Traction (orthopedics)

Early Greek traction device, from a Byzantine edition of Galen's work in the 2nd century AD.

In orthopedic medicine, traction refers to the set of mechanisms for straightening broken
bones or relieving pressure on the spine and skeletal system. There are two types of traction: skin
traction and skeletal traction.

It is largely replaced now by more modern techniques, but certain approaches are still used
today:

• Bryant's traction
• Buck's traction - hip fractures
• Dunlop's traction - humeral fractures in children
• Russell's traction
• Milwaukee brace

Skeletal traction
Although the use of traction has decreased over the years, an increasing number of orthopaedic
practitioners are using traction in conjunction with bracing (see Milwaukee brace). The section
below provides some details on traction and its use.

Bryant's Traction
Bryant's traction is mainly used in young children who have fractures of the femur or congenital
abnormalities of the hip.[1] Both the patient's limbs are suspended in the air vertically at a ninety
degree angle from the hips and knees slightly flexed. Over a period of days, the legs hips are
gradually moved outward from the body using a pulley system. The patient's body provides the
countertraction.
Purpose
The purpose of traction is to:

• To regain normal length and alignment of involved bone.

• To reduce and immobilize a fractured bone.
• To lessen or eliminate muscle spasms.
• To relieve pressure on nerves, especially spinal.
• To prevent or reduce skeletal deformities or muscle contractures.

In most cases traction is only one part of the treatment plan of a patient needing such therapy.
The physician’s order will contain:

• Type of traction
• Amount of weight to be applied
• Frequency of neurovascular checks if more frequent than every four (4) hours.
• Site care of inserted pins, wires, or tongs
• The site and care of straps, harnesses and halters
• The inclusion of any other physical restraints / straps or appliances (eg. mouth guard)
• the discontinuation of traction

Responsibility of initial application

The physician is typically responsible for initial application of traction and weights while the
adjustment or removal (to perform ablution functions / physiotherapy) of skeletal traction
weights will be based on the doctors charted plan.

In most cases cervical traction may be adjusted or temporarily removed, per physician order, by
an orthopedic nurse who has documented competency to do so.

The alignment and moving of the patient will only be changed on physician's directive and the
affected extremity will need to be maintained in proper alignment at all times with the ropes and
traction straps - making sure the mentioned is unobstructed and weights hanging freely.

If it is necessary to move the patient while skeletal traction is in place, the patient should be
moved in the bed with weights hanging freely.

In most cases traction will be applied for a number of weeks to months and Neurovascular
checks will need to be performed by a nurse as ordered by the physician or as dictated per
traction unit policy.

Traction is an appropriate treatment for a number of medical problems including spinal

deformities such as scoliosis.

Evidence basis
There is no high-quality scientific evidence that supports or refutes the use of either intermittent
or continuous traction for chronic neck pain.[2]

See also
• Spinal decompression

References
1. ^ "Traction Guidelines". http://www.kaleidoscope.org.au/docs/GL/Traction_Kal.pdf.
Retrieved 2007-07-01.
2. ^ Graham N, Gross A, Goldsmith CH et al. (2008). "Mechanical traction for neck pain
with or without radiculopathy". Cochrane Database Syst Rev (3): CD006408.
doi:10.1002/14651858.CD006408.pub2. PMID 18646151.

External links
• About
• Byrne T (1999). "The setup and care of a patient in Buck's traction.". Orthop Nurs 18 (2):
79–83. PMID 10410051.
• "Split Russell's / Buck Traction"
• synd/2984 at Who Named It? - Bryant's traction