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Traction

Oct 09, 20253 min read

Function

  • Reduction of fractures
  • Maintaining fracture reduction
  • Immobilization of joint
    • Rest
    • Pain relief

Usage of Traction

  • Uses pulling force to a part of the body to overcome

    • Muscle spasm
    • Shortening
    • Gravity

  • Parts used at:

    • Limbs
    • Spine
    • Pelvis

Usage of Traction

  • Restoring and maintaining bone alignment following fractures * By: Ligamentotaxis / Muscle tightening
  • Resting inflamed joint and maintaining them in functional position
  • Relieving pain due to muscle spasm
  • Gradually correcting deformity due to contracted soft tissue

Types of Traction

  • Manual traction
  • Skin traction
  • Skeletal traction
  • Traction by gravity

Manual Traction

  • Exerted directly when the physician pulls on the part during manipulation to obtain closed reduction of a fracture or dislocation

Manual Traction

Skin Traction

  • Traction is applied on skin
  • By adhesive or non-adhesive strapping

Skin Traction

  • More commonly used in children
  • Temporary management in adults
  • Duration limit < 3 weeks
  • Weight limit < 10 pounds (4.5 Kg)

Skin Traction

  • Contraindications
    • Diseases predisposing to skin damage and poor healing
      • (DM, varicose ulcers and usage of steroids)
    • Wounds, sores or rash
    • Marked swelling
    • History of hypersensitive skin
    • Suspicion of circulatory problem

Skin Traction - Advantages

  • Easy to apply
  • No hazard of bone infection or epiphyseal plate injury

Skin Traction - Types

  • Gallows
    • For femoral fracture
    • Children < 2yrs age, maximum body weight 10-12 Kg
      • If more, may affect circulation
    • Hips flexed 90°

Skin Traction - Types

Fixed traction For transport

  • Using Thomas splint

Balanced traction For treatment

  • Using Thomas splint

Cervical skin traction

  • Temporary in trauma & for cervical disc / spondylosis

Skeletal Traction

By inserting a metal (Steinman pin) into the bone and applying traction on it

  • Indications:

    • Adults where surgical treatment of fractures is not possible or not desirable
    • When a strong force is needed
      • (weight more than 4-5 Kg) ( Adults )
    • When traction is needed for more than 3 weeks
      • To avoid skin blisters

  • Common sites for pin insertion:

    • Upper tibia
    • Femoral condyle
    • Calcaneum
    • Skull

Skeletal Traction - Complications

  • Infection
  • Over distraction of the bone fragments
  • Nerve damage
    • From heavy traction force
    • Direct during insertion!
      • e.g. Common Peroneal n.
  • Bone fragmentation/break
  • Breaking of the pin

Traction - Disadvantages

  • Costly in terms of hospital stay
  • Hazards of prolonged bed rest
    • Thromboembolism
    • Decubitus ulcers
    • Pneumonia, UTI
    • Depression, …
  • Requires meticulous nursing care

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