TRACTION -force applied in a specific direction.

To apply the force needed to overcome the natural force or pull of the muscle groups, a system of ropes, pulleys and weights is used. Purposes of traction 1. 2. 3. 4. 5. 6. To reduce and immobilize a fracture To restore the normal length and alignment of an injured extremity. To lessen or eliminate spasm. To prevent deformity. To give the patient freedom for in bed activities. To reduce pain.

Types of traction Running traction 1. A form of traction in which the pull is exerted on one plane. 2. May use either skin or skeletal traction. 3. Bucks extension traction is an example of running skin traction. Balanced skeletal traction 1. Uses additional weights to counterbalance the traction and float the extremity in the traction apparatus. 2. The line of pull on the extremity remains fairly constant despite changes in the patients position. Application of traction Traction may be applied to the skin or skeletal system. Skin traction 1. Accompanied by applying a light force that pull on tape, sponge rubber, or special device (boot, cervical halter, pelvic belt0 that is in contact with the skin. 2. The pulling force is transmitted to the musculoskeletal structures. 3. Skin traction is used as a temporary measure in adults to control muscle spasms and pain. 4. It is used before surgery in the treatment of hip fracture (Bucks extension) and femoral shaft fractures (Russells traction). 5. Pelvic and cervical traction are used for treatment of back disorders or injuries. Skin traction may be used definitively to treat fractures in children.

Skeletal Traction 1. This term refers to traction applied by an orthopedic surgeon under aseptic conditions using wires, pins or tongs placed through bones. 2. Used most frequently in treating fractures of the femur, humerus (supracondylar fractures), tibia and cervical spine. Complications 1. Infection of pin tracts in skeletal traction. 2. Skin breakdown and dermatitis under skin traction. 3. Complications of immobility: a. Stasis pneumonia b. Thombophlebitis c. Pressure ulcers d. Urinary infection and calculi e. Constipation Nursing diagnosis 1. 2. 3. 4. Impaired physical mobility related to traction therapy and underlying pathology Risk for impaired skin integrity related to pressure on soft tissues Risk or infection related to bacterial invasion at the skeletal site Altered peripheral tissue perfusion related to injury or traction therapy

Nursing intervention Assess the following: 1. Pain, deformity, swelling, motor and sensory function and circulation status of the affected extremity. 2. Skin condition of the affected extremity under skin traction and around skeletal traction, as well as over bony prominences throughout the body. 3. Signs and symptoms of complications. 4. Traction equipment for safety and effectiveness: a. The patient is placed on a firm mattress. b. The ropes and the pulleys should be in alignment c. The pull should be in line with the long axis of the bone. d. Any factor that might reduce the pull or alter its direction must be eliminated. I. Weighs should hang freely. II. Ropes should be unobstructed and not in contact with the bed or equipment. III. Help the patient to pull himself up in bed at frequent intervals. e. The amount of weight applied in skin traction must not exceed the tolerances of the skin. The condition of the skin must be inspected frequently.

Cover the exposed sharp ends of the skeletal pins with cork or other covering to protect the patient and caregiver from injury, 5. The emotional reaction to condition and traction, as well as understanding of the treatment plan.

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TRACTION 1. SIDE ARM TRACTION -supracondylar fracture humerus Shoulder

2.90-90 LOWER EXTREMITY TRACTION -displaced femoral fracture

3. HALO PELVIC TRACTION -scoliosis

4. HALO FEMORAL TRACTION -severe scoliosis

5. BRYANT TRACTION -fracture of femur, injuries to the hip among children before 3 y/o; skin traction

6. HAMMOCK SUSPENSION TRACTION -pelvis region

7.BUCKS EXTENSION TRACTION -affection of femur and hip

8. BOOT TRACTION -ankle metatarsal fracture

9. DUNLOP TRACTION -supracondylar fracture humerus

10. HEAD HALTER TRACTION - cervical spine affection

11. PELVIC TRACTION -lumbar spine such as HNP, low back syndrome

12. HEAD HALTER/PELVIC GIRDLE -non-adhesive lumbar affection -severe cervical sprain, cervical strain, torticollis, mild cervical trauma, potts dse.