coxa Plana  a vascular necrosis, femoral head
12. Chronic Osteomyclitis, tibia  non-healing wound, leg
13. Depresses fracture, frontal  loss of consciousness
14. Epiphyscal separation  altered bone growth
15. Colle’s fracture/wrist fracture  silver fork deformity
16. Osteomyelitis  sequestra formation
17. Buerger’s Disease  non-healing wound
18. Pott’s Fracture  pain and swelling, ankle
19. Scoliosis  rib hump
20. Cerebral Palsy  motor incoordination
21. Open fracture, M/ 3rd femur  bleeding thigh

Terms
1.Anterior Decompression
Spinal Fusion (ADSF)
2. Gibbus Formation
3. Sequestrum
4. Sequestrectomy
5. Debridement
6. Axis
7. Atlas
8.Intertrochanteric
Definition
o Surgical intervention for Pott’s Disease
o Progressive destruction of the anterior spine leading to collapse and
kyphosis
o Classical sign of Pott’s Disease
o Dead or necrotic bone
o Removal of dead or necrotic bone
o Removal of dead or necrotic tissue
o Second cervical spine
o First cervical spine
o Fracture within the greater and lesser trochanter
fracture
9. Supracondylar fracture o Fracture above the condyle
10. Subcondylar fracture o Fracture under or below the condyle
11. Involucrum o New bone

Life is a challenge that we ought to face.

You win some, you lose some, but if you never give up
You will discover that sacrifices have greatest rewards….