Traction



Definition

Traction is force applied by weights or other devices to treat bone or muscle disorders or injuries.


Purpose

Traction treats fractures, dislocations, or muscle spasms in an effort to correct deformities and promote healing.


Description

Traction is referred to as a pulling force to treat muscle or skeletal disorders. There are two major types of traction: skin and skeletal traction, within which there are a number of treatments.

Skin traction

Skin traction includes weight traction, which uses lighter weights or counterweights to apply force to fractures or dislocated joints. Weight traction may be employed short-term, (e.g., at the scene of an accident) or on a temporary basis (e.g., when weights are connected to a pulley located above the patient's bed). The weights, typically weighing five to seven pounds, attach to the skin using tape, straps, or boots. They bring together the fractured bone or dislocated joint so that it may heal correctly.

In obstetrics, weights pull along the pelvic axis of a pregnant woman to facilitate delivery. In elastic traction, an elastic device exerts force on an injured limb.

Skin traction also refers to specialized practices, such as Dunlop's traction, used on children when a fractured arm must maintain a flexed position to avoid circulatory and neurological problems. Buck's skin traction stabilizes the knee, and reduces muscle spasm for knee injuries not involving fractures. In addition, splints, surgical collars, and corsets also may be used.


Skeletal traction

Skeletal traction requires an invasive procedure in which pins, screws, or wires are surgically installed for use in longer term traction requiring heavier weights. This is the case when the force exerted is more than skin traction can bear, or when skin traction is not appropriate for the body part needing treatment. Weights used in skeletal traction generally range from 25–40 lbs (11–18 kg). It is important to place the pins correctly because they may stay in place for several months, and are the hardware to which weights and pulleys are attached. The pins must be clean to avoid infection. Damage may result if the alignment and weights are not carefully calibrated.

Other forms of skeletal traction are tibia pin traction, for fractures of the pelvis, hip, or femur; and overhead arm traction, used in certain upper arm fractures. Cervical traction is used when the neck vertebrae are fractured.

For tibial traction, a pin is surgically placed in the lower leg (A). The pin is attached to a stirrup (B), and weighted (C). In cervical traction, an incision is made into the head (D). Holes are drilled into the skull, and a halo or tongs are applied (E). Weights are added to pull the spine into place (F). (Illustration by GGS Inc.)
For tibial traction, a pin is surgically placed in the lower leg (A). The pin is attached to a stirrup (B), and weighted (C). In cervical traction, an incision is made into the head (D). Holes are drilled into the skull, and a halo or tongs are applied (E). Weights are added to pull the spine into place (F). (
Illustration by GGS Inc.
)



Proper care is important for patients in traction. Prolonged immobility should be avoided because it may cause bedsores and possible respiratory, urinary, or circulatory problems. Mobile patients may use a trapeze bar, giving them the option of controlling their movements. An exercise program instituted by caregivers will maintain the patient's muscle and joint mobility. Traction equipment should be checked regularly to ensure proper position and exertion of force. With skeletal traction, it is important to check for inflammation of the bone, a sign of foreign matter introduction (potential source of infection at the screw or pin site).

Preparation

Both skin and skeletal traction require x rays prior to application. If skeletal traction is required, standard pre-op surgical tests are conducted, such as blood and urine studies. X rays may be repeated over the course of treatment to insure that alignment remains correct, and that healing is proceeding.

Normal results

There have been few scientific studies on the effects of traction. Criteria (such as randomized controlled trials and monitored compliance) do exist, but an outcome study incorporating all of them has not yet been done. Some randomized controlled trials emphasize that traction does not significantly influence long-term outcomes of neck pain or lower back pain.


Resources

books

"Cervical Spine Traction." In Noble: Textbook of Primary Care Medicine, 3rd ed.Mosby, Inc., (2001): 1132.

periodicals

Glick, J.M. "Hip Arthroscopy. The Lateral Approach." Clinics in Sports Medicine 20, no.4 (October 1, 2001): 733-41.

Overly, M.D., Frank and Dale W. Steele, M.D. "Common Pediatric Fractures and Dislocations." Clinical Pediatric Emergency Medicine 3, no.2 (June 2002).


Nancy McKenzie, Ph.D.

