Which is a form of orthopaedic traction primarily used to treat femoral shaft fractures and developmental dysplasia of the hip in children under four years?

1. A

   Bryant's traction

2. B

   Tulloch traction

3. C

   Hamilton traction

4. D

   Russell's traction

Appeared in: BTSC Staff Nurse 30July-2025

Explanation

• Bryant's traction is a form of skin traction specifically designed for young children, typically under four years of age.
• Its primary indications are the treatment of femoral shaft fractures and developmental dysplasia of the hip (DDH).
• The method involves suspending both legs vertically with the hips flexed at 90 degrees, using the child's body weight for countertraction.
• This matches the exact criteria mentioned in the question stem: a specific traction for femoral fractures/DDH in children under four.

Why Other Options Were Wrong

• Option B: Tulloch traction is not a standard or commonly used form of traction for pediatric femoral fractures in modern practice.
• Option C: Hamilton traction is not a recognized standard type of orthopedic traction for this specific pediatric condition. It may be a historical or obscure term.
• Option D: Russell's traction is used for femoral fractures but is typically applied to older children and adults, not infants or toddlers under four.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pediatric Orthopedic Tractions as background academic context rather than a clinical decision trigger.
• The most critical nursing responsibility for a child in Bryant's traction is frequent and meticulous neurovascular assessment of the lower extremities. The vertical position can compromise blood flow, leading to serious complications like Volkmann's ischemic contracture.
• Due to the risk of vascular compromise, the use of Bryant's traction has become less common. Many institutions now prefer immediate treatment with a spica cast for children in this age group.
• What if? If the patient were an 8-year-old child instead of a child under four, Russell's traction or skeletal traction (like 90-90 traction) would be more appropriate choices, as Bryant's traction is not safe or effective for heavier children.

How to Approach the Question

• First, identify the key elements in the question: the patient's age ('children under four years') and the medical condition ('femoral shaft fractures' and 'DDH').
• Next, analyze the options provided, which are all types of orthopedic traction.
• Recall or deduce the specific indications for each type of traction, paying close attention to the typical age group for which each is used.
• Match the patient profile from the question (a child under four) with the appropriate traction. Bryant's traction is specifically indicated for this age group and condition.
• Eliminate other options. For instance, recognize that Russell's traction is for older children or adults, making it an incorrect choice.

Concept Tested & Keywords

• Concept Tested: Pediatric Orthopedic Tractions
• Stem keywords: orthopaedic traction, femoral shaft fractures, developmental dysplasia of the hip, children under four years
• Lead-in keywords: Which is

Question ID

qp0GcKFVcyyDCQDu1BGiV

Copy ID

Reference Book

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 pp. 125-127, 127-129