TRACTION

Presented to: PRESENTED BY:

Mrs. Sherin Sussan Thomas RADHIKA KUMARI SAH
Asst. prof. Medical surgical nursing
SJCON M.SC. 1ST YEAR
SJCON
 DEFINITION
• TRACTION IS THE APPLICATION OF A PULLING FORCE TO A
PART OF THE BODY.

• TRACTION IS A FORCE APPLIED MANUALLY OR

MECHANICALLY GENERATED BY WEIGHS OR FORCE ,
USED TO REDUCE FRACTURES/DISLOCATIONS OR TO
ACHIEVE RELATIVE IMMOBILIZATION.
 PRINCIPLES
• TRACTION MUST CONTINUOUS TO BE EFFECTIVE IN
REDUCING AND IMMOBILIZING FRACTURE.
• SKELETAL TRACTION IS NEVER INTERRUPTED.
• WEIGHTS ARE NOT REMOVED UNLESS INTERMITTENT
TREACTION IS PRESCRIBED.
• ANY FACTOR THAT MIGHT REDUCE THE EFFECTIVE PULL
OR ALTER ITS RESULATANT LINE OF PULL MUST BE
ELIMINATED.
• THE PATIENT MUST BE IN GOOD BODY ALIGNMENT IN THE
CENTER OF THE BED WHEN TRACTION IS APPLIED.
• ROPE MUST BE UNOBSTRUCTED.
• WEIGHTS MUST HAVE FREELY AND NOT REST ON THE BED
OR FLOOR.
• KNOTS IN THE ROPE OR THE FOOT PLATE MUST NOT
TOUCH THE PULLEY OR THE FOOT OF THE BED.
 PURPOSE
• TO REGAIN THE NORMAL LENGTH AND ALIGNMENT OF
INVOLVED BONE.
• TO REDUCE AND IMMBOLIZE A FRACTURE BONE.
• TO RELIEVE OR ELIMINATE MUSCLE SPASM.
• TO RELIEVE PRESSURE ON NERVES.
• TO PREVENT OR REDUCE SKELETAL DEFORMITIES OR
MUSCLE CONTRACTURES.
 Types

Skin Skeletal
traction traction
 SKIN TRACTION

• SKIN TRACTION INVOLES THE APPLICATION OF A PULLING

FORCE DIRECTLY TO THE SKIN THROUGH THE USE OF
SKIN STRIPS, BOOTS, OR FOAM SPLINTS.
 TYPES
1. BUCK’S EXTENSION SKIN TRACTION: A FOAM BOOT IS
APPLIED TO THE CLIENT’S AFFECTED EXTREMITY AND
ATTACHED TO A WEIGHT THAT IS SUSPENDED OFF THE FLOOR
OF THE BED.
USED FOR THE CLIENT WITH A HIP FRACTURE WHO IS
UNABLE TO UNDERGO SURGICAL REPAIR UNTIL
DETERMINED TO BE MEDICALLY SATBLE.
2. DUNLOP’S TRACTION: USED IN THE UPPER LIMBS AND IS
INDICATED FOR SUPRACONDYLAR FRACTURES, INNER
CONDYLAR FRACTURES OF HUMERUS WHERE ELBOW
FLEXION CAUSES CIRCULATORY EMBARRASSMENT.
3. GALLOW’S TRACTION OR BRAYNT’S TRACTION: USED
FOR FRACTURE SHAFT FEMUR IN CHILDREN LESS THAN 2
YEARS .
IF USED IN CHILDREN ABOVE 2 YEARS IT CAUSE VASCULAR
COMPLICATIONS.
4) PELVIC TRACTION:
SPECIAL CANVAS HARNESS IS
BUCKLED AROUND THE PATIENT’S
PELVIS.
LONG CORDS ATTACH THE HARNESS
TO THE FOOT OF THE BED.
FOOT END OF THE BED RAISED
PROVIDES SLIDING TRACTION.
USED IN CONSERVATIVE
MANAGEMENT OF IVDP. TO ENSURE
THAT PATIENT LIES QUIETLY IN BED
RATHER THAN TO DISTINCT THE
VERTEBRAL BODIES.
 MECAHNISM OF SKIN TRACTION.

