Physiological Integrity Q 40
A 2-year-old is admitted for repair of a fractured femur and is placed in Bryant’s traction. Which finding by the nurse indicates that the traction is working properly?
A. The infant no longer complains of pain.
B. The buttocks are 15° off the bed.
C. The legs are suspended in the traction.
D. The pins are secured within the pulley.
Correct Answer: B. The buttocks are 15° off the bed.
The infant’s hips should be off the bed approximately 15° in Bryant’s traction. Bryant’s traction is a form of orthopedic traction. It is mainly used in young children who have fractures of the femur or congenital abnormalities of the hip. Both the patient’s limbs are suspended in the air vertically at a ninety-degree angle from the hips and knees slightly flexed. Over a period of days, the hips are gradually moved outward from the body using a pulley system. The patient’s body provides the counter-traction.
Option A: Absence of pain is not an indication that the traction is working properly. The child’s toes and feet should be warm and pink and the toes should move when touched. Check for these signs of good circulation every four hours the first few days, every four hours after rewrapping the legs, and then whenever the child is fed, changed, or played with.
Option C: The child’s body and the weights are used as tension to keep the end of the femur in the hip socket. The legs are wrapped in adhesive tape attached to a gauze adhesive elastic bandage, then connected to ropes and weights.
Option D: Bryant’s traction is a skin traction, not a skeletal traction. Take the ace wraps (the outer elastic bandage) off the legs. Inspect any skin for redness or irritation. Rewrap the legs with the ace bandages. Start at the feet. Overlap each loop of the wrap halfway. Do not stretch it tight. Stretch with mild tension only (1/3 tight).