Introduction Definition Purpose Indications Classification Methods of applying traction Complication Principles General Nursing care Special Nursing care

1. BY:- JISS MARY JAMES
[NURSING TUTOR]

2. INTRODUCTION
• Therapeutic traction is accomplished by exerting the pull in two directions, the pull of
the traction and the pull of the counter traction.
• The traction force commonly consists of weights.
• Counter traction is the force pulling in the opposite direction. This is used to balance
the force of pulling.
• The counter traction force may be either:
- The weight of the patient’s body (as it rests on and tends to slide down, an inclined
surface such as fitted bed)
- Other weights, when traction is applied in one direction it is necessary to have an
equal traction in the opposite direction.

3. DEFINITION
• Traction is referred as the application of a pulling force to a part of the body.

4. PURPOSE
• To maintain muscle spasm and to relieve pain.
• To reduce, align and immobilize fractures.
• To correct dislocations.
• To correct, lessen or prevent deformity.

5. INDICATIONS
• It is most commonly used to align fragments of broken bone and/or maintain proper
alignment.
• For relief of painful muscle spasms.
• For correction and prevention of deformities.
• For immobilization.
• For treatment of painful arthritis, sore muscles and ligaments, dislocations,
degenerated or ruptured intervertebral discs and spinal cord compressions.

6. CLASSIFICATION
1. Skin Traction:-
Application of a
pulling force to the skin and soft tissues
by means of adhesive plaster and
bandages.

7. 2. Skeletal Traction:-
Application of a
pulling forces directly to the bone by
use of metal pins or wires.
e.g.:- Steinmann pin, Kirschners wire.

8. METHODS OF APPLYING TRACTION
1) Manually:-
It is applied by pulling on the part with hands. It may be applied for
various therapeutic purposes.
e.g.:- correcting dislocation or reduction of a fracture or for giving emergency care to
an injured person.
2) Mechanical Traction:-
It can be applied to either skin or bones, that is skin traction or skeletal
tractions.
e.g.:- with special splints, bandages, ropes, pulleys and weight.

9. 3) Plaster Tractions:-
It may be accomplished by
the use of turn buckle casts or hyperextension
casts.
Also skeletal traction can be
applied by fixing the ends of kirschner wires or
steinmann’s pins in in plaster

10. 4) Tractions:-
It may also be applied with
special brace.
e.g.:- hyperextension brace

11. 5) Straight or Running Tractions:-
In this pulling force is
applied in a straight line with the body part resting
on the bed.
e.g.:- bucks extension traction and pelvic traction.

12. 6) Balanced Suspension Tractions:-
It supports the extremity being treated and allows for patient’s
mobility without disruption of the line of pull.
The metal weights are used as the traction and patients body
weight as counter traction.

13. COMPLICATIONS
• Hypostatic pneumonia
• Constipation, faecal impaction and abdominal distension
• Urinary retention and kidney stone
• Impaired circulation
• Disorientation
• Nerve damage, paralysis, foot drop, wrist drop
• Infection in traumatic open wound or surgical incision

14. PRINCIPLES
• Whenever traction is applied counter reaction is the force acting in the opposite
direction. Generally, patient’s body weight supplies the needed counter traction.
• For traction to be effective it must be continuous.
• Never interrupt skeletal tractions.
• Do not remove weights unless the traction is prescribed intermittently.
• Maintain the line of pull. Any factor that might reduce, the pull must be eliminated.
• The patient is taken into the bed, in good bodily alignment, when traction is applied.
• Weights should be hanging freely and not rest on the bed or floor.
• Ropes should be unobstructed in straight alignment.
• The patient must be helped to maintain the same position for effective traction.

15. GENERAL
NURSING
CARE

16. GENERAL NURSING CARE
• Shave the leg or arm before applying the traction.
• Observe for record and report:
a. Circulation: skin color, joint mobility, numbness, coldness or swelling of the
extremity.
b. Skin condition: check areas over heel, dorsum of the foot and sacral area for
pressure sores.
c. Body alignment: observe for body alignment and position of the extremity
whether traction being maintained.
d. Counter traction: whether or not balanced traction is achieved.
e. Position of bandages: check for position of bandages, pins, supporting pads and
slings.
f. Supporting pads and slings: proper positioning.
g. Prevention of deformity: whether measures are taken to prevent foot drop or hip
flexion in the sitting position.
h. Complications.

17. • Avoid using pillows under the extremity in traction unless ordered by physician.
• Inspect pulleys and ropes daily.
• Report to physician if the foot piece is touching the floor.
• Follow the physician’s order for the exact amount of weight to be used.
• Be sure that the weight is hanging freely.
• Maintain patient’s body alignment.
• Keep the patient clean and comfortable.
• Assist the patient in feeding and elimination.
• Treat pressure areas daily to prevent pressure sores.
• Give exercises to the joints and muscles to prevent joint stiffness and muscle wasting.
• Use sand bags and foot board to support the foot.
• Encourage the patient to exercise the feet periodically to prevent the foot drop.

18. SPECIAL
NURSING
CARE

19. SPECIAL NURSING CARE
1) Fixed Traction:-
• The ring of the patient can cause pressure sores. So the nurse should provide
area care to the skin beneath the ring every 2 hours.
• Place the patient in an upright position.
• Teach the patient to change the position slowly and gently every hour if he feels
discomfort.

20. 2) Balanced Traction:-
• The nurse should provide proper supine position to the patient.
• The nurse should raise the foot of the bed to create counter traction.
• Allow the cords connected to the traction to run freely over the pulley to reduce
friction.
• Avoid extra use of pillows as this increases friction and reduces traction.
• Maintain body alignment at all times.
• Keep the weight to hang freely.
• Teach the patient to move himself up the bed as when required.

21. 3) Skin Traction:-
• The nurse should make sure the bandages should not be too tight or too loose.
• Check the extension plaster is in place or not.
• Observe and do the recording and reporting:
a) Allergy to extension plaster such as redness, rash, pain and irritation.
b) Peripheral pulse and color and temperature of fingers or toes.
c) Tenderness in the calf muscle.
d) Altered sensation.
• Special back care should be provided every 2 hours to prevent pressure
• Encourage for active foot exercises.
• Maintain proper positioning and counter traction.

22. 4) Skeletal Traction:-
• The nurse should clean and do the dressing at the pin site daily.
• Observe for signs of infection.
• Follow for strict surgical aseptic precautions to prevent infection.