Surgery and Healing in the Developing World - Dartmouth-Hitchcock

Orthopedic Surgery
Figure 1. A locally made external fixation device being used to stabilize a pelvic fracture.
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Other traction methods include balanced suspension using felt slings or Thomas
splints, Neufeld (roller) traction, simple straight leg traction with or without an
antirotation boot, and Perkin’s traction. The latter is an especially useful method as
it allows the patient to sit up in bed and move the knee and hip joints. Perkin’s
traction is easily arranged by removing the springs from the bottom half of the bed
allowing the mattress to bend down. Traction from a tibial pin pulls off the end of
the bed with or without a pulley (Fig. 2). The flexed position of the hip and knee
while sitting controls femoral rotation and maintains hip and knee motion. Many
Figure 2. Perkin’s traction being used for a fractured femur. The mattress is bent the
patient’s knee. It can be elevated to normal position for reclining.
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