• TRACTION FORCE IS APPLIED OVER A LARGE AREA LOAD IS

SPREAD AND IS MORE COMFORTABLE AND EFFICIENT.
• FORCE IS APPLIED IS TRANSMITTED FROM SKIN TO THE BONES
VIA THE SUPERFICIAL FASCIA AND INETERAMUSCULAR SEPTA.
• FOR BETTER EFFICIENCY , THE TRACTION FORCE IS APPLIED
ONLY TO THE LIMBS DISTAL TO THE FRACTURE.
 CONTRAINDICATION

• ABRASION
• LACERATIONS
• IMPAIRED CIRCULATION
• DERMATITIS
• SKELETAL TRACTION INVOLVES PASSING A METAL PIN OR WIRE
(KIRSCHNER WIRE, STEINMAN’S PIN) THROUGH THE BONE (E.G.
PROXIMAL TIBIA OR DISTAL FEMUR) UNDER LOCAL ANESTHESIA,
AVOIDING NERVES, BLOOD VESSELS, MUSCLES, TENDON AND
JOINTS.
• USES PIN TO APPLY FORCE TO THE BONE.
• IS USED WHEN CONTINUOUS TRACTION IS DESIRED TO IMMOBILIZE
POSITION, AND ALIGN A FRACTURE OF THE FEMUR, TIBIA AND
CERVICAL SPINE.
• IT IS USED WHEN SKIN TRACTION IS NOT POSSIBLE, GREATER
WEIGHT (11 TO 18 KNG) (25 TO 40 LB) IS NEEDED TO ACHIEVE THE
THERAPEUTIC EFFECT.
SITES
 APPLICATION

• USE GA OR LA.
• PAINT THE SKIN WITH IODINE AND SPIRIT.
• MOUNT THE PIN/WIRE ON THE HAND DRILL.
• HOLD THE LIMB IN SAME DEGREE OF LATERAL ROTATION.
• IDENTIFY THE SITE OF INSERTION AND MAKE A SWAB
WOUND.
• HOLD THE PIN HORIZONTALLY AT RIGHT ANGLES TO THE LONG
AXIS OF LIMBS.
• APPLY SMALL COTTON WOOLEN PADS SOAKED IN TINCTURE
AROUND THE PINS TO SEAL THE WOUND.
• THE PIN SHOULD PASS ONLY THOROUGH SKIN SUBCUTANEOUS
TISSUE AND BONE AVOIDING MUSCLES AND TENDONS.
 COMPLICATION
• AT THE TIME OF APPLICATION
ANESTHETIC PROBLEMS
VASOVAGAL SHOCK
VERY RARELY DEATH DUE TO VASOVAGAL SHOCK
• DURING APPLICATION
INJURY TO THE NERVES
INJURY TO THE EPIPHYSIS
PAIN
• WHEN PIN IS INSITU
INFECTION
MIGRATION
BREAKAGE
LOOSENING
DISTRACTION OF FRACTURE FRAGMENTS
• LATE EFFECTS
PIN TRACT INFECTION
CHRONIC OSTEOMYELITIS WITH RING SEQUESTRA AT THE SITE
DEPRESSED SCAR
 NURSING DIAGNOSIS

• ACUTE PAIN RELATED TO MUSCULOSKELETAL DISORDER AS

EVIDENCED BY FACING GRIMACING DISTRACTING BEHAVIOURS.
• DEFICIENT KNOWLEDGE RELATED TO THE TREATMENT
REGIMENAS EVIDENCED BY FREQUENT QUESTIONING.
• ANXIETY RELATED TO HEALTH STATUS AND THE TRACTION
DEVICE.
• SELF CARE DEFICIT:FEEDING, BATHING HYGIENE AND/OR
TOILETING RELATED TO TRACTION AS EVIDENCED BY
DEPENDENT ON OTHER.
• IMPAIRED PHYSICAL ACTIVITY MOBILITY RELATED TO
MUSCULOSKELETAL DISORDER AND TRACTION AS EVIDENCED
BY RESTRICTED MOVEMENTS.
• IMPAIRED SKIN INTEGRITY RELATED TO TRACTION.