Quantcast Cervical Skeletal traction - Nursing Care Musculoskeletal System

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a. Crutchfield or Vinke tongs are used for skeletal traction in the treatment of
fractures of the cervical spine. The tong points are inserted in the parietal area of the
skull (just in the outer layers of the bone) and the tong is then attached to the pulling
device. The procedures may be done under local anesthesia in the operating room or
on the ward. With skeletal skull traction, the nursing care of the patient is usually less
difficult than when a halter is used--the patient's head and face are relatively free of
pressure and some turning in a "log-roll" fashion may be permissible for back care and
bed making.
b. Prepare the bed as for cervical halter traction. Use an alternating pressure
mattress, if one is available, when the patient is in a conventional bed. The patient in
tong traction may be immobilized for a long period of time, so he may be placed on a
Foster frame.
c. As with cervical halter traction, feed the patient slowly and with great care.
Allow plenty of time to chew and swallow. Keep suction equipment at the bedside for
emergency use.
The Kirschner wire and Steinmann pin are commonly used devices in skeletal
traction. The wire or pin insertion is always an aseptic procedure, and is usually done in
the operating room. A local or general anesthesia is used, and all preoperative and
postoperative precautions must be taken. The wire or pin is inserted through the bone,
distal to the fracture site, and out through the skin on the other side. The sharp
protruding ends of the pin or wire should be covered--corks are generally used for this
purpose. A skeletal tractor device is fitted onto the wire or pin and traction is maintained
by the weight, pulley, and rope attached to the skeletal tractor (see figure 1-15).
Figure 1-15. Skeletal tractor device.

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