WordNet

(orthopedics) the act of pulling on a bone or limb (as in a fracture) to relieve pressure or align parts in a special way during healing; "his leg was in traction for several days"
of or relating to or forming or attached to a skeleton; "the skeletal system"; "skeletal bones"; "skeletal muscles"

PrepTutorEJDIC

けん引(道路などの表面に沿って乗り物などを引くこと) / けん引された状態,引っ張られた状態 / けん引力
骨格に;がい骨の;がい骨のような

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/06/03 18:10:41」(JST)

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In orthopedic medicine, traction refers to the set of mechanisms for straightening broken bones or relieving pressure on the spine^[1] and skeletal system. There are two types of traction: skin traction and skeletal traction.

Modern techniques

Traction procedures are largely replaced now by more modern techniques, but certain approaches are still used today:

Milwaukee brace
Bryant's traction
Buck's traction, involving skin traction. It is widely used for femoral fractures, low back pain, acetabular fractures and hip fractures.^[2] Skin traction rarely causes fracture reduction, but reduces pain and maintains the length of the bone.^[2]
Dunlop's traction – humeral fractures in children
Russell's traction

Skeletal traction

Although the use of traction has decreased over the years, an increasing number of orthopaedic practitioners are using traction in conjunction with bracing (see Milwaukee brace).^{[citation needed]}

Harrison et al. (2005)found that mirror image (opposite posture) postural corrective exercises and a new method of trunk-list traction resulted in 50% reduction in trunk list and were associated with nearly resolved pain intensity in this patient population.^[3] These researchers felt that their findings warranted further study in the conservative treatment of chronic low back pain and spinal disorders.

G.L.Burke found that traction and manipulation gave great relief to those who suffered backache. His methods were amply documented and illustrated to aid practitioners.^[1]

Spinal decompression

Spinal traction as a means of spinal decompression is often applied without directly touching bones as other methods of traction do. This is sometimes isolated inside-out by inflatable girdles or use of the transversus abdominis muscle. It is also done in conjunction with thigh-supported flexed-hip traction (inversion chairs, back hyperextensions) or done in conjunction with whole-leg traction (boots, tables) via inverted forms of suspension.

Traction of the spine (except the cervical) also occurs with upright suspension of the body from the arms, such as with pull-ups (exercise), dips (exercise), captain's chair, chinnings (chin up exercise) or other fitness movements with the feet dangling.

Purpose

The purpose of traction is to:

regain normal length and alignment of involved bone
lessen or eliminate muscle spasms
relieve pressure on nerves, especially spinal and
prevent or reduce skeletal deformities or muscle contractures
to provide a fusiform tamponade around a bleeding vessel

In most cases traction is only one part of the treatment plan of a patient needing such therapy. The physician's order will contain:

Type of traction
Amount of weight to be applied
Frequency of neurovascular checks if more frequent than every four hours
Site care of inserted pins, wires, or tongs
The site and care of straps, harnesses and halters
The inclusion of any other physical restraints / straps or appliances (e.g., mouth guard)
the discontinuation of traction

Responsibility of initial application

The physician is typically responsible for initial application of traction and weights while the adjustment or removal (to perform ablution functions / physiotherapy) of skeletal traction weights will be based on the doctors charted plan.

In most cases cervical traction may be adjusted or temporarily removed, per physician order, by an orthopedic nurse who has documented competency to do so.

The alignment and moving of the patient will only be changed on physician's directive and the affected extremity will need to be maintained in proper alignment at all times with the ropes and traction straps - making sure the mentioned is unobstructed and weights hanging freely.

If it is necessary to move the patient while skeletal traction is in place, the patient should be moved in the bed with weights hanging freely.

In most cases traction will be applied for a number of weeks to months and Neurovascular checks will need to be performed by a nurse as ordered by the physician or as dictated per traction unit policy.

Traction is an appropriate treatment for a number of medical problems including spinal deformities such as scoliosis.

Evidence basis

Lumbar spinal manipulation followed by Harrison "mirror image methods" (lateral translation exercise and traction) were found to produce statistically significant and clinically significant reductions in pain and trunklist posture, a finding not observed in the control group. In fact, the control group’s lateral thoracic translations were slightly worse at follow-up, possibly indicating progression of the disorder. Because these trunk-list postures are commonly associated with lumbar disc herniation and lower back pain, randomized controlled trials should be performed to evaluate the clinical significance of restoration of normal spinal-alignment biomechanics in chronic LBP pain subjects. Due to discrepancy between our study findings and a previous report, it is suggested that AP lumbo-pelvic radiographs and posture of the trunk should both be used as outcome measures in the treatment of the trunk-list deformity.