QUESTIONS TO ASK THE DOCTOR



Also read article about Traction from Wikipedia

User Contributions:

1
marcia chalanda
very good article easy to understand i have used in teaching student nurses
2
arshad
hi,
this site is very effective and good.it helps a lot and give much benefits to surgeon.
3
charles
complication broughtabout by traction as fracture management.
4
tamasha dutta
it is a verry good site.it help me to prepare my project.
5
AMITA
THE ARTICLES IN THIS SITE ARE VERY INFORMATIVE WHICH HELPED ME A LOT IN MY IN SERVICE EDUCATION.
6
lynda abdullah
this articles help me in nursing programme when am doing a clinical posting
7
Ceasar
can someone give me the types of Traction and the sub parts of each traction I mean Example : Skin traction the sub part of it.... plss help me out
8
ghazwan
whats the principle of action of skeletal traction..? how does it work..? I mean from the physiological and pathological point of view..! plzz...my boss keep asking me this question and I have NO clue where to find the answers.!
9
frozen tear
i feel this article is quite easy to understand, and also very useful...
10
pinky lyn presto
what are the body parts involved in skin traction and their function??
11
armaencarl peralta
How is traction related to nursing course?
what physics concept applied it?
12
Dr. P
"Cervical traction is used when the neck vertebrae are fractured."

Isn't this a contraindication to perform traction.
13
Dr. P
Q: Cervical traction is used when the neck vertebrae are fractured?

A: Red flags indicative of a serious or non-musculoskeletal condition (i.e. tumor, fracture, metabolic diseases, RA, osteoporosis, prolonged history of steroid use, etc.)
thank you very much for this topic
whatis nursing intervention for patient with traction?
if there are other types, mention .
thank you.
thank u very much for such a concise and up to date piece of data. it really helps...
traction is a set of mechanisms for straightening broken bones or releiving pressure on the spine and skeletal system.A VERY GOOD ARTICLE.
17
angel
i have learned so many things from this article... thanks
we need the traction's catalog which efect on BACKBONE.
could you please tell me do youu have any thing in this area?
this article really help me.
i will apply this teory in my practical area.thanks a lot..
20
P . T. A
Tnx 4 ur comprehensive notes.we expect more from u. JAH BLESS
thanks, this info really help me in my reporting regarding tractions
GOOD FOR UNDERSTANDING BUT FURTHER INFORMATION LIKE COMPLICATIONS OF MISMANAGEMENT IN HOSPITALS IN THE ARTICAL WOULD BE MORE BENEFICIAL
IT WAS NICE NOTE BUT I NEED TO KNOW THE ROLE OF NURSES AND CONTRAINDICATIONS OF SKELETAL TRACTION. THANK YOU!1
24
sajad
NICE WORDING AFFORDABLE AND EXCELLENT . this enable easy reading for me as a student nurse
it is short and precise article. It guided me in my orthopaedic experience.
26
devonna
can someone give me the indication for skeletal fractures
Needed some pt teaching guidelines for traction/trapeze use
good information, i use this note, for my assgment...tq
29
mia
Thanks.this article help me a lot but what is a care of skin traction.?
30
Kaseem
Skeletal nd skin traction is d major method in the management of fracture and any bone deformities by using good architectural design items. Tnx
31
sg
what are the complications of traction? And how to treat and prevent them??
32
blaise
this site is so helpful for me in my assignment. but what are the management of a child in traction?
33
Abigail Hughes
what conditions can skin traction be used to manage
34
nmrass
what are the nursing management for the patient on skin traction?
35
Kassim Aziz
thanks,it help me in my surgery studies i realy enjoyed the articles
36
Tshepo
All thanks to this article, i just completed my assignment at ease and with increased/benefited knowledge. simple and straight to the points. (physiotherapy student)
37
David
How do I calculate the traction weight to be applied.
this site has really helped me while doing my assesment at orthopaedic ward
39
Dr sajad lone phd botany
Good information.people become aware by such article.i had an patien admitted in hosp.and by searching this site i got patience
40
pk
amazing n thanks for your knowledge highly appreciated
Help me with indication,procedure and complications of skeletal traction
42
Deepa
Is it reliable that 18 kg weight can be applied in skeletal traction?
43
Bethel
Why should weight for skeletal traction hang free?
44
Aya
It is fantastic and easy information, thank you very much for this good noleadge

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