Traction is a directional pull on the trunk or on an extremity. Its applications include immobilization and reduction of fractures, correction of deformities, and elevation of extremities for the management of soft tissue injuries and burns.
Traction is accomplished by attaching immobilizing devices either to the skin or to the skeleton. Depending upon this the traction is called skin traction and skeletal traction.
Skin traction is used in the treatment of conditions for which only a small amount of pull is required. It is often used for
- Immobilization of extremities after internal fixation of fractures
- For relief of muscle spasm in low back pain
- For immobilization of septic joints.
Elderly patients are not good candidates for skin attachment, because their skin is fragile and their circulation may already be impaired. Traction with skin attachment is mostly applied to the lower extremity, although it is occasionally indicated for traction to an upper extremity.
There are two kinds of skin tractions
Adhesive skin traction has been discontinued because the adhesive material used causes many complications.The maximum weight that can be attached with skin traction is 15lb or 6.5 kgs but should be individualized
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 requires pins, screws, or wires to be driven into the bone which allows to put traction directly on skeleton. Skelteal traction is used in cases where heavier traction is required 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 . The pins must be clean to avoid infection. Damage may result if the alignment and weights are not carefully calibrated.
Skeletal traction is most commonly employed in lower limbs and is rarely employed for upper limb problems.