TRACTION

What is traction?

In the medical field, traction refers to the practice of slowly and gently pulling on a fractured or
dislocated body part. It’s often done using ropes, pulleys, and weights. These tools help apply
force to the tissues surrounding the damaged area.

The purpose of traction is to guide the body part back into place and hold it steady. Traction may
be used to:

• stabilize and realign bone fractures, such as a broken arm or leg

• help reduce the pain of a fracture before surgery

• treat bone deformities caused by certain conditions, such as scoliosis

• correct stiff and constricted muscles, joints, tendons, or skin

• stretch the neck and prevent painful muscle spasms.

TYPES OF TRACTION

The two main types of traction are skeletal traction and skin traction. The type of traction used
will depend on the location and the nature of the problem.

Skeletal Traction

Skeletal traction involves placing a pin, wire, or screw in the fractured bone. After one of these
devices has been inserted, weights are attached to it so the bone can be pulled into the correct
position. This type of surgery may be done using a general, spinal, or local anesthetic to keep
you from feeling pain during the procedure.

The amount of time needed to perform skeletal traction will depend on whether it’s a preparation
for a more definitive procedure or the only surgery that’ll be done to allow the bone to heal.
Skeletal traction is most commonly used to treat fractures of the femur, or thighbone. It’s also the
preferred method when greater force needs to be applied to the affected area. The force is
directly applied to the bone, which means more weight can be added with less risk of damaging
the surrounding soft tissues.

Skin Traction

Skin traction is far less invasive than skeletal traction. It involves applying splints, bandages, or
adhesive tapes to the skin directly below the fracture. Once the material has been applied,
weights are fastened to it. The affected body part is then pulled into the right position using a
pulley system attached to the hospital bed. Skin traction is used when the soft tissues, such as the
muscles and tendons, need to be repaired. Less force is applied during skin traction to avoid
irritating or damaging the skin and other soft tissues. Skin traction is rarely the only treatment
needed. Instead,
it’s usually used as a temporary way to stabilize a broken bone until the definitive surgery is
performed.

Cervical Traction

During cervical traction, a metal brace is placed around your neck. The brace is then attached to
a body harness or weights, which are used to help correct the affected area. Cervical traction is
performed using a general anesthetic, so you’ll be asleep throughout the entire procedure.

Cervical traction might be used in two different situations. First, it may be done to gently stretch
the neck muscles so muscle spasms can be relieved or prevented. It may also be performed to
immobilize the spine after a neck injury.

CARE FOR THE CLIENT WITH TRACTION

1. When assisting with a.m. and p.m. care, encourage the patient to do as much for himself
as is possible within the constraints of his immobilization. Assist with or perform those
tasks that the patient cannot perform.
2. Assess the patient and the traction set-up to determine the best method for changing the
bed linen. There are several acceptable methods for making an occupied bed and,
depending upon the type of traction in use, you will want to use the method that is easiest.
3. When assisting with the bedpan or urinal, provide adequate time and privacy for the
patient. Many patients do not adjust easily to the awkwardness of using a bedpan or
urinal. The presence of roommates, visitors, or hospital personnel just outside the privacy
curtain is enough to make anyone uncomfortable. Always place toilet tissue, moist
towelettes, and call bell within easy reach. Check daily to see whether the patient has had
a bowel movement. Treating constipation will prevent the more serious problem of fecal
impaction. Physicians will routinely prescribe a stool softener for immobilized patients in
order to prevent constipation.
4. Encourage the patient to eat all of the prescribed diet. If permitted by the physician,
suggest that family and friends bring fruit or a “healthy” favorite food from home. A
recovering patient’s diet should be high in calcium, protein, iron, and vitamins. Plenty of
fluids and foods high in roughage will help prevent bowel and bladder complications.
 5. Assist the patient to take several deep breaths each hour. Coughing and deep breathing
will help prevent respiratory complications. Encourage the patient to actively exercise the
unaffected extremities.

6. Eliminate any factors that reduce the traction pull or alter its direction. Ropes and pulleys
should be in straight alignment and the ropes should be unobstructed. Traction is NOT
accomplished if the knot in the rope is touching the pulley or the foot of the bed. The
weights must be suspended and not in contact with the bed or resting on the floor. The
patient’s body should always be in alignment with the force of traction.

7. Check the extremities for color (pallor, cyanosis), numbness, edema, signs of infection,
and pain. Look for areas of skin breakdown or pressure sores on all skin surfaces.

8. Orthopedic patients confined in traction will need some sort of diversional activity to
relieve boredom and prevent depression. If your treatment facility has no occupational
therapy department, encourage family and friends to visit frequently and bring books or
games for the patient. Television and radio may also help to pass the time.

COMPLICATIONS OF SKELETAL TRACTION

• Infection. In skeletal traction, a metal pin is inserted into your bone. This pin acts as a
base for reducing the fracture. The insertion site can become infected, whether it is in
bone or soft tissue.
• Pressure sores. Pressure sores are also known as pressure ulcers or bedsores. They can
happen when you’re lying in the same position for an extended period of time. They often
form in areas where your bones are close to your skin.
• Nerve damage. There are different ways your nerves can be damaged when undergoing
skeletal traction. Pin insertion and wire arrangement are factors, but more research is
needed in the area.
• Misalignment of the bone or joint. Medical staff will make every effort to realign your
joints or broken bone correctly. Misalignment can happen in some cases.
• Stiff joints. Your joints can become stiff from traction. This is possibly due to reduced
blood flow.
• Wire malfunction. The wires that suspend your limb during skeletal traction can
sometimes malfunction or break.
• Deep vein thrombosis (DVT). DVT is when you develop a large blood clot in your deep
veins. It usually happens in your legs when you’re unable to move for a long period of
time.