IRCT2016111730936N1 IRCT 2017-01-27 Vice Chancellor for research and technology of Kurdistan University of Medical Sciences The effect of chewing sugar-free gum massage the abdomen and constipation Comparative study of the effect of abdominal massage, chewing sugar-free gum and a combined method on the incidence and severity of constipation in patients who have undergone lower limb skeletal traction in Sanandaj in Year 1395 2017-01-20 anticipated 124 Complete https://irct.ir/trial/24441 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Single, Purpose: Prevention. N/A constipation. Intervention 1: For patients (3) a combination of chewing sugar-free gum a number Barbd Mark van an hour-a-day eating meals (breakfast, lunch, dinner) for half an hour and massage the abdomen in a clockwise direction for 15 minutes on the clock in the direction transverse colon and descending colon in the left upper abdomen in the direction of the anterior superior iliac spine down the left Without prejudice to patient privacy for 7 days + care routine will be performed by the principal investigator. Intervention 2: To control (4) routine actions, such as recommendations to increase fluid intake, fiber intake, and active and passive movements in bed is recommended. Intervention 3: For patients (2) clockwise abdominal massage for 15 minutes per hour of 9 am and 9 pm with gentle constant pressure with two or three fingers in a clockwise direction to rotate the area of the anterior superior iliac spine straight day + care routine will be performed by the principal investigator. Intervention 4: For patients (1) chewing sugar-free gum a number Mark van (25-gram package containing xylitol) 3 times a day for 30 minutes after an hour of eating every meal + routine hospital for 7 days prescribed by Research Associate and monitored.