Traction,Type of traction, Methods of applying traction Name and uses of tractions

Traction is used for:

(i) reduction of fractures and dislocations, and their maintenance; 

(ii) for immobilising a painful, inflamed joint; 

(iii) for the prevention of deformity, by counteracting the muscle spasms associated with painful joint conditions; and 

(iv) for the correction of soft tissue contractures by stretching them out.

TYPES OF TRACTION

For effectiveness of any traction, a counter-traction is necessary. Depending upon what acts as counter traction, a traction can be fixed or sliding.

➤Stable and fix traction: In this type, counter-traction is supplied by a part of the body e.g., in Thomas splint fixed traction, the ring of the splint comes to lie against the ischial tuberosity and provides counter-traction 

➤Sliding traction: In this type, the weight of the body acts as counter-traction; e.g., traction given for a pelvic fracture, where the weight of the body acts as counter-traction; made effective by elevating the foot-end of the bed 

More Tractions Multiple Choice Questions Orthopaedic MCQ  ➤  click here..

METHODS OF APPLYING TRACTION

There are two methods of applying traction - skin and skeletal (Fig-4.4).

➽ Skin traction: An adhesive strap is applied on the skin and traction applied. The traction force is pass on from the skin across the deep fascia and intermuscular septae to the bone.

These days, readymade foam traction kits are available for this purpose.

➽Skeletal traction:  Traction is put directly on the bone by inserting a K-wire or Steinmann pin across the bone.

Some of the differentiating features of skin and skeletal traction is given below

Common traction systems used

➲ Traction systems and their uses

Name                             Use      

Gallows traction       ➨    Fracture shaft of the femur in children below 2 years

Bryant's traction      ➨    Fracture shaft of the femur in children below 2 years

Russell's traction     ➨   Trochanteric fractures

Buck's traction        ➨   Conventional skin traction 

Perkin's traction     ➨    Fracture shaft of femur in adults

90-90 traction          ➨    Fracture shaft of femur in children

Agnes-Hunt traction    ➨    Correction of hip deformity

Well-leg traction      ➨   Correction of adduction or abduction deformity of hip

Dunlop traction       ➨   Supracondylar fracture of humerus

Smith's traction       ➨   Supracondylar fracture of humerus

Calcaneal traction   ➨   Open fractures of ankle or leg

Metacarpal traction    ➨   Open forearm fractures

Head-halter traction   ➨   Cervical spine injuries

Crutchfield traction    ➨   Cervical spine injuries

Halo-pelvic traction    ➨   Scoliosis

DAILY CARE OF A PATIENT IN TRACTION

A patient ⥋in traction can develop serious complications and needs the following care:

a) The traction should be as comfortable as possible.

b) Proper functioning of the traction unit must be ensured. Traction weights should not be touching the ground. See that the ropes are in the grooves of the pulleys. The foot of the patient or the end of the traction device should not be touching the pulley, as it makes traction ineffective.

c) One must see that terminal part of the limb in traction (hand or foot) is warm and of normal colour. Sensations over toes and fingers should be normal. Any numbness or tingling may point to a traction palsy of a nerve.

d) Any swelling over the fingers or toes may point to a tight bandage or slipped skin traction.

e) A pin tract infection in skeletal traction can be detected early by eliciting pain on gentle tapping at the site of the pin insertion.

f) The proper position of the fracture should be ensured by taking check X-rays in traction.

g) Physiotherapy of the limb in traction should be continued to minimise muscle wasting.

h) A watch must be kept on general compli cations of recumbency, i.e., bed sores, chest congestion, UTI, constipation etc.

Diversion therapy is important for any patient confined to bed for a long period of time. This may be done by suggesting the patient to do things he likes - such as reading, craft, games, watching television, net surfing, etc.