PORTABLE VERSION OF BRYANTS TRACTION

Abstract

For years Bryants method of
traction has been used in management
of femur fractures in children under 2
years. However, the construct of Bryants
traction is cumbersome and difficult to
maintain occupying a large amount of
space. Feeding, comforting and perineal
care of the children were also difficult
leading. Several modifications of Bryants
traction have been described to make
the construct less cumbersome and easier
to use. We describe a modification of
Bryants traction, simple and portable.
The portable version of Bryants traction
is made using a Thermacol sheet, Earthaflex
foam and a Light-weighted aluminum
frame. The clearance of the childs
buttocks just off the bedding was considered
sufficient traction. The neonates
were managed in Neonatal ICU with phototherapy,
nursing care and feeding in no
way hindered by the traction. Compliance
of the children and parents were
better in older children. The only complications
noticed were the frequent loosening
of the traction and occasional development
of skin blisters.
Only Patients, below 2 years and weighing
below 20kg, with femur shaft fracture and
post-arthrotomy septic arthritis of hip were
provided traction in this frame. This even
facilitated breast feeding by the mother in
case of infants, and also better nursing
care. The child can be transported without
removing or disturbing the traction and can
also be transported for investigations like
ultra sonogram. Most importantly, none of
the cases had any ischaemic injury.Our
modified version of Bryants traction is a
compact, light-weighted and portable device
with high safety and efficacy profile
and most importantly good compliance
from the child and the parents. They can
be used in selected cases of femur shaft
fractures and post-arthrotomy septic arthritis.
Their efficacy in managing different
stages of developmental dysplasia of hip is
to be tested.