Techniques of Nonoperative

Management
TRACTION:
Thomas splint with a Pearson Knee Piece

• Thomas splint supports the leg and

balanced traction is applied.
Braun traction and a weight and pulley system

• Permits traction in the longitudinal

axis of the femur.
Hamilton-Russell Traction

• Uses a one-pulley system to provide

support for the femur and to apply
traction.
Perkins Traction

• A straight pull along the axis of the

femur through a proximal pin but
without splint.
Fisk Traction

• Consists of a short Thomas splint and

a hinged knee piece.
• Traction in the axis of the femur was
maintained using a proximal tibial
transosseous pin, but the patient
could flex the hip and knee.
90-90 Traction

• The thigh is pulled upward and both

hip and knee are at 90 degrees.
Spinal Traction
Cervical Spine
• Use for the management of cervical fractures and dislocations.
• To reduce a fracture or dislocation, thereby decompressing the neural
elements and providing a degree of spinal stability.
Cranial Tongs
• Consists of a hemicircular frame with
two spring-loaded angulated pins
that are placed into the outer table
of the skull at points about 1 cm
posterior to the external auditory
meatus and 1 cm superior to the
pinna of the ear.
Halo Rings
• Tolerate higher loading than cranial
tongs and can be incorporated into a
cast or brace to allow definitive
treatment.
• Attached with 4 pins: 2 anterior and 2
posterior.
Complications
• 31% of normal cervical spinal motion is permitted by halo-body
orthoses.
• 10% of patients lose fracture reduction.
• Pin track sepsis occurs in 20% of patients.
• Pin loosening at rates of 36-60%.
• Nerve damage, dural puncture, skull perforation and brain abscesses.