traction

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Traction

 

Definition

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

Purpose

Traction is usually applied to the arms and legs, the neck, the backbone, or the pelvis. It is used to treat fractures, dislocations, and long-duration muscle spasms, and to prevent or correct deformities. Traction can either be short-term, as at an accident scene, or long-term, when it is used in a hospital setting.
Traction serves several purposes:
  • it aligns the ends of a fracture by pulling the limb into a straight position
  • it ends muscle spasm
  • it relieves pain
  • it takes the pressure off the bone ends by relaxing the muscle
There are two main types of traction: skin traction and skeletal traction. Within these types, many specialized forms of traction have been developed to address problems in particular parts of the body. The application of traction is an exacting technique that requires training and experience, since incorrectly applied traction can cause harm.
Positioning the extremity so that the angle of pull brings the ends of the fracture together is essential. Elaborate methods of weights, counterweights, and pulleys have been developed to provide the appropriate force while keeping the bones aligned and preventing muscle spasm. The patient's age, weight, and medical condition are all taken into account when deciding on the type and degree of traction.

Precautions

People who are suffering from skin disorders or who are allergic to tape should not undergo skin traction, because the application of traction will aggravate their condition. Likewise, circulatory disorders or varicose veins can be aggravated by skin traction. People with an inflammation of the bone (osteomyelitis) should not undergo skeletal traction.

Description

Skin traction

Skin traction uses five-to seven-pound weights attached to the skin to indirectly apply the necessary pulling force on the bone. If traction is temporary, or if only a light or discontinuous force is needed, then skin traction is the preferred treatment. Because the procedure is not invasive, it is usually performed in a hospital bed.
Weights are attached either through adhesive or nonadhesive tape, or with straps, boots, or cuffs. Care must be taken to keep the straps or tape loose enough to prevent swelling and allow good circulation to the part of the limb beyond the spot where the traction is applied. The amount of weight that can be applied through skin traction is limited because excessive weight will irritate the skin and cause it to slough off.
Specialized forms of skin traction have been developed to address specific problems. Dunlop's traction is used on children with certain fractures of the upper arm, when the arm must be kept in a flexed position to prevent problems with the circulation and nerves around the elbow. Pelvic traction is applied to the lower spine, with a belt around the waist. Buck's skin traction is used to treat knee injuries other than fractures. The purpose of this traction is to stabilize the knee and reduce muscle spasm.

Skeletal traction

Skeletal traction is performed when more pulling force is needed than can be withstood by skin traction; or when the part of the body needing traction is positioned so that skin traction is impossible. Skeletal traction uses weights of 25-40 pounds.
Skeletal traction requires the placement of tongs, pins, or screws into the bone so that the weight is applied directly to the bone. This is an invasive procedure that is done in an operating room under general, regional, or local anesthesia.
Correct placement of the pins is essential to the success of the traction. The pin can be kept in place several months, and must be kept clean to prevent infection. Once the hardware is in place, pulleys and weights are attached to wires to provide the proper pull and alignment on the affected part.
Specialized forms of skeletal traction include cervical traction used for fractures of the neck vertebrae; overhead arm traction used for certain types of upper arm fractures; and tibia pin traction used for some fractures of the femur, hip, or pelvis.

Preparation

X rays are done prior to the application of both forms of traction, and may be repeated during treatment to assure that the affected parts are staying in alignment and healing properly. Since the insertion of the anchoring devices in skeletal traction is a surgical procedure, standard preoperative blood and urine testing are done, and the patient may meet with an anesthesiologist to discuss any health conditions that might affect the administration of anesthesia.

