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A TRACTION SLEEVE
ROBERT T. FINDLAY
J Bone Joint Surg Am. 1936;18:796-798.



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Publisher Information          The Journal of Bone and Joint Surgery
                               20 Pickering Street, Needham, MA 02492-3157
                               www.jbjs.org
                                                                                            A           TRACTION                                              SLEEVE

                                   BY                  ROBERT                             T.           FINDLAY,                            M.D.,              F.A.C.S.,                       NEW                  YORK,                     N.         Y.


                   This                     is a i)rief                       description                               of        an             article                  used              in         the             treatment                                 of         frac-
tures,                        \Viii(h                     has            1)een                    thoroughly                                     and              successfully                                   tried                             on
                                                                                                                                                                                                                                       out Patielits
ill         the              ami)ulamlce                                     of          the             Beckman                           Street                    Hospital                           in            the            City                   of         New
York                    during                             the l)ast                     three               years.
                   r1iie            traction                            sleeve                    is    an        adjustable,                                  one-piece                              apparatus                              for            applica-
t.ion                   to             standard                                          metal                  splints                            (i\iurray-Jones                     hinged                         arm                51)lillt. and
Tilonias                          half-ring                                   leg              splint)                      in          the            t.reatnient                            of        fractures                            of         the             extrem-
ities              at            tile                  site             of           accident                and             during                        transportation                                  to         a     hospital.                                   In
cOllJ          unction                                      with              tile                 splint           ,       the                 sleeve                     accomplishes                               immobilization,


                             ,
                                                           -    9
                                                                                 -        --..---                       1                 traction,
                                                                                                                                          part.
                                                                                                                                                                      and
                                                                                                                                                                     It.     is
                                                                                                                                                                                     suspension
                                                                                                                                                                                      considered
                                                                                                                                                                                                                           of
                                                                                                                                                                                                                                 an
                                                                                                                                                                                                                                   the             injured
                                                                                                                                                                                                                                                 improve-
                                                                    I                                                                     inemit    over     the    various                                                 methods                           now               in

        \
                                                .---



                                                                        4
                                                                    l._..,
                                                                                     I
                                                                                                            R
                                                                                                             ‘                            use witil

                                                                                                                                          purpose.
                                                                                                                                                         the SaIfle


                                                                                                                                                         Figure
                                                                                                                                                                       splints,


                                                                                                                                                                                  1      shows
                                                                                                                                                                                                                             for the


                                                                                                                                                                                                                                       the
                                                                                                                                                                                                                                                            same


                                                                                                                                                                                                                                                          traction
                   --        I                                                                                                            sleeve              as             a one-piece                                  article,                     ready       for
                                                                                                                ;                         use.               The                  sleeve                        part                is            made                        of
                                                                                                                                          heavy                       sail             canvas                          with                  a         zipperill
                                                                                                                                          back.                           The            only              purpose                       of the                    zipper
                                                                                                                                          is      to        change                       the canvas                         to          one    thick-
                                                                                                                                          ness             for            scrubbing.                            When                    the canvas
                                                                                                                                          is        opened                           out              to              one               thickness,                                  it
                                                                                                                                           measures                                twenty-one                             inches                       at             the
                                                                                                                                           top,              thirteen                            inches            at.           the              bottom,
                                                                                                                                           and             thirty                     inches                     at           s
                                                                                                                                                                                                                            the ides.                     The
                                                                                                                                           sleeve             slides                  over             the       Illetal                rods           ofthe

                                                                                                                                           51)liI)t                (Fig.                2)            and,                  without                            adjust-
                                                                                                                                           ment,                    fits              the             largest                    size                       standard
                                                                                                                                           leg           splint.                         The               two                  tapes                  extendmg
                                                       _____                                                                               upward                     at. the                  top              of         the           sleeve                       (Fig.
                                            .      lI.:             .                                                                      1)       are            web                tapes,                    one illch                wide              and
                                       ..   -                                                                                              fifteen                   inches                    long.                        These                      tapes                   are
                                                &;                                                                                         equip)edI                              with                adjusting                                  i)Uckles                       at
L                                                                   .                                        _______ the                                    bottom                            and               halter                      clips,                          with
                                                           FIG.              1                                                             holes             one-half                          an            inch      in                diameter,                             at
                                                                                                                                           the             top.                      These                   clips                fasten                      to            rings
at          tile                 joimits                   of           the               s1)lints                           and                 they prevent                            the            sleeve                     from                     slipping
 distally                        Oil            the             splint.                  Wileil             the              imljured                      extremity                             is        riding                  on            it.               The               six
              *     These               rings, OIl     011 eacil     side,                                                        are            sewed               to       tile         leather                   ringthe       atjoint              of both
standard                           leg and arm     splints.         There                                                                added
                                                                                                                                   is also                         a one-inch    web   strap,                                      with                a two-way
buckle,                  at        the     top ofthe     leg splint, which                                                              straps              across      the upper thigh.                                         (See            Figure               2.)

