Traction

J.A.K.E NCMB 316 RLE

BST Manual traction

Traction
- An act of pulling OR drawing which is associated with a
counter traction
- Traction means that a pulling force is applied to a part of
the body or an extremity while a countertraction pulls in
the opposite direction
- Purposes
• Prevent and correct deformity
• Relieve pain
• Relieve muscle spasm - used if traction is done by a healthcare personnel /
• Reduce or immobilize fracture operator
- Principles - to provide a very specific and controlled distraction force
1) Position should be supine to extremity or joint
2) Avoid friction
3) Allow the weights to hang freely Specific types of skeletal traction
4) Apply traction continuously Cervical Skeletal Traction
5) There should be an adequate countertraction - Gardner-Wells tongs are commonly used today because
6) The line of pull should be in line with the deformity they are considered less likely to pull out of place than are
Crutchfield tongs.
Main types of traction: - Holes are drilled into the sides of the skull, and the tongs
Skeletal Traction are inserted into these holes .
- Traction is applied to the tongs to stabilize the cervical
spinal cord. The client stays in bed and must remain
immobile until the injury heals, surgery is performed, or a B.
Halo device is applied.
Femoral Traction
1) Upper femoral traction
- Several traction options for acetabular fractures.
- Lateral traction for fractures with medial or anterior
force
- Stretched capsule and ligamentum may reduce
- performed when more pulling force is needed , it uses
acetabular fragments.
weights of 25-40 pounds
2) Distal femoral traction
- requires the placement of tongs, pins, or screws into the
- Alignment of traction along axis of femur
bone so that the weight is applied directly to the bone
- Used for superior force acetabular fx and femoral shaft
- an invasive procedure that is done in an OR under GA, RA
fx
or LA
- Used when strong force needed or knee pathology
Skin traction
present
Perkin’s traction
- Treatment of # tibia
- Treatment of # of femur from the subtrochanter region and
distally.
- Trochanteric # of femur in pts under 45-50 yrs age.
- Denham pin is inserted trough upper end of tibia for # of
femur, the mid tibia for # of condyles of tibia.

- used if traction is temporary, or if only a light or

discontinuous force is needed; uses 5-7 pounds weights
attached to the skin to indirectly apply the necessary
pulling force on the bone
- weights are attached either through adhesive or
nonadhesive tape, or with straps, boots, or cuffs.
- is not invasive; it is usually performed in a hospital bed/
bedside
BST 1 of 2
J.A.K.E Traction NCMB 316 RLE

Distal Tibial Traction - Can only be used a few hours at a time

- Useful in certain tibial plateau fx
- Pin inserted 5 cm above the level of the ankle joint, midway
between the anterior and posterior borders of the tibia.
- Avoid saphenous vein
- Place through fibula to avoid peroneal nerve
- Maintain partial hip and knee flexion

Parts of Balkan Frame/ Orthopedic Bed:

• 4 vertical Bars
• 2 horizontal bars
• 3 Cross Bars
• Pulleys
Hanging trapeze
Buck’s Traction or Extension • Firm mattress
- Used in temporary management of fractures of:
• Fracture Board
• Femoral neck
• Femoral shaft in older children Equipment’s for BST
• Displaced shaft in older children • Balkan frame
• After reduction of a hip dislocation • Steinmann’s pin
• To correct minor flexed deformities of the hip or knee • Thomas splint
• In place of pelvic traction in management of low back • Pearson attachment
pain • Rest splint
- Can use tape or pre-made boot
• Sash cord (Ropes)
- Not more than 4.5 kgs
• Slings
- Not used to obtain or hold reduction
• Suspension bag = 5% of traction weight
Hamilton Russel Traction
• Traction bag with weights = 10% TBW
- Buck’s with sling
- May be used in more distal femur fracture in children.
- Can be modified to hip and knee exerciser.
Bryant’s Traction
- Useful for treatment of femoral shaft fracture in infant or
small child
- Combines gallows traction and buck’s traction
- Raise mattress for counter traction
- Rarely used currently
Forearm Skin Traction
- Adhesive strip with ace wrap
- Useful for elevation in any injury
- Can treat difficult clavicle fracture with excellent cosmetic
result
- Risk is skin loss
Dunlop’s traction
- Used for supracondylar and transcondylar fractures in
children
- Used when closed reduction difficult or traumatic
- Forearm skin traction with weight on upper arm
- Elbow flexed at 45 degrees
Head halter traction
- Simple type cervical traction
- Management of neck pain
- Weight should not exceed 2.3 kg
BST 2 of 2