Aftercare

Aftercare for skin traction involves making sure the limb stays aligned, and caring for the skin so that it does not become sore and irritated. The patient should also be alert to any swelling or tingling in the limb that would suggest that the limb has been wrapped too tightly.
Aftercare for skeletal traction is more complex. The patient is likely to be immobile for an extended period. Deep breathing exercises are taught so that respiratory function is maintained during this time of little activity. Patients are also encouraged to do range-of-motion exercises with the unaffected parts of the body. The patient is taught how to use a trapeze
Traction refers to the usage of a pulling force and special devices, such as a cast or splint, to treat muscle and skeletal disorders. It is used to treat fractures, dislocations, and long-duration muscle spasms, and to prevent or correct deformities. The illustration above features several commonly used forms of traction.
Traction refers to the usage of a pulling force and special devices, such as a cast or splint, to treat muscle and skeletal disorders. It is used to treat fractures, dislocations, and long-duration muscle spasms, and to prevent or correct deformities. The illustration above features several commonly used forms of traction.
(Illustration by Electronic Illustrators Group.)
(an overhead support bar) to shift on and off a bedpan, since it is not possible to get up to use the toilet. In serious injuries, traction may be continued for several months until healing is complete.

Risks

The main risks associated with skin traction are that the traction will be applied incorrectly and cause harm, or that the skin will become irritated. There are more risks associated with skeletal traction. Bone inflammation may occur in response to the introduction of foreign material into the body. Infection can occur at the pin sites. If caught early, infection can be treated with antibiotics, but if severe, it may require removal of the pin.
Both types of traction have complications associated with long periods of immobility. These include the development of bed sores, reduced respiratory function, urinary problems, and circulatory problems. Occasionally, fractures fail to heal. Being confined to traction for a long period can take a an emotional toll on the patient, also.

Normal results

When correctly applied, traction generally produces very good, if slow, results.

Resources

Books

"Traction." In Everything You Need to Know About Medical Treatments. Springhouse, PA: Springhouse Corp., 1996.

traction

 [trak´shun]
the exertion of a pulling force, as that applied to a fractured bone or dislocated joint to maintain proper position and facilitate healing, or, in obstetrics, that along the axis of the pelvis to assist in delivery of a fetal part. It also may be used to overcome muscle spasms in musculoskeletal disorders such as herniated disk, to lessen or prevent contractures, and to correct or prevent a deformity.



Traction may be applied by means of a weight connected to a pulley mechanism over the patient's bed; this is known as weight traction. In elastic traction an elastic appliance exerts a pulling force upon the injured limb. In skeletal traction, a type for long-term heavyweight use, force is applied directly upon a bone by means of surgically installed pins and wires or tongs. Splints and reinforced garments, such as surgical corsets and collars, also may be employed to provide forms of traction. In skin traction, a temporary and lightweight type, moleskin or some other type of adhesive bandage is used to cover the affected limb, and traction is applied to the bandage.
Various types of traction and suspension.
Patient Care. Patients in prolonged traction must be protected from the hazards of immobility. The integrity of the skin must be maintained and pressure sores avoided. A trapeze bar over the bed may be prescribed to give patients greater freedom in moving themselves about in bed and help them feel more independent. Patients should be instructed to lift themselves straight up so as not to alter the position of the affected limb in traction.



The apparatus used for traction must be checked frequently to be sure the weights are hanging free and exerting the required amount of pull. The patient's body weight should counteract the pull of the weights, i.e., the feet should not be resting against the footboard nor should the body position interfere in any way with the tension on the ropes of the traction apparatus.

The physical therapist, nurse, and occupational therapist often work together to plan and implement a program of structured exercise for maintaining the patient's muscle tone and joint mobility. Muscle strengthening is another component of care for some patients in traction. Prevention of the hazards of immobility must be a high priority.

trac·tion

(trak'shŭn),
1. The act of drawing or pulling, as by an elastic or spring force.
2. A pulling or dragging force exerted on a limb in a distal direction.
[L. tractio, fr. traho, pp. tractus, to draw]

traction

/trac·tion/ (trak´shun) the act of drawing or pulling.
axis traction  traction along an axis, as of the pelvis in obstetrics.
elastic traction  traction by an elastic force or by means of an elastic appliance.
skeletal traction  traction applied directly upon long bones by means of pins, wires, etc.,
skin traction  traction on a body part maintained by an apparatus affixed by dressings to the body surface.

