What is Buck’s Traction?
Buck’s traction is an extension method for the treatment of traumatic injuries of the extremities. The purpose of the method is the gradual reduction of fragments with the help of loads and keeping them in the correct position until primary bone callus forms.
Buck’s traction technique
To treat a fracture, it is necessary to draw the needle through a certain point depending on the location of the fracture. The needle is held under local anesthesia. The main points of the needles are for the upper limb, for fractures of the shoulder blade and shoulder – the ulnar process, for fractures of the pelvis and thigh – its supracondylar region or tuberosity of the tibia. In case of fractures of the lower leg, the spoke is held beyond the ankle, and in case of injuries of the ankle joint and lower leg in the lower third of the diaphysis – for the calcaneus.
After the knitting needle through the bone, it is fixed in a bracket of a special design, and then is set through the block system the initial load: for shoulder fractures – 2-4 kg, hips – 15% of the weight of the victim, for fractures of the leg – 10%, and for fractures pelvis – 2-3 kg more than with hip fractures.
The individual adjusting load is selected according to the control radiograph 24-48 hours after the start of treatment. After changing the load along the axis of the damaged segment or changing the direction of the side adjusting loops after 1-2 days, X-ray control of the fracture site is mandatory.
The position of the damaged limb during skeletal traction
A damaged limb must be in a forced position. For fractures of the scapula: in the shoulder joint – abduction to an angle of 90, in the elbow joint – flexion of 90. The forearm should be in the middle position between pronation and supination and fixed with glue traction with a load along the axis of the forearm of up to 1 kg. In the case of fractures of the shoulder, the position of the arm is the same, with the exception of the shoulder joint, in which the arm is bent to an angle of 90. In fractures of the lower limb, the leg is laid on the Beler splint, the design of which allows uniform relaxation of the antagonist muscles.
Duration of bed rest
With fractures of the upper limb and lower leg, treatment lasts about 4-6 weeks, with fractures of the pelvis and thigh – about 6-8 weeks. A reliable clinical criterion for the sufficiency of treatment by the method of constant skeletal traction is the disappearance of pathological mobility at the fracture site, which must be confirmed radiographically. After that, they switch to a fixation method of treatment.
Indications for skeletal traction
- Fracture of the diaphysis of the humerus;
- Hip diaphysis fracture;
- Fracture of the diaphysis of the bones of the leg;
- Gypsum dressing is not possible (manual reposition of fragments is not possible).
Advantages and disadvantages of the method
“Cons” of this method:
- the possibility of purulent infection;
- long duration (from 4-6 weeks on average);
- limited use in children and the elderly.
“Pros” of this method:
- the possibility of constant visual control of a damaged limb;
- lack of secondary displacement of fragments;
- minimally invasive intervention;
- method functionality;
- reduction of rehabilitation time.