Traction involves applying a pulling force to part of the body while countertraction pulls in the opposite direction. It is used to provide alignment, reduce muscle spasms, prevent deformities, provide immobilization, and increase space between opposing surfaces. There are several types of traction including skin, skeletal, and manual traction. Skin traction applies force to the skin and soft tissues using materials like bandages and tapes. Skeletal traction applies direct force to bones using pins or wires inserted through the bone. Nursing care for patients in traction focuses on maintaining proper positioning and traction, preventing skin breakdown, and assessing neurovascular status.

1. 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
Purposes
 Provide alignment.
 Reduce muscle spasms.
 Prevent deformities.
 Provide immobilization.
 Increase space between opposing surfaces.
Principle-every action there is equal and opposite reaction
 Have an opposite pull or traction.
 Free from friction.
 Continous.
 Good body alignment.
 Line of pull
COUNTER TRACTION-Is a force that counteracts the pull of traction.
 Keep the bed flat.
 Foot& bed should be elevated.
 Change the position of the patient .
 Assist the patient in lifting himself
Classification
 STRAIGHT TRACTION/running traction
 SUSPENSION TRACTION/balanced traction –Used with skin or skeletal traction.Used to approximate
fractures of the femur, tibia, or fibula.Produced by a counterforce other than client. Position the client in low
Fowler’s, either on the side or back.Maintain a 20-degree angle from the thigh to the bed.Protect the skin
from breakdown.Provide pin care if pins are used with the skeletal traction.Clean the pin sites with sterile
normal saline and hydrogen peroxide or Betadine as prescribed or per agency procedure
DEVICES USED-SLINGS, HAMMOCKS, SPLINTS
 SKIN TRACTION
 SKELETAL TRACTION
 MANUAL TRACTION
 SKIN TRACTION -It is the application of a pulling force to the skin & soft tissues.MATERIALS USED-
Wrapping bandages,Tapes,Slings.
 Uses-
 Applied to skin & soft tissues,Used to control muscle spasms.
Weight applied- 10% Of body weight

2.  Types of skin traction: BUCK’S TRACTION,CERVICAL HEAD HALTER,PELVIC BELTCervical
traction Bryant’s traction,Pelvic traction,Russell’s traction
 CERVICAL SKIN TRACTION - Relieves muscle spasms and compression in the upper extremities and
neck.Uses a head halter and a chin pad to attach the traction.Use powder to protect the ears from friction
rub.Position the client with the head of the bed elevated 30 to 40 degrees and attach the weights to a pulley
system over the head of the bed.Used to alleviate muscle spasms; immobilizes a lower limb by maintaining a
straight pull on the limb with the use of weights
 BUCK’S SKIN TRACTION: A boot appliance is applied to attach to the traction.Weight is attached to a
pulley; allow the weights to hang freely over the edge of bed.Not more than 5 pounds of weight should be
applied.Elevate the foot of the bed to provide the traction
 PELVIC SKIN TRACTION: Used to relieve low back, hip, or leg pain and to reduce muscle spasm. Apply
the traction snugly over the pelvis and iliac crest and attach to the weights. Use measures as prescribed to
prevent the client from slipping down in bed.
 CONTRA-INDICATIONS: Dermatitis , Diabetes, Varicose ulcers, Skin & soft tissue injury.
 COMPLICATIONS:Skin break down,Nerve pressure,Circulatory impairment
 ENSURING EFFECTIVE TRACTION
 Avoid wrinkling & slipping of the traction bandage,Provide proper positioning,Bandages & tapes & other
“soft goods’ ‘are applied in a correct way.
 MONITORING & MANAGING POTENTIAL COMPLICATIONS
 SKIN BREAK DOWN- Monitor the reaction of the skin.Assist patient in personal hygiene
procedures.Palpate the area of traction tapes daily.Inspect the skin, ankle,achilles tendon three times a
day,Provide back care every two hourly ,Inspect skin specially pressure points.Provide comfort devices,Change
the position of the patient frequently.
 NERVE – PRESSURE:Avoid pressure on peroneal nerve,Check sensation & movemen,Immediately
investigate any complaint of the patient.Report altered sensation or motor function.
 CIRCULATORY IMPAIRMENT: Assess the circulation of foot or hand. Check for 5 P’S,Encourages the
patient to perform active foot exercises.
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 .
 USES: Fractures of femur, cervical spine.Displaced fractures of pelvis & proximal end of tibia, calcaneus,
proximal ulna.
 DEVICES USED-Steinmann pin,Kirschner wire
NURSING MANAGEMENT
MAINTAINING EFFECTIVE TRACTION
 Check position, ropes , apparatus.

3.  MAINTAINING POSITIONING: Maintain alignment of patient’s body,Support the patient’s foot in a
neutral position, Avoid footdrop,inward movement,outward rotation
 PREVENTING SKIN BREAKDOWN: Protect elbows & heels from injury, Inspect for preessure
ulcers.Encourage movement of body part.Provide back care frequently.Special precaution should be taken
while doing procedure.Provide special comfortable devices.
 ASSESS THE NEUROVASCULAR STATUS : 5 P’s
 PROVIDING PIN SITE CARE: Use aseptic technique while dressing. Check for complications. Avoid
infection& development of osteomyelitis.Check the insertion site.
Manual traction
 It is used to tying to mobilize soft tissues& to treat hypomobility.It is applied with hands. It is a temporarily
measure used in neck- injury . It is also used to apply the necessary pull to an extremity when cast is applied.

Nursing diagnosis
 Acute pain r/t musculo skeletal disorder as evidenced by facial expression of the patient
 Impaired physical mobility r/t application of traction as evidenced by decreased muscle strength,limited
ROM
 Risk for impaired skin integrity R/ T insertion of traction pins,wires, screws
 Self- care deficits r/t application of traction, fracture .