Other Recommendations m the hterature regarding the frequency
of this monitoring lack consistency Stewart &
Hallett (1983) recommend daily checking Lewis (1977)
emphasizes 'constant sujjervision', whereas Hilt &
Cogbum (1980) suggest that the cord and weights are
checked at least once a shift hut that the line of pull
requires 'more frequent' monitoring Rowe & Dyer (1977)
suggest that each time the nurse passes the patient's bed
the position of the patient should be consciously noted
It IS apparent, therefore, that momtonng of Hamilton
Russell traction is essential However, precise instructions
on how a nurse might achieve this are not su^ested A
preliminary study using a questionnaire design demonstrated
that nurses working m the orthopaedic area under
study had a poor level of knowledge about Hamilton
Russell traction and especially about the orgamzation of
forces within the system and many aspects of its mamtenance
It was therefore speculated that the resultant forces
in the majority of Hamilton Russell traction systems would
be of the wrong magnitude and direction
Larson & Gould (1974) suggest that hip flexion be maintamed
at 20° This would require the angle between the
mattress and the axis of the femur to be 20° In anwas then attached to the semi-circle and the smaller extension
nveted to the centre ofthe larger extension The nvet
was so positioned that the moveable extension pivoted in
the centre of the protractor The upper surface of the fixed
extension formed the baseline and corresponded with the
scored basehne along the length of the moveable extension
Measurement of an angle would be between the
upper surface of the fixed extension and the scored haselme
on the moveable extension (Figure 3)