TRACTION IN

ORTHOPAEDIC
WHAT IS TRACTION ?
Traction - the application of
a force to stretch certain
parts of the body in a
specific direction
Purpose of traction

To regain normal length and alignment of involved bone

Controls pain.
Reduces fracture.
Maintain reduction.
Prevents & corrects deformity.
Disadvantages

Costly in terms of hospital stay

Hazards of prolonged bed rest
DVT/Thromboembolism Pneumonia
Requires continuous nursing care
Can develop contractures
Types(based on method)

Manual traction
Skin traction
The traction force applied over a large area of
skin.
Adhesive and Non-adhesive skin tractions.

Skeletal traction
Applied directly to the bone either by a pin or
wire through the bone. (eg- Steinmann pin,
denham pin, kirschner wire)
Types(based on mechanism)

Fixed traction
by applying force against a fixed
point of body.
Ex: fixed traction by Thomas splint.

Sliding traction
by tilting bed so that patient tends to
slide in opposite direction to traction
force.
When the weight of all or part of the
body, acting under the influence of
gravity, is utilized to provide counter-
traction.
SKIN TRACTION

The traction force is applied over a large area, this spreads the load
and is more comfortable and efficient.

Force applied is transmitted from skin to the bones via superficial

fascia, deep fascia and intramuscular septa

the traction force is applied only to the limb distal to the fracture
SKIN TRACTION

Adhesive skin traction

Maximum weight 6.7 kg

Non-adhesive skin traction

Maximum weight should not exceed 4.5 kg
Used in thin and atrophic skin, skin sensitive to adhesive
strapping.
SKIN TRACTION

Indications
Temporary management of neck of femur fracture.
Femoral shaft fracture in children.
Un displaced fracture of acetabulum.
After reduction of dislocation of Hip.
To correct minor fixed flexion deformities of hip and knee.
SKIN TRACTION

Contraindications
Abrasions and lacerations of skin in the area to which traction is to
be applied
Varicose veins, impending gangrene
Dermatitis
When there is marked shortening of the bony fragments as the
traction weight required is greater than which can be applied
through the skin
SKIN TRACTION

Complications
Allergic reactions from the adhesive material
Blister formation and pressure sores from slipping straps
Compartment syndrome from over-tight wrap
Peroneal nerve palsy from wraps about the knee
SKELETAL TRACTION

pin or wire
more frequently used in lower limb fractures
Should be reserved for those cases in which skin traction is
insufficient.
Generally used when more weight is needed to give traction.
To treat fractures conservatively.
SKELETAL TRACTION

Complications
Introduction of infection into bone.
Distraction at fracture site.
Ligamentous damage.
Damage to epiphyseal growth plates.
Depressed scars.
 CERVICAL TRACTIONS
SKINTRACTION - Head Halter traction

SKELETALTRACTION- Crutchfield tongs

Cone or Barton tongs

Head Halter traction

Simple type cervical
traction Management of
neck pain Weight should
not exceed 3 kg initially
Can only be used a few
hours at a time Head end
should be elevated to give
counter traction

Crutchfield tongs Cone