>
> Rowley,
>
> You are worrying me. We have had little problem with the finger
> traps and traction method over a couple of years, but do not have
> enough experience to have met the rare complications. Was the
> degloving during manual reduction or using weights? If using weights
> how much was used?
>
> Many thanks for sharing your complications - too many people
> would hide them rather than discuss them.
>
> Tim.
This was simply using the old fashioned method of maximal traction. In so far as I was ever taught, I was taught to apply vast
amounts of traction before anything else. So there was with this ancient lady, Biers block in place, and have simply pulled and all
the skin of her arm followed me. I was absolutely horrified, although the lady herself was quite anaesthetic and unbothered.
However, I learnt that you must take into account the whole patient rather than simply the wrist. I use the analogy of a twig that
had been broken and then jammed together. It would be clear that you could use an enormous amount of force to distract the
pieces or you could gently wiggle the pieces apart. I accept that this is a less useful method on the young fit male, but of course
as Colles himself described this is not a Colles fracture. If this technique is restricted to the over Sixties it is extremely effective.
Gently manipulate with an up and down motion until the distal radial styloid is free floating. You can then apply just enough
traction to hold the radial styloid in line with the remainder of the radius. At this stage you apply plaster and hold gentle
traction until the Plaster sets. Job done.
Best wishes,
Rowley Cottingham
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