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Tractions

Abegail de Jesus

Traction
Traction means that a pulling force is applied to a part
of the body or an extremity while a countertraction pulls in the opposite direction to prevent patient from being pulled out of the bed

Principles of Traction
Patient must be placed in correct body alignment in center of
bed to maintain line of pull

Traction is maintained continuously, unless the physician


prescribes otherwise

Countertraction is maintained continuously All ropes must move freely on the pulley at all times Rope knots should never touch the pulley Ropes should be kept clear of bed linens andany other objects

Weights must hang freely at all times


Skeletal traction must never be released

Classification Of Tractions
the patient must maintain his or her position in order to maintain the pull of the traction.

POSTIONS USED- FLAT, TILTED AWAY, ELEVATING


HEAD OR KNEE
allows the patient to change position in bed while still accurately maintaining the traction pull.

DEVICES USED-SLINGS, HAMMOCKS, SPLINTS

Types of Tractions

Skin Traction
Skin traction is applied directly to the patients skin through the use of a traction boot, a traction strip, halters, or belts USE:

-control muscle spasm


-to temporarily immobilize an injured extremity

Bucks Traction
used to immobilize the lower extremities,
usually due to a hip and knee fracture

Russells Traction
Russells traction allows for the knee to be flexed and
suspended in a sling.

This type of traction is most often used to immobilize a


fractured tibia

Russells Traction

Cervical Head Halter


Simple type cervical
traction

Management of neck
pain

Weight should not


exceed 5 lbs initially

Can only be used a


few hours at a time

Complications
Skin break down Nerve pressure Circulatory impairment
Nursing Management: Skin Break Down -Monitor the reaction of the skin. -Assist patient in personal hygiene procedures. -Palpate the area of traction tapes daily.. -Inspect skin specially pressure points. -Change the position of the patient frequently.

Nerve Pressure -Check sensation & movement . Immediately investigate any complaint of the patient. Report altered sensation or motor function. CIRCULATORY IMPAIRMENT

Assess the circulation of foot or hand. Check for-Peripheral pulses -Color & capillary refill & temperature. -Indicators of deep vein thrombosis. -Encourages the patient to perform active foot exercises.

MANUAL TRACTION
It is applied with hands to temporarily immobilize an
injured part. A firm smooth steady pull is maintained

It is also used to apply the necessary pull to an


extremity when cast is applied, reduction of a fracture or dislocated joint

Skeletal Traction
*It is applied directly to the bone by use of a metal pin or wire that is inserted through the bone distal to the fracture to achieve alignment

USES
*Fractures of femur, cervical spine. *Displaced fractures of pelvis & proximal end of tibia, calcaneus, proximal ulna

15 to 25 pounds this amount of weight is required to


overcome muscle spasms and maintain bone alignment

Devices Used

Steinman Holder

Kirschner Wire Tractor

Crutchfield Tong

Balanced Suspenion
Enables elevation of limb to correct angular malalignment Counterweighted support system Four suspension points allow angular and rotational control

Complication
Infection:
predisposing factor -Poor insertion technique -Loosening of the pin -Tension of the skin and subcutaneous tissues leading to necrosis

Nerve damage: can result from the use of heavy


traction forces

Breaking of the pins or wire

Nursing Management
Providing Pin Site Care

Use aseptic technique while dressing. Check the insertion site. Check for complications. Avoid infection& development of osteomyelitis
Promote Exercise Encourage movement of unaffected part. Explain range of motion exercises. Provide conducive environment to the patient.

Other Tractions
Bryants Traction
Bryants traction is used for developmental dislocated hip(s) (DDH). In Bryants traction, the child's body and the weights are used as tension to keep the end of the femur (the large bone that goes from the knee to the hip) in the hip socket. Traction will help position the top of the femur into the hip socket correctly

90-90 Traction

The thigh is suspended in the vertical plane by weight traction pulling vertically upwards The ill effect of gravity as the cause of backward angulation of the fragments is thus eliminated

Halo Traction

*Provides stabilization and support for fractured cervical vertebrae. The surgeon insert spins into the skull.

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