796                                                                                                                                           THE          JOURNAL                       OF        BONE                AND             JOINT                 SURGERY
                                                                                   A     TRACTION                            SLEEVE                                                                                             797




                                                                                                                                                                                                                     )

                                                                                                                                                                                        -


                                                                                                                                                          -               ;:



                                                                                                          FIG.         2



small              tapes              coming                  from                  the             back on             each                side               are             half          annch
                                                                                                                                                                                              i                    in Widtil
and          eight                    illches in             length,                      and             are              placed                       five              imiches                apart..                        These                 are
used         to           tie          across        in back                  inthe width      of the
                                                                                         adjusting                                                                                    sleeve               to the                  width
of the     sl)lint.                                The     length      of the  sleeve    is adjusted                                                                                     by          tucking
                                                                                                                                                                                                        ill  the                  top
and    the      bottom.                              Wilen      tucked    in to its full    extent-to                                                                                             the
                                                                                                                                                                                                    attachment
of the             two one-incil                             web             straps                  at. the                  and
                                                                                                                             top              the              one-inch                       web              strap iii the
center          at. the                         bottom-the         sleeve     fits the                                                     smallest                        standard                        arm
                                                                                                                                                                                                            splint.
            The     two                          large     straps,        extending                                                         from                    the
                                                                                                                                                                  right-hand                           side        of                the
sleeve                (Fig.                1),         are            of       heavy                      canva.s                      with                   buckles                       and               holes,                 and             fasten
completely                               around                     the             extremity                               and              the                  splint,                   above                   amid           below                    the
elbow                or          knee             (Fig.              2).                 Each                  strap                  is      thirty-three inches                                long              and            three
and            three-fourths                                      inches                      wide               at          the              buckle
                                                                                                                                                  and                      tapers                      clown           to         the
width                of          the        buckle                    at           the         holes.                        There                      are              sixteen                   each
                                                                                                                                                                                              in holes                      strap,
one        illch            apart,                 amid             reenforced                             with                  metal.                             The               straps                   are            fastened                      to
the        main                   camvas with                         metal                    snappers                          and               are               adjustable                              up          aild               clown.
           The                  tape    which                         extends                        from                  the
                                                                                                                            center                 of          the             lower               portion                        of         the
sleeve               is         a one-inch                   wei)            tape,                  eighteen                          inches long,                             amid          iloldis                 the           main
canvas                to          the           leather                    piecebelow.                          This              is merely                               to     keel)  the                        apparatus in
one        piece.                        The             oblong                    part,shown                  near              the bottom                                     of Figure                           1 (fastened
around                    the            patient’s                      ankle in               Figure                      2),         is      made of                     heavy,                  felt-lined                          soft
leather,                   fifteen                inches by                  six          inches,                      with              a
                                                                                                                                       one-inch                           leather                belt             attached
to       the          middle.                             This               is          to         be           applied                      as              a       secure                     cuff             around                      wrist               or
ankle.                      Attached                         to        the              leather                  cuff             by          a metal                     andringwel)bimlg,                              in     psi-
tions             correspondmg                               to       each                side            of          the             wrist                   or         ankle,                  are            two
                                                                                                                                                                                                             strands                   of
clothesline,                             sixty             inches                      long,             which                   are           tied                  to         the          end              of         tile          splint               and
hich              continue                         for            susl)ensioll                 of        the          sl)lilltedl                       extremity.
            The   “winder”,                                which                   is attached                               for            safe              keeping                       to         the          buckle                    of      the
belt        of the cuff                           in       Figure                       1 and              is seen                    between                             the          distal
                                                                                                                                                                                      elld             of    the            sleeve
and          the                end        of        the            splint in             Figure                      2,         is        made                     of         two           ringed                      halter                 clips
(with              holes              one-half                an           inch           in        diameter),                               which                       are          held                  together                         with
a ring               of          heavy               leather in the                            center,                     so     that                   the  winder                            will bend any
                                                                                                                                                                                                      in
direction                         aild            adjust                     its            wi(lth.
                                                                                          Own                                    This                   is placed                            between       the
                                                                                                                                                                                                          two

VOL.        XVIII,               NO.       3,     JULY              1936
798                                                                 R.      T.     FINDLAY


strands    of clothesline                          and             wound               as a Spanish                    windlass               to     obtain           traction;
it is then    clamped                       to      the            rods           of     the splint.


                                                                    CONCLUSIONS

           The      traction            sleeve           is washable,                        non-shrinkable,                       and        nearly             indestruct-
ible.            Several              advantages                          of       the          sleeve           method                  over          other            forms           of
emergency                  traction           have             been               observed:
           1.       It     is more           comfortable                           to the           patient.
           2.       It     may    be        applied      more                       quickly            and           gently.
           3.        It    requires          less experience                                 and     training                  for its application.
           4.      It      provides            even    pressure                                 underneath                       the  injured       extremity.
There            is no       undue          sagging.
           5.       It     does       not        slip         distally                 on the   splint.
           6.       It     is adjustable                 to      either                arm   or leg splint                        of      any          standard                size.
           7.       It     is made           in         one         piece,              is compact,                   and        the      parts            are       not       easily
mislaid.
           8.       Its      appearance                       is         neater              than         most           other            types            of       emergency
traction             apparatus.
           9.       It     is possibly                  more              economical                     in    the       long          run.




                                                                                       THE     JOURNAL           OF      BONE          AND         JOINT         SURGERY

				
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