traction

(trăk′shən)
n.
Medicine A sustained pull applied mechanically especially to the arm, leg, or neck so as to correct fractured or dislocated bones, overcome muscle spasms, or relieve pressure.

trac′tion·al adj.

traction

[trak′shən]
Etymology: L, trahere, to draw
1 (in orthopedics) the process of putting a limb, bone, or group of muscles under tension by means of weights and pulleys to align or immobilize the part to reduce muscle spasm or relieve pressure on it. Kinds of traction include Bryant's traction, Buck's traction, Russell's traction, skeletal traction, skin traction,and split Russell traction. See also orthopedic traction.
2 the process of pulling a part of the body along, through, or out of its socket or cavity, such as axis traction with obstetric forceps in delivering an infant.

traction, 90-90

an orthopedic mechanism, used especially in pediatrics, that combines skeletal traction and suspension with a short-leg cast or a splint to immobilize and position the lower extremity in the treatment of a displaced fractured femur. This type of traction is usually unilateral with the opposite leg in Buck's traction or in split Russell traction for immobilization. The pin used in this kind of skeletal traction is inserted into bone in the knee area and attached to a riser running through a pulley on an overhead traction frame to a pulley and weight system fitted over the foot of the bed. The pulley and weight system at the foot of the bed also accommodates additional attachments to the short-leg cast or splint of the involved lower limb. Application of 90-90 traction may also incorporate a jacket restraint to help immobilize the patient. A variation of this type of traction is often used with adults in the treatment of low back pain.

traction/immobilization care

a nursing intervention from the Nursing Interventions Classification (NIC) defined as management of a patient who has traction and/or a stabilizing device to immobilize and stabilize a body part. See also Nursing Interventions Classification.

traction

Orthopedics The use of a pulling force to treat muscle and skeleton disorders and Fx steady pulling of a body part by manual or mechanical means; once applied, the force must remain constant until the fracture heals or sets Purpose Relieve pain, ↓ muscle spasms, align fracture ends; ↓ pressure on fracture ends. See Buck's traction, Cervical traction, Gallows traction, Hamilton Russell traction, Pelvic traction, Simple traction, Skeletal traction, Skin traction.

trac·tion

(trak'shŭn)
1. The act of drawing or pulling, as by an elastic or spring force.
2. A pulling or dragging force exerted on a limb in a distal direction.
[L. tractio, fr. traho, pp. tractus, to draw]

traction

The process of exerting a sustained pull on a part of the body, to achieve and maintain proper alignment of parts, as in the treatment of fractures. Spinal traction is used to reduce the tendency for soft tissue to be squeezed out of INTERVERTEBRAL DISCS.

traction (trakˑ·shn),

n therapeutic technique that stretches the soft tissues of joints and limbs by gentle pulling.

trac·tion

(trak'shŭn)
Act of drawing or pulling, as by an elastic or spring force.
[L. tractio, fr. traho, pp. tractus, to draw]

traction,

n the act of drawing (pulling).
traction, external,
n a fracture reduction appliance principally used in the management of midfacial fractures. Points of fixation are located in the oral cavity and over the cranial area, and elastic or rigid connectors are placed between the cranial and oral points of fixation.
traction, intermaxillary,
n See traction, maxillomandibular.
traction, internal,
n a pulling force created by using one of the cranial bones above the point of fracture for anchorage.
traction, maxillomandibular (intermaxillary traction),
n the technique for reducing fractures of the maxilla or mandible into functional relations with the opposing dental arch through the use of elastic or wire ligatures and interdental wiring or splints.

traction

the exertion of a pulling force, as that applied to a fractured bone or dislocated joint to maintain proper position and facilitate healing, or, in obstetrics, that along the axis of the pelvis to assist in delivery of a fetal part.

traction hook
traction splint
see Schroeder-Thomas splint.
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Spicer 37R and 43R axles are available with Posi-Torq(TM) and Hydraloc(TM) differential designs that provide excellent torque bias performance in a wide range of ground traction conditions.