Orthopaedic and Traumatology Department

Definition
Traction is the use of a pulling force to treat muscle and
skeleton disorders

Purposes
Pulling the limb into a straight position
Ends muscle spasm
Relieves pain

Skin Traction

Applied 5 cm distal from the # site

Adhesive and Non-Adhesive

Max. weight :
Adhesive: 15 lbs (6.7kg)
Non- Adhesive: 10 lbs (4.5kg)

Contraindications: skin disorder, Skin Injury

Skin Traction

Anteromedial and
posterolateral position for
adhesive tape

Protect heel with small soft

pillow for prevent pressure sore

Re evaluate in 2 weeks

Complication: allergic,
excoriation, pressure sores,
peroneal nerve palsy

Skeletal traction

When more pulling force is needed

Pin transfixing into the bone

K-Wire
Steinmann pins

Complication:
infection, incorrect placement, distraction of the #
site, ligamentous damage, Epiphyseal damage,
depressed scar.

Lateral surface of the

femur mid way
between the anterior
and posterior surface
of femur
1 inch below the most
prominent part of
greater trochanter

Predisposes to knee
stiffness 2-3 weeks
must be removed /
replaced by proximal tibia
traction
1st method:
Draw a horizontal line at the

level of upper pole patella

Draw a vertical line at the
anterior to the head fibula
Insert Steinmann pin where
the 2 lines intersect

2nd method:
1.25 inches (3 cm)

proximal to the
articulation between
lateral femoral condyle
and lateral tibial
plateau

inch (2 cm) behind

the crest and below
the tubercle of tibia

2 inches (5 cm) above

the level of ankle joint,
mid way between the
anterior and posterior
border of tibia

inch (2 cm) below

and behind lateral
malleolus
1.25 inches (3 cm)
below and behind
medial malleolus

Use general / local anesthesia

Local anesthesia the skin and periosteum on both

sides of the limb must be infiltrated

Shave the skin

Use full aseptic precautions (mask, cap, gown,
gloves, and drapes)
Paint the skin with povidone iodine
Drape skin towels under and around the limb
Ask an assistant to hold the limb in the same
degree of lateral rotation as the normal limb

Hold the pin horizontally and at right angle to the

long axis of the limb
Drive the pin from lateral to medial, through the
skin and bone with a gentle twisting motion of
the forearm, while keeping the flexed elbow
against the side of the body
Apply on each side a small cotton wool pad,
soaked in Tincture Benzoin, around the pin to
seal the wounds
Fit the Bhler stirrup
Apply guards over the ends of the pin

Head Halter

Conservative th/ of neck pain,

stable acute injury

Consists 2 pads, occiput and chin.

Weight never exceed 5 lbs

Crutchfield Tongs

Reduce a dislocation or fracture-dislocation of cervical spine,

maintain position after fusion, nerve root compression

Halo Ring

Direction of traction can be control

Allow patient out of bed

Complication:
pin track infection

Cotrel

Idiopathic scoliosis
Dynamic traction
Weight: less than 15 lbs

Dunlop

Supracondyler and transcondyler of

humerus in children, where distal
fragment is displaced posterolaterally

Abduct the shoulder about 45,

flexed the elbow 45, weight 0,5-1,0
kg

Complication :
ischemic contracture.

Olecranon

Supracondyler , shaft humerus

fracture

Olecranon pin traction

Complication :
compartment syndrome

Chinese finger trap

Reduction of Colles fracture or other distal forearm

injury

Pelvic Sling

Pelvic fracture with minimal displaced

Upper femoral Skeletal

traction

Acetabular fracture
displaced

Insertion screw to
greater trochanter to
neck femur

Buck Extention

Lower back, hip, femur, or knee

Skin traction

Risk: edema, vascular

obstruction, skin necrosis

Bryant (Gallows)

Shaft of the femur in the children,

up to 2 yo

Hip flexion 900, knee extention.

Vascular complication

Ninety-90 degrees

Subtrochanter and shaft middle

third of femur

Knee and hip flexed to 90 degrees,

weight 4,6-9,2 kg

Knee stiffness, hip flexion

contracture, injury of epiphyseal
plate, neurovascular damage

Hamilton Russel

Femoral shaft fracture, post hip

arthroplasty

Resultant of 2 forces pull in the

line of shaft femur

Adult Weight 3,6 kg, infant

0,28-1,8 th

Bohler-Braun

Tibia or femur fracture

Skin traction or skeletal traction

Weight 3,2-4,5 kg

Complication: lateral bowing

Thank You