TRACTION

WHAT IS TRACTION?
Traction refers to the practice of slowly
and gently pulling on a fractured or
dislocated body part. Its 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

helpreduce the pain of a fracturebefore surgery

treat bone deformities caused by certain
conditions, such asscoliosis

correct stiff and constricted muscles, joints,

tendons, or skin

stretch the neck and prevent painful muscle

spasms

WHAT ARE THE DIFFERENT 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 its a preparation for a more definitive procedure or the only
surgery thatll be done to allow the bone to heal.

Skeletal traction is most commonly used to treat fractures of the femur,

or thighbone. Its 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 addedwith 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, its usually used as a temporary
way to stabilize a broken bone until the definitive surgery is
performed.

PROCEDURE
ON HOW TO
APPLY
TRACTION

1. Check the order. The order will state the type of

traction to be used, the weight to be applied, and the
allowances for restriction on the activity of the client.
2. Assess the client for possible complication of
traction. It is essential to make a careful assessment of
the client initially, and at regular interval thereafter.
The assessment should include all systems with special
emphasis on circulation, motor function, and sensation
in any extremity affected. If circulation for example is
less than adequate, special padding over bony
prominences may have to be added to prevent skin
breakdown.
3. Wash your hands.
4. Ensure that an assistance you might need will be

5. Gather the equipment you need. Skin traction

will make use of several of the following:
solutions, tapes, boots, bandages, harness,
ropes, pulleys, weights, padding, trapeze,
spread bars, footrests and footboards.

6. Identify the client.

7. Explain the procedure. Find out what the physician has told
the client and explain the purpose of the traction, whether
weights are to be used intermittently or continuously and how
much the client will be allowed to turn or move. Some client in
traction cannot move as much as those in intermittent skin
traction.
8. Provide for privacy and drape the client as appropriate.
9. Place the bed in proper position.
10. Cleanse and prepare the skin according to the procedure of
the facility. If tape is to applied the skin is often shaved
beforehand so that pain when tape is being removed will be
lessened. Tincture of benzoin solution maybe applied to protect
the skin before any type of skin traction is initiated.

11. To secure the traction, apply the type, boots, slings, or

halters, appropriate to the specific procedure. Make sure all
appliances are the right size for the particular client.
12. Thread and not ropes through lubricated pulleys. Check that
both are aligned properly for the traction you are carrying out.
13. Using the hooks provided, attach the ropes to the clients
appliance. Check for the security of the tapes, boot, or wrappings
by gently tugging on the attached rope.
14. If more than one weight is to be applied, add one at a time
with a gentle motion.
15. Tape the end of the rope.
16. Carefully check that all appliances are functioning effectively.
17. Place the Call signal, all personal possessions, and items
needed for self care with easy reach.

18. Evaluate the following:

a. Is the client comfortable?
b. Are all ropes, pulleys, and weights correctly placed and
unobstructed.
c. Are the skeletal pin sites free of inflammation or infection.
d. Does the client show any signs of complication of
immobility especially skin breakdown?
19. Make any necessary adjustments. You may need to add
paddings to bony prominences. Take care not to exert any
additional pressure when adding padding. Ropes and pulleys
may also need some adjustments.
20. Wash your hands for infection control.
21. Chart the type of traction applied, any observation or
concerns, and the clients tolerance of the procedure.

SPLINTING

WHAT IS A SPLINT?
A splint is a piece of medical equipment used to
keep an injured body part from moving and to
protect it from any further damage.

A splint is often used to stabilize a broken bone

while the injured person is taken to the hospital for
more advanced treatment. It can also be used if
you have a severe strain or sprain in one of your
limbs. Placed properly, a splint will help ease the
pain of an injury by making sure that the wounded
area does not move.

INDICATIONS FOR SPLINTING

Acute arthritis, including acute gout
Severe contusions and abrasions
Skin lacerations that cross joints
Tendon lacerations
Tenosynovitis
Puncture wounds/bites to the hands, feet, and joints
Fractures and sprains
Reduced joint dislocations

SPLINTING EQUIPMENT
Stockinette
Splinting material
Plaster
Strips or rolls (2-, 3-, 4- or 6-inch widths)

Prefabricated Splint Rolls

Plaster
Fiberglass with polypropylene padding (at CMH)

Padding (Webril)
Ace Wrap
Bucket/receptacle of warm water
Trauma sheers

GENERAL SPLINTING PROCEDURE

1)

Stockinette is applied

2)

Webril is applied

3)

The wet plaster is positioned

4)

Elastic bandage is applied

5)

The plaster is molded

GENERAL SPLINTING PROCEDURE

Measure and prepare the plaster
Apply the stockinette so that it extends 2 or 3 inches beyond the
plaster

Apply 2 or 3 layers of Webril over the area to be splinted

Be generous
Avoid wrinkles
Place extra padding around bony prominences
Place Webril between digits that are going to be splinted to avoid
maceration

Wet the plaster and place it over the area to be splinted

Submerge the premeasured plaster in unused warm water

Remove the splint from the water and squeeze out the excess water and
remove wrinkles

Fold the ends of stockinette over the the plaster to smooth the
edges of the splint

GENERAL SPLINTING PROCEDURE

(CONTD)
Place a layer of Webril over the plaster
Apply the ace wrap around the splint to secure it in place
Unwrap the bandage without placing too much tension around the extremity

While still wet, mold the plaster to conform to the shape of the
extremity
Use the palms of your hand rather than the fingers

Place the patients extremity in the position desired

Keep the patient still until the splint has dried and hardened(the plaster will

become warm as its drying)

Fast-drying: 5-8 minutes
Extra-fast drying: 2-4 minutes

After the splint has dried, check the splinted extremity for function,
arterial pulse, capillary refill, temperature of skin, and sensation