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Anatomy, Physiology And Pathophysiology


Anatomy, Physiology And Pathophysiology

Anatomy, Physiology And Pathophysiology of the Human Pelvis and Femoral Bones in Relation to Femoral Fractures.

The human pelvis is a closed bony ring that is strong and massively constructed. It is the foundation for the torso and support for lower limb attachment and locomotion. It is shaped so that the ischial tuberosity forms a platform for sitting in an upright position. This occurs because the ischial tuberosity is the most distal part of the pelvis. When the legs are flexed anteriorly, all the weight of the body can be rested unencumbered on the ischial tuberosities.

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Application of Traction

Application of traction breaks the spasm and eliminates much of the pain. It also causes alignment of the bone fragments and subsequent increase tissue pressure. This reduces and controls bleeding and shock, and prevents further nerve, vascular and tissue damage. World War I studies indicate that properly applied traction and immobilization of a fractured femur helps control shock and reduces morbidity and mortality (1).

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Safe Traction

Safe traction for field use should be traction in a known amount prescribed by protocol or a Medical Consultant. It should also be traction that is dynamic in nature using a resilient member that permits graded reduction of the traction force as the muscle spasm decreases and the leg length increases. It should avoid the pitfalls of rope, weight and pulley traction. This type of traction is a constant and unrelenting force that can result in over-extension of the bone elements and should only be available in a Hospital setting under the care of an Orthopedic Surgeon or other designated Medical Consultant.