THE BALANCED SKELETAL TRACTION: Special Procedure

Procedure Phase 1. 2. Attach rest splint to the Thomas splint with Pearson attachment Upper part is the Thomas splint, which will support the thigh, lower part is the Pearson attachment which will support the leg Tie the short/thigh rope to the medial upright of the Thomas splint with slipknot to provide privacy to the patient Attach slings to the Thomas splint and Pearson. Start from the longest side (at least 2) to the Thomas splint and add 3 to the Pearson. Smooth side should be touching the patients skin. Provide at lease one inch apart between the slings for ventilation. It must not be too loose nor too tight enough to support and follow the contour of the leg. Provide space at the popliteal area to prevent irritation and provide ventilation. Apply manual traction on the affected leg. Instruct the patient to flex the unaffected leg and hold on to the overhead trapeze. With the help of assistants one applying the manual traction, one lifting the affected leg, one removing the Braun Bohler, coordinate your movement. At the count of three, insert the ready made Thomas splint to the affected leg. Synchronized the procedure for patients comfort. There should be continuous traction, so dont remove the manual traction unitl the longer/traction rope has been tied with a slip knot to the Steinmann pin holder or Kirchner wire holder. Then pass it to pulley number 1, then to traction weight making a slip knot or any kind of knot will do as long as the weight bag is securely tied and will not fall. Check the groin if resting on the half ring to prevent irritation

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10. Tie the other end of the short thigh rope to the lateral aspect of the Thomas splint 11. Tie the longest rope to the middle/thigh rope with a slip knot. Insert it to the pulley number 3 then insert it to the short / thigh rope with a slip knot. Insert it to pulley number 3 then insert it to the handle of the suspension weight bag as you anchor it temporarily to a pulley knob, then insert it to pulley number 2. 12. After the second pulley, tie it to the Thomas splint using clove hitch knot but be sure to pass the rope under the rest splint. Tie it again to the Pearson attachment suing same clove hitch knot. Be sure that the suspension rope is outside the traction rope for support and to prevent the affected leg from swaying sideways. 13. Release suspension weight bag. 14. Apply food support using ribbon knot 15. Remove the rest splint

To check the efficiency of the traction: Instruct the patient to flex his unaffected leg and hold the Overhead trapeze and swing the affected leg with balanced skeletal traction.
Removal of Traction 1. 2. 3. 4. 5. 6. Attach the rest splint Anchor the suspension weight Remove suspension rope Apply manual traction Remove traction weight, then tie the rope to the rest splint, Thomas and Pearson using the clove hitch. Patient is ready for transfer to the stretcher. Instruct the patient to flex his unaffected leg while holding on the trapeze. Help him slowly to the stretcher.