References

^ ^a ^b Burke, G.L., "Backache from Occiput to Coccyx"
^ ^a ^b Skin Traction - Lower Extremity from University of Stellenbosch, Department of Orthopaedic Surgery. Retrieved May 2, 2013
^ Eur Spine J. 2005 Mar;14(2):155-62. Epub 2004 Oct 27. A non-randomized clinical control trial of Harrison mirror image methods for correcting trunk list (lateral translations of the thoracic cage) in patients with chronic low back pain. Harrison DE, Cailliet R, Betz JW, Harrison DD, Colloca CJ, Haas JW, Janik TJ, Holland B.

External links

About
Byrne T (1999). "The setup and care of a patient in Buck's traction.". Orthop Nurs 18 (2): 79–83. PMID 10410051.
"Split Russell's / Buck Traction"
synd/2984 at Who Named It? - Bryant's traction
Traction in Physiotherapy

UpToDate Contents

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1. 成人における股関節骨折 hip fractures in adults
2. 成人における大腿骨骨幹部骨折 midshaft femur fractures in adults
3. 小児における大腿骨遠位部骨折 distal femoral fractures in children
4. 小児における大腿骨骨幹部骨折 femoral shaft fractures in children
5. デュピュイトラン拘縮 dupuytrens contracture

English Journal

Long-term Outcome of Gradual Reduction Using Overhead Traction for Developmental Dysplasia of the Hip Over 6 Months of Age.

Kaneko H, Kitoh H, Mishima K, Matsushita M, Ishiguro N.SourceDepartment of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Journal of pediatric orthopedics.J Pediatr Orthop.2013 Sep;33(6):628-34. doi: 10.1097/BPO.0b013e31829b2d8b.
BACKGROUND: In children over 6 months of age with developmental dysplasia of the hip (DDH), achieving a concentrically reduced hip while avoiding avascular necrosis (AVN) is challenging. The utility of gradual reduction (GR) using traction has insufficient evidence. We therefore report the long-term
PMID 23812143

Palatal implant versus zygoma plate anchorage for distalization of maxillary posterior teeth.

Kaya B, Sar C, Arman-Özçirpici A, Polat-Özsoy O.SourceDepartment of Orthodontics, Faculty of Dentistry, Baskent University, Ankara, Turkey.
European journal of orthodontics.Eur J Orthod.2013 Aug;35(4):507-14. doi: 10.1093/ejo/cjs059. Epub 2012 Sep 11.
This study aimed to examine the skeletal, dental, and soft tissue effects of the implant-supported pendulum (ISP) and the zygoma anchorage system (ZAS) used for the distalization of maxillary posterior teeth. Among 30 patients showing Angle class II malocclusion, 15 patients with a mean age of 14.3�
PMID 22968670

Use of shape correspondence analysis to quantify skeletal changes associated with bone-anchored Class III correction.

Nguyen T, Cevidanes L, Paniagua B, Zhu H, Koerich L, De Clerck H.Sourcea Assistant Professor, Department of Orthodontics, University of North Carolina, Chapel Hill, NC.
The Angle orthodontist.Angle Orthod.2013 Jul 25. [Epub ahead of print]
Abstract Objective: To evaluate the three-dimensional (3D) skeletal changes in the mandibles of Class III patients treated with bone-anchored maxillary protraction using shape correspondence analysis. Material and Method: Twenty-five consecutive patients with skeletal Class III who were between the
PMID 23886012

Japanese Journal

歯胚位置異常の上顎犬歯を移転排列した骨格性反対咬合症例

間山寿代,福田大介,清野幸男,三浦廣行
岩手医科大学歯学雑誌 36(1), 71-78, 2011-05-10
初診時年齢9歳0か月の女児で,埋伏した上顎右側中切歯と位置異常の犬歯を伴った骨格性III級の一症例を報告する.埋伏した中切歯は逆生で歯根が屈曲していた.中切歯を抜去後,犬歯は抜去した中切歯の位置に自然に移動したが萌出は認められなかったため,上顎歯列にNanceのホールディングアーチを装着し犬歯の牽引を開始した.上顎犬歯はマルチブラケット装置を使用して十分なスペースを獲得した後,中切歯の位置に排列し …
NAID 110008752163