Nursing Care Related to the Musculoskeletal System


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a. In this form of skin traction, a system of suspension and traction pull is used. Adhesive strips are applied as in Buck's extension, and the knee is suspended in a sling. A rope is attached to the sling's spreader bar. This rope passes over a pulley which is attached to an overhead bar and is then directed to a system of three pulleys at the foot of the bed: first to a pulley on the bed's foot bar, next to a pulley attached to the foot spreader bar, and then back to a second pulley on the bed's foot bar. There is an upward pull from the sling pulley and a forward pull from the pulleys at the foot of the bed. In Russell traction, the angle between the thigh and the bed is approximately 20 and there is always slight flexion of both the hip and the knee. The advantage of Russell traction is that some movement in bed is permissible. The patient can turn slightly toward the side in traction for back care, bedpan placement, or linen change.


b. Check the popliteal space for signs of pressure from the sling such as redness, indentations, abrasions, or pain. Check all the tape and wrappings as in Buck's traction. Keep the patient from sliding down the bed. The foot of the bed may be elevated to help prevent this.



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