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
help reduce the pain of a fracture before surgery
treat bone deformities caused by certain conditions, such
as scoliosis
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 added with 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 available.
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