Traction is an important orthopaedic therapeutic technique used to align fractured bones, reduce dislocations, relieve muscle spasm, and correct deformities. It involves the application of a controlled pulling force to a part of the body, while a counterforce is applied to maintain balance and alignment. Nurses play a crucial role in the application, maintenance, observation, and care of patients undergoing traction.
Understanding the various methods and classifications of traction is essential to ensure safe and effective patient management.
Methods of Applying Traction
Methods of Applying Traction
Traction may be applied using different methods, depending on the clinical condition, purpose, and duration of treatment.
1. Manual Traction
Manual traction is applied by pulling on the affected body part using the hands. It is usually applied for a short duration and under close supervision.
Uses:
- Reduction of fractures
- Correction of joint dislocations
- Emergency management of musculoskeletal injuries
- Relieving muscle spasm temporarily
Manual traction is commonly performed by trained healthcare professionals and is often used as an immediate or preliminary intervention.
2. Mechanical Traction
Mechanical traction uses equipment such as weights, pulleys, ropes, splints, halters, and bandages to apply a continuous and controlled pulling force.
Mechanical traction may be applied as:
- Skin traction
- Skeletal traction
This method allows for prolonged traction and precise control of the force applied.
3. Plaster Traction
Plaster traction is achieved using plaster casts designed to apply traction, such as:
- Turnbuckle casts
- Hyperextension casts
In some cases, skeletal traction may be incorporated by fixing the ends of Kirschner wires or Steinmann pins within a plaster cast. This method provides stability and sustained traction, particularly in spinal and lower limb conditions.
4. Brace-Assisted Traction
Traction may also be applied using special orthopaedic braces, such as hyperextension braces. These braces help maintain spinal alignment and relieve pressure on vertebral structures while allowing limited mobility.
5. Straight or Running Traction
In straight (running) traction, the pulling force is applied in a straight line, with the patient usually lying flat on the bed.
Examples:
- Buck’s extension traction
- Pelvic traction
This type of traction is commonly used to immobilise and align fractures of the lower limb or pelvis.
6. Balanced Suspension Traction
Balanced suspension traction supports the affected limb off the bed using pulleys and weights, allowing limited patient movement without disrupting the line of pull.
Advantages:
- Maintains consistent traction
- Allows patient mobility and comfort
- Reduces pressure on the skin and tissues
Classification of Traction
Traction is broadly classified based on the method of application:
A. Skin Traction
Skin traction involves the application of a pulling force to the skin and underlying soft tissues using adhesive plaster, foam straps, or bandages. The patient’s body weight often acts as the counter-traction.
Features:
- Less invasive
- Used for short-term treatment
- Limited weight can be applied
Examples:
- Buck’s traction
- Russell’s traction
B. Skeletal Traction
Skeletal traction applies the pulling force directly to the bone using metal pins or wires, such as:
Steinmann pins
Kirschner wires
This method allows for greater traction force and is used for long-term treatment of fractures.
Types of Skin and Skeletal Traction
Both skin and skeletal traction can be further classified as:
1. Fixed Traction
- The pulling force is applied between two fixed points
- Commonly used in immobilisation
2. Balanced Traction
- Metal weights provide the traction force
- The patient’s body weight acts as the counter-traction
- Allows movement without loss of alignment
Nursing Responsibilities in Traction Care
- Ensure proper alignment and continuous traction
- Check weights and pulleys regularly
- Assess circulation, sensation, and movement distal to the traction
- Maintain skin integrity and pin site care
- Monitor for complications such as infection, nerve damage, or pressure sores
- Provide patient education and psychological support
Traction remains a vital orthopaedic intervention in the management of fractures, dislocations, and spinal conditions. A thorough understanding of the various methods and classifications of traction enables nurses to provide safe, effective, and patient-centred care.
Proper application, vigilant monitoring, and prompt recognition of complications are essential to achieve optimal outcomes and ensure patient comfort and recovery.